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NEW 

WAEREN'S 



HOUSEHOLD PHYSICIAN, 



ENLARGED AND REVISED, 



BEING A 



BRIEF DESCRIPTION, IN PLAIN LANGUAGE, 



OF ALL THE 



Diseases of Men, Women and Children, 



WITH THE 



LATEST AND MOST APPROVED METHODS OF TREATMENT. 



ALLOPATHIC DEPARTMENT 

/ BY 

LEA WARREN, A.M., M.D., 

Fellow of the Massachusetts Medical 
Society, etc. 

REVISED BT 

WILLIAM THOENDIKE, M.D., 

Fellow of Massachusetts Medical Society, and 
Member of Boston Society for the Improve- 
ment of Medicine, etc., and others. 



HOMOEOPATHIC DEPARTMENT 

BT 

A. E. SMALL, A.M., M.D., 

President of the Hahnemann Medical 
College, Chicago, 111. 

REVISED BY 

J. HEBEE SMITH, M.D., 

Professor of Materia Medica, Boston University 
School of Medicine, and late President of Mas- 
sachusetts Homoeopathic Society. 



And many others on special subjects. 



FULLY ILLUSTRATED. 



By 86 Figures on 16 Splendid Colored Lithograph Plates, 262 Engravings, and 
Two Full-Page Manikins. 

This book is published strictly as a Subscription Book, and to be sold only as such. A ny person or 
persons infringing tip on these rights ivillbe held liable. 

THE RIGHT OF TRANSLATION IS RESERVED. 



BOSTON: 



A. I. BEADLEY & COMPANY, 

234 AND 236 CONGRESS STREET, 

1898. 




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V^fik 



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VED 






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3573 



Entered according to Act of Congress, in the year 1859, by 

IRA WARREN, 

In the Clerk's Office of the District Court of the District of Mass. 

Entered according to Act of Congress, in the year 1863, by 

IRA WARREN, 

In the Clerk's Office of theDistrictCourt of the District of Mass. 

Entered according to Act of Congress, in the year 1870, by 

CHARLES ROBINSON, Jr., 
In the Office of the Librarian of Congress, at Washington. 

Entered according to Act of Congress, in the year 1885, by 

CHARLES ROBINSON, Jr., 
In the Office of the Librarian of Congress, at Washington. 

Entered according to Act of Congress, in the year 1889, by 

CHARLES ROBINSON, Jr.. 
In the Office of the Librarian of Congress, at Washington. 

Entered according to Act of Congress, in the year 1897, by 

GEO. A. BLANEY, Admstr. Estate of Ira Warren, 
In the Office of the Librarian of Congress, at Washington. 



RIGHT OF TRANSLATION IS RESERVED. 



This work is published strictly as a Subscription Book, 
and to be sold only as such. Any person or persons in- 
fringing upon these rights will be held liable. 



Plimpton Jpress 

PLIMPTON & CO., PRINTERS & BINDERS, 
NORWOOD, MASS., U S.A. 



PREFACE. 



This book is written for the people. It is based on the assump- 
tion that every man — the mechanic, the farmer, and the day laborer, 
as well as the professional man — has a right to all the knowledge 
he is capable of acquiring, on all subjects, — medicine not excepted. 
The book aims, therefore, to popularize and adapt to the many what 
has been claimed as belonging only to the few. 

I do not hesitate to avow that my sympathies, as a man, are with 
the great masses, who may be called the bone and muscle of the race. 
They are, in the main, more shrewd, more endowed with common 
sense, more simple and true in their natural instincts, and conse- 
quently less perverted, than those who claim more refinement and a 
higher place in the social scale. 

" All men," says Hippocrates, one of the great fathers of medicine, 
" ought to be acquainted with the medical art. I believe that knowl- 
edge of medicine is the sister and companion of wisdom." Such 
knowledge would shield the many from the impositions of quackery. 
No one, I venture to say, who reads this book thoroughly, will be 
often imposed upon thereafter by quack nostrums, or quack doctors. 
Every man's physical organization is his own ; and he is charged with 
the responsibility of taking care of it. To do this properly, he needs 
knowledge of it ; and to withhold this from him is another form of 
the old oppression, which decreed knowledge and power to the few, 
and ignorance and obedience to the many. 

In accordance with the design of the work, it has been written in 
plain, simple English, and brought within the comprehension of all 
who have medium powers of mind. 

In preparing this book, a great number of authors have been care- 
fully consulted, to whom I acknowledge large indebtedness ; yet the 
work is not a mere compilation. In dealing with each disease, I 
have aimed to sketch a brief pen-and-ink portrait, so like it that 
every reader shall know the original whenever he sees it ° 3 and then 
to give, in the fewest words, the best treatment. 
■ No work of the sort has ever explained the reasons, or given the 
whys and wherefores of medicine to anything like the extent of this ; 
nor has any one been so extensively illustrated. The engravings 
have been, with few exceptions, done expressly for this work. The 
colored lithographs and manikins are inserted at great expense, and 
add much to the value of the book. 

I. W. 



SECOND PREFACE. 



The Household Physician was written in the belief that the people were 
ready and waiting for a popular medical work based on liberal principles ; 
and that one hundred and forty thousand copies have already been sold 
is a sufficient evidence that the belief was well-founded — many persons 
assuring the publishers that fifty or one hundred dollars would be no tempta- 
tion for them to part with the copy they have if they could not obtain 
another. Such an extensive sale of so large a book, with the demand 
constantly increasing, shows its value. 

For these evidences of public favor the Publishers are not ungrateful or 
unmindful of corresponding duties on their part. A chapter is now added, 
therefore, on "Old Age and its Diseases," — a subject never before intro- 
duced into any popular treatise on medicine, and very rarely, indeed, into 
any medical book. Great pains have been taken in preparing it, and we 
sincerely hope that many fathers and mothers will, in future years, be 
kindly remembered in consequence of the suggestions it contains. Also a 
chapter on new popular Gymnastics, illustrated with many cuts. 

The Publishers. 



THIRD PREFACE. 



The Household Physician, now so well known throughout the English 
and German-speaking world, again appears before the public, printed from 
entirely new plates, revised and improved in accordance with the progress 
of medical science of the present day. 

Old, obsolete matter has been discarded, and only those methods and 
remedies of olden times have been preserved to which, though numerous, 
recent discoveries have found nothing superior. 

Much new information has been added, including articles on Russian 
and Turkish baths at home, Drowning, and on Diseases of the Nervous 
System peculiar to modern times. The illustrations have been supple- 
mented by fine colored plates and manikins showing the arrangement of the 
various organs of the body, the muscles, arteries, veins, and nerves. New 
colored plates of medicinal herbs have also been added, thus giving a dis- 
tinct idea, not only of the pathological seat of many maladies, but of many 
of the sources from whence are derived their specific remedies. 

The prescription list has been most carefully revised, and the old heroic 
doses of opium in its various forms have been superseded by milder nar- 
cotics and sedatives. Mercury no longer shows its hideous features on 
these pages, except as it is to be given in syphilitic affections. The work 
now fairly competes in rich information with any newer system of popular 
medicine, and may be relied on, as ever before, for accuracy, best advice, 
and the most modern medical customs. 

The Publishers. 



TABLE OF CONTENTS. 



Page 

Preface % ....... . 3 

General Introductory Remarks ........ 5 

Anatomy 14 

Physiological Laws of Life and Health — Hygiene .... 54 

Temperaments, Constitution and Symptoms . . . . . 122 

Skin Diseases ............ 134 

Diseases of the Brain and Nerves ....... 164 

Diseases of the Throat . 208 

Diseases of the Chest 229 

Heart Diseases ........... 274 

Diseases of the Abdominal Cavity ....... 291 

Venereal or Sexual Diseases 360 

Female Diseases 379 

Married Ladies' Perpetual Calendar ....... 443 

Care of Children and their Diseases ....... 445 

Diseases of the General System and Miscellaneous Diseases . . 469 

Diseases Peculiar to Modern Times ...... \ . 493 

Old Age and its Diseases ......... 496 

Accidents 509 

Surgical Diseases .......... 517 

Homoeopathic Treatment of Diseases 608 

A Treatise by A. E. Small, M.D. . . . . . . 608 

Diseases of the Head . . . ...... 613 

Diseases of the Brain and Nerves . . . • .' . 615 

Diseases of the Eye and Lids 622 

Diseases of the Ear . 625 

Disorders of the Nose 62^ 

Diseases of the Respiratory Organs 628 

Diseases of the Urinary Organs . 634 

Diseases of the Organs of Generation . . . . . 638 

Diseases of the Skin 642 

Diseases of the,Organs of Circulation 651 

Diseases involving the Various Organs ..... 653 

Diseases of Various Organs and Regions . . . . . 665 

Dropsies, Hydropsies 684 

Insidious Diseases QS6 



TABLE OF CONTENTS. 

Homoeopathic Treatment (continued). Paoe 

Miscellaneous Diseases 690 

Affections of the Mind 692 

Surgical Diseases 700 

Diseases of Infants 706 

Diseases of Women 713 

Labor, Parturition 716 

Specific Indications for Remedies in Fevers .... 720 

Poisons and their Antidotes 726 

Processes of the Hydropathic Treatment 732 

Domestic Management of the Sick-Room 756 

Cookery for the Sick-Room ......... 789 

Dieting in regard to Health . 798 

Dieting in Disease .......... 801 

Bathing 803 

Proofs of Death 807 

Medicines and their Preparations — Materia Medica .... 808 

Prescriptions — Recipes 920 

Proprietary and Patent Medicines 944 

Physical Culture — Gymnastics 950 

Pronouncing Dictionary 961 

General Index ........... 965 

Index to Homoeopathic Department 982 



LIST OF COLORED AND FULL-PAGE PLATES. 



Portrait of Dr 


Plate 


I. 


u 


II. 


u 


III. 


u 


IV. 


a 


v. 


a 


VI. 


u 


VII. 


u 


VIII. 


u 


IX. 


a 


X. 


it 


XI. 


u 


XII. 


« 


XIII. 


tt 


XIV. 


tt 


XV. 


tt 


XVI. 


tt 


XVII. 


tt 


XVIII. 


u 


XIX. 



. Ira Warren . 

Sectional Manikin of Human Head 

The Human Skeleton . 

Muscles of the Human Body 

Arteries and Veins of the Human Body 

Fig. 1, Measles ; Fig. 2, Scarlet Fever 

Small-Pox 

Erysipelas 

Sectional Manikin of Human Trunk 

Internal Organs of Human Body . 

Syphilitic Eruptions 

Syphilitic Affections of Throat 

Medicinal Plants (Aloes, etc.) 

" " (Bittersweet, etc.) 

" " (Dandelion, etc.) 

" " (Ground Ivy, etc.) 

" " (Hemlock, etc.) 

" " (Mullein, ete.) 

" " (Plantain, etc.) 

" " (Thorough wort, etc.) 



Frontispiece. 

Facing Preface. 

. . p. 19 

Facing p. 27 

37 

136 

140 

142 

164 

291 

362 

368 

814 

820 

836 

840 

844 

856 

864 

882 




Copyright, by Bradley & Woodruff, 1S92. 



GENERAL INTRODUCTORY REMARKS. 



Progress of Medicine. 

Medicine may be divided into a science and an art. It is a science 
as it presents facts and evolves principles ; an art as it consists of 
rules for practice. For its present attainments, it is indebted partly 
to researches scientifically conducted, and partly to empirical and 
haphazard discovery. 

As a science, medicine is chiefly indebted, and must ever be, to the 
members of what is called the " regular profession." This body of 
men, while it contains numerous persons whose talents and attain- 
ments do not raise them above the merest quacks, does yet embrace 
large numbers of men who are alike ornaments of the race, and lights 
of their profession. It is to the writings of this class that every stu- 
dent must go who would qualify himself for the proper discharge of 
the duties of a physician ; and he who attempts the practice of medi- 
cine without a knowledge of standard medical writings is either a 
fool or a knave — either without the brains to understand science, or 
destitute of the honesty to deal fairly with men. 

While this is said, however, it must be granted that a respectable 
portion of the facts which make up the science of medicine have been 
contributed by the industry of men who have not had what is called 
a regular standing in the profession. I am sorry to be obliged to add 
that the great body of this class have been quacks and charlatans, 
while only a few of them have had talents and acquirements. 

Nevertheless, they have been too indiscriminately condemned. 
Their labors have been useful in various ways, and have contributed 
to the advancement of medical knowledge. A regard for truth, not 
less than justice to these persons, requires this statement. 

One=Idea Men The " irregulars," as they have been called, have 

generally had their hobbies, which they have ridden with singular 
diligence, and often in little better than John Gilpin plight. Yet they 
have drawn attention to great truths, which the regular profession 
either did not see, or would not commend ; and they have done this 
by dwelling incessantly upon some single idea. 

The one-idea men, of every class, have been ridiculed in all ages ; 
and indeed have always exhibited some singular obliquities. Yet 
when they have been men of learning and talents, they have accom- 
plished great things, either for good or evil. 



b GENERAL INTRODUCTORY REMARKS. 

Martin Luther was strictly a one-idea man. The whole force of 
his extraordinary character was given to the propagation of the single 
doctrine of justification by faith ; and by the incessant efforts he made 
for this purpose, he sank the doctrine deeper into the heart of Europe 
than a hundred equally powerful men could have done by giving it 
only an ordinary share of attention. 

William Ellery Channing was a one-ideaist. Man, the noblest 
work of creation, to be developed, educated, adorned, loved, made 
like unto God, was the thought of his life, — a thought which he em- 
bellished and moulded into all the forms of beauty which our flexible 
language is capable of producing. Under the mild promptings of 
his genius, and the workings of this thought, philanthropy, quick- 
ened into a new life, spread out her arms, and embraced the world. 

Sir Isaac Newton was a one-ideaist. So entirely did he devote his 
great powers to astronomy and the higher mathematics, that he be- 
came unfitted for the duties of social and domestic life — so unfitted, 
that when induced by his friends to give a little attention to courtship, 
he fell into one of his abstractions, and detected himself in using his 
lady-love's fore-finger to poke down the ashes in his pipe ! But Sir 
Isaac advanced mathematical science to a point far beyond its previ- 
ous attainments, and laid it under such obligations as no general 
scholar could have done. 

It is in this way, though in a vastly less degree, and without the 
scientific method, that one-ideaists in medicine benefit the world. 
They seize upon some single remedy, — generally one which has been 
overlooked — and using it themselves to the exclusion of all others, 
they press it upon the world as the panacea for all its ills. With 
them disease is a unit, and they have found its one all-important 
remedy. Thus convinced, they press it upon others with the enthu- 
siasm of fanatics. Testing it in all cases, they develop all its virtues. 
Those who have the good sense to turn their attention to it have 
only to use it in those cases for which its adaptation is proved. 

It is in this way that these men become, incidentally, medical dis- 
coverers ; and not being burdened with modesty, they never with- 
hold their importunities till the world acknowledges whatever value 
there is in their discovery. And although they may do some mis- 
chief with the single-edged tool which they handle so industriously, I 
doubt if they do much more than many better workmen who use too 
many. At all events, wise and generous men thank them for their 
gift to the profession, small though it may be, and use it in the light 
of a clearer knowledge. 

Hydropathy. — As an illustration of what I have just been saying, 
I may refer to hydropathy, or the plan of treating all diseases by water. 

The singularly careful avoidance, by the whole medical faculty, for 
many ages, of the article of pure water as a medicinal, or, rather, 
health-imparting agent, was anything but creditable to the profession. 

It is now admitted by all sensible men that water, cold and warm. 



GENERAL INTRODUCTORY REMARKS. 7 

used at proper times and to a reasonable extent, has great power over 
several diseases, and is a powerful promoter of health. No physicians, 
except those who are too indolent to know what is going on in the 
world, or too fast locked in old prejudices to. touch new things, now 
omit its use in many cases. How warm and, sincere my own approval 
of water as a remedy is, almost every page of this volume will attest. 

Indeed, it may honestly he allowed that the hydropathists have 
fairly drowned the almost criminal professional prejudice against 
water. They are in all the more need of this concession, since in 
their absurd zeal to cure all diseases by water, and make aquatic an- 
imals of men, they have also drowned their own common-sense. 

Homoeopathy. — This mode of practice is of comparatively recent 
origin ; but it has already sunk itself deep into the popular heart, 
and has drawn to its support many of the wealthy, the cultivated, 
and the intelligent, in our most refined communities. I do not pro- 
fess to comprehend and appreciate its principles, nor would it be 
honest in me to pretend to see how its infinitesimal doses can pro- 
duce the results which it often shows, and which it is fair to confess 
look like singular success ; and saying this, I can neither adopt nor 
approve the violent denunciations and censures which so many are 
induced (by fashion, I fear) to employ towards this generally well- 
cultivated class of practitioners. I hold them as useful members of 
the profession, and mean ever to cultivate towards them fraternal 
feelings. They give great attention to exercise, diet, the use of 
water, etc., — things which contribute very powerfully to preserve 
health, and to restore it when lost. In this thing, the old-school 
practitioners ought to learn a most important lesson from them. In 
truth, they are learning it, but very slowly and reluctantly, I am 
sorry to say. 

The central idea of the homoeopathist, that " like cures like," the 
"great law of cure," as he styles it, I do not feel called upon to dis- 
cuss — theories being of much less consequence than rules of prac- 
tice. The old-school men have certainly much to learn from him 
respecting the augmented power of medicine from the greatest possi- 
ble division by trituration. We have learned from him, too, — 
though many are too ungenerous to confess the source of the infor- 
mation, — that we may gain our purposes with much less medicine 
than we were once in the habit of giving. 

Eclectics. — There is a large and growing class of physicians, called, 
at first, after the founder of the school, Thomsonians. Subsequently, 
they were generally known as Botanic Physicians. Now they pass 
under the title of Eclectics. 

These men, directing their attention, at first, chiefly to cayenne 
and lobelia, have gradually extended their zealous researches over 
the vegetable kingdom, and have gathered much information worthy 
to be preserved. These researches have revealed a sadly neglected 
duty on the part of old-school practitioners. 



(S GENERAL INTRODUCTORY REMARKS. 

The education and talents of this class of practitioners have grad- 
ually risen, year by year, until they have several medical schools, 
where students are well instructed in the principles of medicine, by 
men of real ability. They have also a literature of no mean signi- 
ficance, especially in the department of materia medica. The list 
of remedies the) r have given to the world, drawn from our home 
plants, are a boon of no small value. I regard them as equal in 
value to all we were previously in possession of from the vegetable 
kingdom. The substitution of vegetable remedies, in most cases, 
for mercurials, can hardly be too highly prized. 

Physiologists. — Besides these various direct practitioners of medi- 
cine, there is the large and quite intelligent class of physiologists, 
including the phrenologists, who nearly discard medicine, and ap- 
pealing to the laws of life established by the Creator, urge temper- 
ance in eating and drinking ; exercise in the open air ; securing of 
pure air by ventilating dwellings, school-houses, and churches ; bath- 
ing in cold and warm water; cheerfulness of mind ; and the cultiva- 
tion of the Christian virtues, as the only rational modes of securing 
health and life. 

I confess myself inclined to forgive this class their error in ban- 
ishing medicine, in view of their zeal and success in disseminating 
hygienic information of the utmost value and importance to man- 
kind. Put man into harmony with nature, and establish over him 
the empire of reason, and their theory would be excellent; but as 
things are, medicines, like prisons, and alms-houses, and large cities, 
are " necessary evils." 

Other Practitioners. — Finally, we have Mesmerists, Pathetists, 
Electro-biologists, Spiritualists, Nutritivists, and what not, all pre- 
tending to cure disease by processes peculiar to themselves. They 
are all experimenters in different departments of nature, — now 
spreading over our eyes a large plaster of humbuggery, and now 
drawing a small curtain and giving .us a peep into the large and 
well-furnished rooms which nature has fitted up for our reception, by 
and by, when we are better instructed. 

All Useful in a Degree. — On the whole, I am disposed to regard 
all the operators in the different departments of medicine as useful 
in their degree ; excepting always those mercenary quacks, who lie 
about their remedies to make money. Each of all these (I mean all 
sincere and true men who believe what they teach) is aiding in some 
measure the general advancement. And though the truths, as they 
gather and present them, are but fragmentary, they are useful in the 
hands of those true Eclectics, who have the wisdom and independence 
to select the best things out of all systems. 

General Conclusion. — This brings me to remark that there is but 
one truly liberal and philosophical school of medicine. It is the Ec- 
lectic, — composed of those who have liberality enough to reject 



GENERAL INTRODUCTORY REMARKS. 9 

every exclusive system, and to select out of all systems those things 
which are approved by experience and reason. 

I have already spoken of the school of practitioners called Eclectic. 
To a certain extent they are entitled to the name, but I think not 
entirely. They have formed a separate and exclusive school. They 
have turned some articles out of the materia medica possibly for no 
better reason than because their party is committed to their rejec- 
tion ; whereas they should have no party, but allow each man to act 
as if he were a citizen of the world only, and not a member of any 
restricted association. But I will not quarrel with them on this 
point. I think they are becoming eclectic. 

Progress of Medicine. — There have been long periods when the 
science and the art of medicine made scarcely any progress. They 
are now advancing, — in some departments quite rapidly. 

The Chemistry of Man, commonly called Animal Chemistry, is 
opening new sources of light. 

The writer was in the habit of asserting, many years ago, that 
most of the true progress in medicine must come through Animal 
Chemistry ; and the developments of the last few years have made 
good the assertion. Liebig, a diligent student in chemistry, has done 
much to open the way for inquirers in this department. Simon has, 
perhaps, done more. Mialhe is a yet later explorer, and has made 
valuable discoveries. 

The result is that students have now before their minds, and are 
endeavoring to solve and act upon as fast as possible, inquiries and 
propositions like these : — 

What is the chemical composition of the solids and fluids of the 
healthy human body ? 

What is the nature of the changes which occur in the composition 
of the solids and fluids during disease? 

What alterations in the chemical composition of the solids and 
fluids take place during the operation of , medicines ? 

Before it can exert any remote action on the animal economy, a 
remedy must be absorbed. 

Before it can be absorbed, it must be soluble in the fluids of the 
living body. 

Medicines are subject to chemical changes during their passage 
through the system. 

These changes are regulated by ordinary chemical laws, and may 
therefore, to some extent, be foretold and made available in the cure 
of disease. 

These chemical laws are disturbed and varied, to some extent, by 
the law of vitality, — just as the magnetic needle is made to vary by 
disturbing forces. 

What are those disturbances, and to what extent, and under what 
circumstances, do they occur ? 

With these and similar inquiries and propositions before his mind. 



10 CENERAL INTRODUCTORY REMARKS. 

diligently studied, a man will in time learn to prescribe with some 
intelligent aim. Me will not know everything, to be sure, but what 
he does know, he will have a reason for knowing. If he give 1 a 
medicine, he will have in view the chemical changes of the solids 
and fluids of the body, known to be produced by the disease he is 
combating. He will also keep in mind the solution of the medicine 
in the fluids of the body, and the chemical reaction between its com- 
ponents and the acids, alkalies, etc., found in the alimentary tube 
and elsewhere. 

As the science of medicine advances, and becomes liberal and ec- 
lectic in its character, gathering from all systems the best attested 
facts, and using them to the exclusion of all mere theories, these 
facts must not themselves degenerate into mere petted theories, but 
must be held in subordination to future experience. Medical prac- 
titioners, who would meet the wants of the age, must be men of 
progress. The light of to-morrow, with them, must modify and im- 
prove the light of to-day. They must knock every hour for admis- 
sion into some new apartment of nature. 

Need of Liberality. — That medical progress may be real, physi- 
cians must be free from bigotry. They must have no narrow preju- 
dices against any man, or class of men ; but be ready to examine 
candidly an}- new thought or new remedy brought to their notice, 
from whatever source it may come. 

They should not hedge themselves about with such restrictive by- 
laws and societary rules as are calculated to fetter their thoughts, 
and turn their investigations, b}~ a sort of moral necessity, into the 
narrow channels of party conservatism; remembering that he who is 
once enclosed by such restrictions must hew a path for lus feet 
through bigotry, and even malevolence itself, before he can escape 
them, or be a free man in any noble sense. 

The members of medical societies do themselves no credit, in the 
nineteenth century, by putting on airs, and telling others to stand at 
a distance. This would do better, had medicine become an exact 
science ; but while the primary effects of even opium are not settled 
— some physicians considering it as primarily stimulant, others as 
sedative, others as stimulant to the nerves and sedative to the 
muscles, others as neither, and still others as alterative, — such ex- 
clusiveness seems neither wise nor modest. When the professors of 
the healing art can hoard medical knowledge as misers hoard gold, 
and can submit its purity to equally certain tests, it will appear in 
better taste for them to grow exclusive. Until then, the most be- 
coming badge they can wear is the Christian direction : " Let each 
esteem others better than himself/' 

Medical societies, with liberal by-laws, are fitted to do good ; but 
it would be hard to show that those with stringently restrictive rules 
can operate otherwise than as checks upon progress. In truth, they 
are apt to become mere catacombs in which to embalm dead ideas. 



GENERAL INTRODUCTORY REMARKS. 11 

They are very liable to be made the instruments for accomplishing 
the ambitious purposes of a few leading men. They tend to suppress 
all sympathy with everything outside their organization ; and they 
beget a feeling like that which would forbid the fixed stars to drop 
their light into our atmosphere without first coming down and joining 
the solar system. 

Conservative Leaders. — There are no influences which hold so 
steady a check upon medical progress as the conservative leaders in 
many of our medical associations. Not that they are opposed to im- 
provement in the medical art, or would object to any amount of dis- 
covery, if it could come to the profession through channels which they 
have the honor of opening. But against all light from outside, or 
from obscure sources, they will draw down the curtains, and close the 
doors ; and, if it chance by any means, in spite of them, to get within 
the sacred enclosure, they will call it darkness, and, as priests of the 
temple, will attempt to atone for the indignity offered to the god of 
medicine, and fill the whole sky with murky clouds from their altars. 

These men have strong faith in caste, and in the right of the few 
to govern the many. In the low places of society, they look for 
nothing but ignorance and poverty. Notwithstanding that the light 
of every natural day breaks in the horizon, and ascends, they so far 
despise analogies as to insist that all medical light breaks at what 
they call the zenith of the profession, and comes down. With them 
the temples of Esculapius are all rebuilt, and they are the priests ; 
and to offer in sacrifice the smallest medicinal plant is a sacrilege, 
unless it be entrusted to their hands. 

Such persons measure and weigh a man by the amount of money 
he has. Property is their god, which gives laws to everything. 
With them, knowledge, like property, goes to posterity by will, — 
they being the principal testators. Like their money, too, it goes 
chiefly to their sons, and to certain favored institutions, by whom and 
in which it is to be hoarded, and whence it is to go out only in certain 
approved channels, weighed and stamped, like coin from the mint. 

These are the men who regard knowledge as a contraband article, 
unless regularly entered at the custom-house, with bills of lading 
properly certified by the conservative magnates at some other me- 
tropolis. With them, knowledge is not like the west wind, fanning 
the brow of the peasant as gently as that of the king — not like the 
light of heaven, entering the small, clean window of the hut, as 
readily as the larger one of the palace ; not a boon which comes alike 
freely to all, and which is to be everywhere amplified, changed as 
circumstances and conditions require, and especially adapted to the 
present hour. It is rather, as they too often view it, like litho- 
graphed letters of advice, printed upon stamped paper, and carefully 
sealed up and addressed to posterity. And then, if they can be 
made the mail-carriers, and be permitted to pass, unchallenged, with 
the precious bag, from post to post, and pass it over, carefully sealed, 



12 GENERAL INTRODUCTORY REMARKS. 

to the next generation, they will think it has done its work, and that 
they have fulfilled their mission. 

I would not be unjust or severe, but I cannot but remark further, 
that these men present but one view of humanity. They are monot- 
onous objects of inspection. Look at them a thousand times, and 
you see only the same unaltered phase of life. To the mariner on 
life's ocean, they are not safe lights. If he approach them on the 
dark side they remain black as night to him, until he comes round to 
their shining front. They are not revolving lights. They have 
light : it may be bright and genial ; but it gleams out upon the 
waters only in one direction. It does not sweep round, and throw its 
rays upon every mariner's path. 

Such men are useful, but only to a certain class. They have in 
them no true omnilogy — they are not all-teaching. Their lives are 
ins ructive to their friends, their clique, their party, their school ; 
but a stumbling-block, a hindrance, an oppression, an offence to every- 
body else. They are like porcupines, with fronts smooth and easy 
of access ; but their backs bristle with quills to stick into those on 
the wrong side. They are not whole men. Humanity has infused 
into them only one or two of its elements. They have length, but no 
breadth. They are citizens of Boston, New York, Philadelphia, or 
Cincinnati, but not of the world. Within certain circles, they are 
genial friends, but cynics and haters outside of them. From their high 
places they come down to their humble followers with tokens of 
friendly recognition ; upon others they frown and lower like armed 
castles. 

The True Physician.— How different the character of the true man 
and physician! He is genial in his disposition. He has no dislikes 
and antipathies, and hates no men except tyrants. He accepts knowl- 
edge, though it come from the humblest source ; believing there is no 
experience but will repay a study of it, and no husbandman's plough- 
share but turns up a soil worth analyzing. He belongs exclusively 
to no party, and can be approached easily by respectable men of 
every stamp. Whether belonging to the same society with him or 
not, y ou may take hold of his nature and draw it out, without hav- 
ing it slip from your fingers, and spring back from your presence into 
a thousand kinks, like an overtwisted thread. He is a whole man. 
God made him for the world, and not for a party. By some strong 
influence you may possibly, for a time, draw him from the world into 
some narrower sphere, but not only will his reluctant nature, like a 
retiring tide, run back continually to embrace the continent, but will 
soon break from its confinement, and, like a full sea, come back, boil- 
ing and running over. 

What is now Wanted. — The foregoing remarks indicate one great 

leading want, in order that medical knowledge may increase. It is 

liberality in the true and full sense. We want true men in high 

places, who will not only let their own light shine everywhere, but will 

to hinder other n/>-,/'s light from shining. 



GENERAL INTRODUCTORY REMARKS. 13 

Be}"ond this, and of nearly equal importance with it, we want med- 
ical knowledge diffused among the people. We want — what the 
world has never seen — a popular medical literature. We want the 
temples of Esculapius pulled down, and the priests turned into the 
streets to become teachers of the multitude, rather than worshippers 
in the inner sanctuary. 

I know this want will be stoutly denied, but not, I think, on well- 
considered grounds. We do not think it necessary to confine a 
knowledge of the soul to the ministers of religion. There is no 
branch of theology which we do not deem it proper for laymen to 
study; we even popularize it for our children. In the obscurest 
towns of New England, laymen who follow the plough or push the 
plane, become, in many cases, eminent theologians. Why should 
they not study the lower science which relates to the body? They 
have not been able to heretofore, because its mysteries have been 
purposely hidden under technicalities. These coverings should be 
torn off. 

It is said that those who begin to read upon medicine are very apt 
to imagine themselves afflicted with the various symptoms they find 
described. To some small extent this is true ; but it is also true 
that the light they obtain relieves them from many apprehensions 
which their previous ignorance allowed to prey upon them ; as boys 
lose their fears when the light of the morning changes to some 
familiar object the ghost of the preceding night. 

Physicians oppose the popularizing of this kind of knowledge too 
often, I fear, upon the sordid ground of self-interest. They think 
their own services will be less sought. 

We do not dispense with the services of ministers because the 
people study theology, neither shall we cease to employ teachers and 
practitioners of medicine when each man and woman is wise enough 
to study the healing art. The principal change we shall witness will 
be much larger attainments in knowledge among practitioners, — 
just as the ministers of religion now know, and are obliged to know, 
ten times as much as in those darker periods when the people re- 
ceived all spiritual knowledge from their mouths. The teachers of 
any art or science are obliged to keep in advance of their pupils. 
Let medicine become a popular study, and we shall have very few 
ignorant physicians, and quackery will become one of the impossi- 
bilities. Homceopathists, Eclectics, Hydropathists, and Physiolo- 
gists, believe in scattering medical books, stripped of their techni- 
calites, among the multitude, and their people purchase very few 
secret, advertised medicines ; — these being chiefly bought and con- 
sumed by the followers of those who believe this kind of reading- 
fosters quackery! 



ANATOMY. 



ANATOMY describes the structure and organization of living be- 
ings. 

Special Anatomy treats of the weight, size, shape, color, etc., of 
each organ separately. 

General Anatomy investigates the tissues or structures from which 
organs are formed. 

Surgical Anatomy or Regional Anatomy considers the relations of 
organs to one another. 

Physiological Anatomy treats of the uses or functions of organs in 
health. 

Pathological Anatomy describes the alterations made upon dif- 
ferent organs by disease. 

We shall here introduce a very brief compendium only of Special 
Anatomy. 

It is of great consequence that every person should have some 
knowledge of anatomy and physiology. Self-knowledge ought to 
extend to the body as well as the mind. To know one's self, physi- 
cally, is to gain a new insight into that wonderfully skilful adjust- 
ment of means to ends which is never absent from the works of God. 
Without this knowledge, one cannot know how to take care of the 
health ; and without health, life loses most of its value. 

Structure of the Body. 

The human body is composed of solids and fluids. 

The fluids are most abundant in children and youth. It is this 
which gives softness and pliancy to their flesh. In old age the fluids 
are less abundant, and the flesh is more hard and wrinkled. 

The fluids contain the whole body, as it were, in a state of solu- 
tion ; or rather, they hold the materials out of which it is manufac- 
tured. 

Chemical Properties of the Body. 

The four elements, oxygen, hydrogen, carbon, and nitrogen, make 
up nearly the whole bulk of the fluids and soft solids of the human 
body. A number of other elements, chiefly in a state of combina- 
tion, and in much smaller quantities, enter into several of the tissues. 

Binary Compounds. — Thus, we have carbonic acid in blood, urine 
and sweat; and we have water universally diffused through the sys- 
tem, -each of these substances being a binary compound, that is, 
composed of two elements. 

Compounds of more than two Elements are widely distributed 
over the body ; as, 

14 



ANATOMY. 15 

Carbonate of Soda in serum, saliva, bile, mucus, sweat, and tears. 
Carbonate of Lime in cartilage, bone, and teeth. 
Phosphate of Lime in bones, teeth, and cartilage. 
Phosphate of Iron in blood, gastric juice, and urine. 
Chloride of Sodium in blood, brain, muscle, bone, cartilage and 
pigment. 

Chloride of Potassium in blood, gastric juice, milk, and saliva. 

Chloride of Calcium in gastric juice. 

Sulphate of Potassa in urine, gastric juice, and cartilage. 

Sulphate of Soda in sweat, bile, and cartilage. 

Sulphate of Lime in bile, hair, and scarf-skin. , 

Oxide of Iron in blood, black pigment, and hair. 

Organized Compounds. — Besides the above inorganic elements 
and compounds, several organized substances, or proximate elements, as 
they are called, exist largely in the body. The chief of these are 
albumen, fibrin, gelatin, mucus, fat, and casein. Others need not be 
named. 

Albumen is found in great abundance in the human body. It is 
the raw material out of which the flesh and other tissues are made. 
The white of an egg, which is nearly pure albumen, is a good speci- 
men of it. 

Fibrin, when removed from the human body, changes from a solu- 
ble to an insoluble state. In other words, it coagulates in a kind of 
net-work. Nearly the same thing takes place constantly in the living 
body, when the liquid fibrin leaves its soluble state, and is deposited 
as solid flesh. Fibrin bears the same relation to albumen that wool- 
len yarn does to wool ; it is spun from it in the busy wheel of or- 
ganic life. And the flesh or muscle is related to fibrin as the cloth 
is to yarn ; it is woven from it in the vital loom. Fibrin has been 
called liquid flesh. 

Gelatin exists largely in the ligaments, cartilages, bones, skin, and 
cellular tissue. When dissolved, five parts in one hundred of hot 
water, it forms a thick jelly. Isinglass is a form of gelatin obtained 
from the air-bladder of the sturgeon and the codfish. Glue is still 
another form of gelatin. It is extracted from the bones, and parings 
of hides, and the hoofs and ears of cattle, by boiling in water. Black 
silk, varnished over with a solution of gelatin, forms court-plaster: 

Mucus is a sticky fluid secreted by the gland-cells. It is spread 
over the surface of the mucous membranes, and serves to moisten and 
defend them from injury. 

Fat consists of cells held together by cellular tissue and vessels, 
and contains glycerin, stearic acid, margaric acid, and oleic acid. It 
has no nitrogen. If the stearic acid be in excess, the fat is hard ; if 
the oleic acid preponderate, it is soft. The stearine extracted from 
fat is used for making very hard candles. 



16 ANATOMY. 

Casein is abundant in milk and constitutes its curd. It is held 
in solution in milk by a little soda. When dried, it is cheese. It is 
found in blood, saliva, bile, and the lens of the eye. It forms the 
chief nourishment of those young animals which live on milk. It is 
found in peas, beans, and lentils. Vegetable and animal casein are 
precisely alike in all their properties. Fibrin and albumen contain 
almost exactly the same amount of oxygen, hydrogen, carbon, nitro- 
gen, and sulphur, which is found in casein. This latter, when taken 
into the stomach, therefore, goes, without much change, to the forma- 
tion of the albumen and fibrin of the body. 

Physical Properties of the Body. 

The Tissues. — The solid organized substances of which the human 
body is composed, are called tissues. There are various kinds of tissues. 

The Cellular Tissue, commonly called areolar, is made up of small 
fibres and bands woven together into a sort of net-work, with numer- 
ous little spaces opening into each other. These spaces are filled with 
a watery fluid ; and when this is greatly increased by disease, so as 
to cause the parts to swell, and the skin to shine, the person has ana- 
sarca, or cell-dropsy. The uses of this tissue are to give parts and 
organs a kind of elastic cushion to rest upon, so that they may not be 
bruised and injured by the shocks of life ; to make a kind of safe 
highway for delicate vessels to pass from one part of the body to 
another ; and to furnish a beautifully arranged lodgment for the wa- 
tery fluid which gives such roundness, smoothness, and grace to the 
human form. The opening of the cells into each other explains the 
reason why feeble persons have swelled feet and ankles in the even- 
ing, and not in the morning — the fluid settling down from cell to cell, 
into the lowest parts, while they are up during the day, and running 
back to its proper place while they are lying down during the night. 

The Mucous Tissue, or mucous membrane, lines all the cavities 
which communicate with the air, as the mouth, stomach, bowels, lungs, 
etc. It is supplied with numerous small glands which secrete a 
sticky kind of fluid called mucus, to protect the surface from any 
injury which might be inflicted by air, or by irritating substances 
suspended in it. 

The Serous Tissue, or membrane, lines all the cavities which do not 
communicate with the air, that is, all those which are shut, and have 
no outward opening. The skull, the chest, and the belly are lined by 
this kind of membrane. The membrane itself forms a closed sac, 
— one layer of it being attached to the cavity it lines, while the other 
is folded back upon and around the contents of the cavity, which are 
left outside of the sac. A watery fluid oozes from the inner surface 
of the sac, to make its sides glide easily upon each other. When 
some disease causes this water to be poured out too freely, so as to 
fill or partly fill the cavity, we have dropsy of the brain, or chest, or 
abdomen, as the case may be. 



ANATOMY. 17 

The Dermoid Tissue covers the whole outside of the body. We 
call it the skin, or cutis. It is similiar in structure to the mucous 
membranes, which are a mere continuation of it. It is harder than 
the mucous membrane, because more exposed to injury. In health, 
it never ceases to secrete and throw off a fluid which we call insen- 
sible perspiration while it is in the form of an invisible vapor, and 
perspiration, or sweat, when it is so increased as to be seen. So 
great is the sympathy between this dermoid covering of the body 
and the mucous membranes, that when it is chilled so as to stop the 
invisible perspiration, the internal membrane becomes affected, and 
we have a sore throat, or diarrhoea, or running at the nose ; that is 
to say, when the skin cannot sweat, the mucous membrane begins to 
sweat. 

The Fibrous Tissue consists of closely united fibres, and for what- 
ever purpose used, forms a fine, dense, and enduring body. In some 
cases it takes the form of a membrane, as the dura mater, which lines 
the interior of the skull and spinal column. The ligaments which 
hold the bones together, and the tendons or cords, which fasten the 
muscles to the bones, are fibrous bodies. It is this firm substance of 
which rheumatism frequently takes hold, and this is the reason why 
it lingers so much about the joints. It sometimes takes hold of the 
ligament which fastens the deltoid muscle to the bone of the upper 
arm, about two-thirds of the way from the elbow to the shoulder. 
This muscle lifts up the arm. In this form of rheumatism, therefore, 
the arm hangs helpless at the side. 

The Cartilaginous Tissue covers the ends of the bones where they 
come together to make a joint. It is well fitted to make the joint 
work easy, being smooth, hard, and elastic. 

The Osseous or Bony Tissue varies in its composition, density, 
and strength, according to the age of the person, and the uses of the 
bone. 

The Muscular Tissue, or muscle, being made for a great deal of 
pulling and lifting, is formed something like a rope, except that 
there is no twisting. Many small 
fibres or filaments unite to form 
fasciculi. A fasciculus is a bundle 
of fibres surrounded by a delicate 
layer of cell-tissue called sarcolemma, 
— just as a cord is a number of 
smaller threads of cotton or hemp 
bound together. A number of these 
fasciculi united together make a 
muscle, — just as several cords, called 
strands, twisted together, make a fig. i. 

rope. Figure 1 gives us a good view of the fibres and bundles, 
highly magnified. 




18 ANATOMY. 

The Adipose Tissue is the material which the human body works 
up into pots and cells containing fat. It is found chiefly under the 
skin and muscles of the belly, and around the heart and kidneys. 
By the increase of this tissue, persons may become enormously en- 
larged without having their muscles at all increased in size. Such a 
condition is to be deplored, — the body having become merely the 
storehouse or depot of myriads of pots of fat. 

The Nervous Tissue is composed of two distinct kinds of matter, 
— the one gray and pulpy, called cineritious, the other white and 
fibrous, called medullary. The external part of the brain and the in- 
ternal portion of the spinal cord are composed of the gray or ash- 
colored tissue ; the nerves are made only of the white or fibrous 
matter, and are inclosed in a delicate sheath called neurilemma. 

Vital Properties of the Body. 

Bodies begin their growth with a simple cell, which is a delicate 
little bladder or shut sac. Cells take their rise in that portion of 
the blood which is capable of being organized, and which is called 
blastema. 

In animal bodies each cell generally begins as a minute point in 
the blastema, and grows until a transparent bladder or vesicle springs 
out from one side of it, and soon appears to enclose it. The bladder 
is then called the cell, and the point or dot is its nucleus. Within 
tins nucleus appears another dot, which is called the nucleolus. 
When fully ripened, the cell bursts and sets the nucleus free, and 
this, in its turn, matures and yields up its contents. Thus all cells 
have their origin in germs produced by previously existing parents 
cells. They are multiplied with great rapidity. Having grown to 
a certain extent, they lose their fluid contents, and their walls col- 
lapsing or coming together, they form simple membraneous discs. 
In this way, with some variations, the simple tissues of the body be- 
gin to be, and the foundation is laid for the noble structure of man. 

Anatomy of the Bones. 

The human skeleton is composed of two hundred .and eight bones, 
the teeth not included. 

When fastened together by natural ligaments, the bones are said 
to form a natural skeleton; when attached by wires, an artificial skele- 
ton. 

In Figure 2, — 1, 1, represent the spinal column; 2, the skull; 3. 
the lower jaw ; 4, the breast-bone (sternum) ; 6, the ribs ; 7, the col- 
lar-bone ; 8, the bone of the upper arm (humerus) ; 9, the shoulder- 
joint ; 10, the radius; 11, the ulna; 12, the elbow-joint; 13, the 
wrist; 14, the hand; 15, the haunch-bone; 16, the sacrum; 17, the 
hip-joint; 18, the thigh-bone; 19, the knee-cap (patella); 20, the 
knee-joint; 21, the fibula; 22, the tibia; 23, ankle-joint; 24, the 
foot ; 27, 28, 29, the ligaments of the shoulder, elbow, and wrist ; 




- 29 



- — 30 



28 
1 

15 

29 



31 
32 



- 34 



33 

36 



20 ANATOMY. 

30, tlie large artery of the arm; 31, the ligaments of the hip-joint; 
32, the large blood-vessels of the thigh; 33, the artery of the leg; 
34, 35, 36, the ligaments of the knee-cap, knee, and ankle. 

The protuberances or swellings in certain parts of the bones are 
called processes, and nit' the points to which muscles and ligaments 
are fastened. 

The bones are supplied with nutritive vessels, and, like other parts 
of the body, are formed from the blood. At first they are compara- 
tively soft and cartilaginous. After a time, in the young animal, 
they begin to change to bone at certain places, called points of ossifi- 
cation. They are covered with a strong, fibrous membrane called the 
periosteum. A somewhat similar covering upon the cartilages has 
the name of perichondrium, and that which covers the skull is the 
pericranium. 

The bones are compounded of earthy and animal matter. From 
the former — phosphate and carbonate of lime — they receive their 
strength; from the latter — cartilage — they derive their life. 

Put a bone for a few days into diluted muriatic acid, — one part 
of acid to six of water, — and the phosphate and carbonate of lime 

will all be removed, while 
the bone will remain the 
same in shape. It will now 
be comparatively soft, and 
may be bent, or even tied 
into a knot without break- 
ing. Place a similar bone 
in the fire for a few hours, 
and it w^ill also retain its 
shape, but the cartilaginous 
portion will be gone. It is 
now brittle, and may be 
picked in pieces with the fingers. 

The bones are divided into those of the head, thirty ; of the body, 
fifty-four; of the upper limbs, sixty-four ; and of the lower limbs, 
sixty. 

Bones of the Head. 

The bones of the head are divided 'into those of the shall, the ear, 
and the face. 

The skull has eight bones. They are composed of two plates, one 
above the other, with a porous partition between. These two plates 
are capable of giving the brain very powerful protection against in- 
jury, the outer one being fibrous and tough. — the inner one, hard 
and giass-iike, and hence called vitreous. 

The middle layer has the name of diploe. Its spongy nature 
deadens the jar from a blow inflicted upon the outer table. In early 
life, when the bones are tender and yielding, this porous layer is not 
needed, and is not found. 




ANATOMY. 



21 




Fig. 4. 



That the bones of the skull may not easily slip by each other, and 

get out of place, they are dovetailed together in curious lines called 

sutures. In advanced years, these gen- 
erally close up, the bones uniting firmly 

together. In early life they are quite 

open, the firm bones not covering the 

whole brain. The opening of the 

coronal suture in childhood is called a 

fontanelle. It presents a soft place 

upon the top of the head, where the 

finger could be pressed down into the 

brain. In Figure 4, — 1, 1, show the 

coronal suture on the front and upper 

part of the skull ; 2, the sagittal suture 

on the top of the skull ; and 3, 3, the 

lambdoidal suture, running down on 

each side of the back part of the skull. 

Figure 5 shows the skull-bones separated from each other at the 

sutures : 1, the frontal bone ; 2, the parietal ; 2, the occipital : 4, the 

temporal ; 5, the nasal ; 6, the malar ; 7, the superior maxillary ; 8, 

the unguis ; 9, the in- 
ferior maxillary. Ar- 
nott has demonstrated 
that the form of the 
skull is the best possible 
for sustaining weights, 
and resisting blows. The 
summit of the head is a 
complete arch, like that 
of a bridge. 

The ear has four 
small bones, which aid 
the sense of hearing. 

The bones of the face 

are fourteen in number. 

They hold the soft parts 

in place, and aid in 

FlG 5 grinding the food. 




Bones of the Trunk. 

In the trunk there are twenty-four ribs ; twenty-four pieces in the 
backbone or spinal column ; four bones in the pelvis and hips ; one 
breast-bone, called sternum ; and a bone at the base of the tongue, 
called os hyoides. They are so put together as to form two great 
cavities, namely, the thorax or chest, and the abdomen or belly. 

The ribs, connecting with the backbone behind and the breast-bone 
in front, form the thorax, which contains the lungs and heart. Fig. 



22 



ANATOMY. 




Fig. 6. 



6 shows the natural form of the healthy chest : 1, is the spine ; 2, 2, 
ill.- collar-bones; 3, 3, the seven upper, or true ribs; 4, 4, the five 
lower or false ribs; 5, the breast-bone, to which the true ribs are 

united ; 6, the sword-shaped 
cartilage which constitutes the 
lower end of the breast-bone, 
called ensiform cartilage ; 7, 7, 
the upper part of two lungs ; 8, 
8, the right lung, seen between 
the ribs ; 9, 9, the left lung ; 10, 
10, the heart; 11, 11, the dia- 
phragm, or midriff; 12, 12, the 
liver ; 13, 13, the stomach, 14, 
14, the second stomach, or 
duodenum ; 15, the transverse 
colon ; 16, the upper part of the 
colon on right side; 17, upper 
part of colon on left side. 

Each piece of the spinal col- 
umn is called a vertebra. Upon 
every one of these are seven 
projections, called processes — a part of which are for linking the 
bones together, and the rest to furnish 
attachments for the muscles of the back. 

The projections are linked together in 
such a way, that a continuous channel or 
opening runs down through the whole, 
in which is lodged the spinal cord, or 
medulla spinalis. This nervous cord is 
connected with the base of the brain, and 
is a kind of continuation of it. 

Between all the vertebrae are certain 
cartilaginous cushions, which, when com- 
pressed, spring back, like India rubber, 
and thus protect the brain from being injuriously jarred by running, 

leaping, or walking. 

The pelvis has four bones : 
the two nameless bones — in- 
nominate^ the sacrum, and the 
coccyx. In the side of each of 
the nameless bones is a deep, 
smooth cavity, called the ace- 
tabulum. Into this the round 
head of the thigh-bone is nicely 
fitted. When the bone is 
thrown out of this cavity, the 
hip is said to be out of joint. 
The sacrum took its name 




Fig. 




Fig. 8. 



ANATOMY. 



23 



from the fact that the heathens used to offer it in sacrifice. With 
them, it was the sacred bone. The coccyx is the lower termination 
of the backbone. These bones are represented in Fig. 8 : 1,1, being 
the innominata ; 2, the sacrum ; 3, the coccyx ; 4, 4, the acetabulum : 
a, a, the pubic portion of the nameless bones ; d, the arch of the 
pubes ; e, the union of the sacrum and the lower end of the spinal 
column. 

Bones of the Upper Extremities. 

The shoulder-Made (scapula), the collar-bone, (clavicle), the bone of 
the upper arm (humerus), the two bones of the forearm (ulna and ra- 
dius), the bones of the wrist (carpal bones), the bones of the 
palms of the hand (metacarpal bones), the bones of the 
thumb and fingers (phalanges), — these are the bones of 
the upper limbs. 

The collar-bone is fastened at one end to the breast-bone, 
at the other end to the shoulder-blade. It keeps the shoul- 
ders from dropping forward. Many persons allow it to fail 
of this end by getting very much bent in early life. This 
happens at school, when children are allowed to sit in a 
stooping posture. In the French, a race re- 
markable for a straight, upright figure, this 
bone is said to be longer than in any other 
people. 

The shoulder-blade lies upon the upper part 
of the back, forming the shoulder. It has a 
shallow cavity (glenoid cavity), into which is 
inserted the head of the upper arm-bone. Sev- 
eral strong muscles are attached to the eleva- 
tions of this bone, which keep it in its place, 
and move it about as circumstances require. 
The upper arm-bone has its round head fast- 
ened in the glenoid cavity, by the strong capsular liga- 
ment, forming a joint capable of a great number of move- 
ments. At the elbow it is united with the ulna of the 
fore-arm. It is a long, cylindrical bone, represented by 
Fig. 9 : 1, is the shaft of the bone ; 2, the large, round 
head which fits into the glenoid cavity ; 3, the surface i 
which unites with the ulna. FlG - 10 - 

Of the two bones of the fore-arm, the ulna is on the inner side, and 
unites with the humerus, making an excellent hinge-joint. The 
other bone of the fore-arm, the radius, lies on the outside of the arm, 
— on the same side with the thumb, — and unites, or articulates, as 
we say, with the bones of the wrist. In Fig. 10 : 1, is the body of 
the ulna ; 2, the shaft of the radius ; 4, the articulating surface, with 
which the lower end of the humerus unites ; 5, the upper extremity 
of the ulna, called the olecranon process, which forms the elbow- 
joint ; 6, the point where the ulna articulates with the wrist. 



Fig. 




24 



ANATOMY. 



The eight bones of the wrist or carpus are ranged in two rows, and 
being hound close together, do not admit of 
very tree motion. In Fig. 11 : S, is the scaphoid 
hone; L, the semilunar bone; C, the cuneiform 
bone ; P, the pisiform bone ; T, T, the trapezium 
and trapezoid bones ; M, the os magnum ; u, the 
cuneiform bone. The last four form the sec- 
ond row of carpal bones. 11, 11, are the meta- 
carpal bones of the hand ; 2, 2, the first range 
of the finger-bones ; 3, 3, the second range of 
finger-bones ; 4, 4, the third range of finger- 
bones ; 5, 6, the bones of the thumb. 

Of the five metacarpal bones, four are at- 
tached below to the first range of the finger- 
bones, and the other to the first bone of the 
thumb, while the whole are united to the second 
range of the carpal bones above. 




Bones of the Lower Extremities. 

These are the thigh-bone (femur), the knee-pan (patella), the shin- 
bone (tibia), the small bone of the leg (fibula), the bones of the instep 
(tarsal bones), the bones of the middle of the foot (meta- 
tarsal bones), and the bones of the toes (phalanges). 

The thigh-bone is the longest bone in the system. Its 
head, which is large and round, fits admirably into the 
cavity in the innominatum, called acetabulum, and forms 
what is called a ball-and-socket joint. In Fig. 12 : 1, is 
the shaft of the thigh-bone (femur) ; 2, is a projection 
called the trochanter minor, to which some strong mus- 
cles are attached; 3, is the head of the femur, which fits 
into the acetabulum ; 5, is the external projection of the 
femur, called the external condyle ; 6, the internal con- 
dyle ; 7, the surface which articulates with the tibia, 
and on which the patella slides. 

The knee-pan or knee-cap (patella) is placed on the 
front of the knee, and being attached tc the tendon of 
the extensor muscles above, and to the tibia by a strong 
ligament below, it acts as a pulley in lifting up the leg. 

The shin-bone (tibia) is the largest of the two in the 
lower leg, and is considerably enlarged at each end. 

The small bone of the leg (fibula) lies on the out- 
side, and is bound to the larger bone at both ends. Fig. 
13 shows the two bones of the leg: 1, being the tibia;] 
5, the fibula ; 8, the space between the two ; 6, the 
junction of the tibia and fibula at the upper extrem- 
ity ; 3, the internal ankle ; 4, the lower end of the tibia that unites 



Fig. 12. 



ANATOMY. 



25 



with one of the tarsal bones to form the ankle-joint ; 7, the upper 
end of the tibia, which unites with the femur. 

The instep (tarsus) has seven bones, which, like those of the 
wrist, are so firmly bound together as to allow but a limited motion. 

The metatarsal bones, corresponding with the palm of the hand, are 
five in number, and unite at one end with the tarsal bones, and at 
the other with the first range of the toe-bones. 

The tarsal and metatarsal bones are put together in the form of 
an arch, the spring of which, when the weight of the body descends 
upon it in walking, prevents injury to the organs above. (Fig. 14.) 

The phalanges have fourteen- bones. The great toe has two ranges 




FIG. 14. 




Fig. 13. 

of bones ; the other toes have three. Fig. 15 gives a view of the 
upper surface of the bones of the foot : 1, is the surface of the as- 
tragalus where it unites with the tibia ; 2, the body of the astragalus ; 
3, the heel-bone (os calcis) ; 4, the scaphoid bone ; 5, 6, 7, the cune- 
iform bones ; 8, the cuboid ; 9, 9, 9, the metatarsal bones ; 10, the 
first bone of the great toe ; 11, the second bone ; 12, 13, 14, three 
ranges of bones forming the small toes. 



The Joints. 

That bones may be of any use, they must be jointed together. 
Joints are of the greatest importance. It is necessary they should be 
so constructed that there shall be no harsh grating of the bones upon 
each other, and no injurious jars in walking, etc. To prevent these 
things, a hard, smooth, and yet yielding, cushion-like substance is 



26 



ANATOMY. 




required between them in joints. Such are the cartilages. Fig. 16 
gives a specimen of these intervening cartilages. I), is the body of 

a hone, at the end of 

which is a socket; C, 

the cartilage lining the 

socket, thin at the sides 

and thick in the centre ; 

B, the body of a bone, at 

fig- 16. the end of which is a 

round head ; C, the investing cartilage, thin at the sides and thick 

in the centre. 

Cartilage grows thinner, harder, and less elastic in old age. Hence 
old people are not quite as tall as in middle life, and a little stiffer 
in their joints. 

The synovial membrane is a thin layer covering the cartilage, and 
being bent back upon the inner surface of the ligaments, it forms a 
closed sac. From its inner surface a sticky fluid oozes out, which 
helps the joints to play easily. 

There are other smaller sacs connected with the joints, called 
bursa mucosae. They secrete a fluid similar to that from the syno- 
vial membrane. 




Fig. 17. 



Fig. 18. 



Fig. 19. 



The ligaments. To retain the bones in their places at the joints, 
some strong, flexible straps are required to stretch across from one 
to the other, and to firmly unite them. Such are the ligaments. 

They are the pearl-colored, lustrous, shining parts about the joints, 
in the form of straps and cords. There are a number of them so 
woven together as to form a complete covering of the joint, called a 
capsular ligament. In Fig. 17 : 1, 2, are ligaments extending from 
the hip-bone, 6, to the femur, 4. In Fig. 18: 1, is the socket of the 
hip-joint; 2, head of the femur, lodged in the socket; 3, the ligament 
within the socket. In Fig. 19: 1, is the tendon of the muscle which 
extends the leg ; 2, the knee-cap (patella) ; 3, the anterior ligament 



ANATOMY. 27 

of the patella ; 6, the long external lateral ligament ; 4, 4, the syno- 
vial membrane ; 5, the internal lateral ligament ; 7, the anterior and 
superior ligament that unites the tibia with the fibula. 

Uses of the Bones. 

The bones are to the body what the frame is to the house. They 
hold up and retain the other parts in their proper places. They fur- 
nish points of attachment for the muscles, to hold the body together 
and to give it motion. They also furnish strong, bony cavities for 
the lodgment and protection of such delicate organs as the eye, the 
brain, and the heart. 

A single bone, examined by itself, might not seem to have much 
beauty or design about it; it might even look clumsy and misshapen. 
But when all the bones are inspected with reference to each other, 
we immediately discover a general plan upon which they are made, 
and are compelled to admire their beautiful harmony, and the sym- 
metrical grace with which they act. They show us that God can 
command our wonder, even in the bony frame of our bodies. 

The riuscles. 

That part of the animal's body which we call lean meat is com- 
posed of muscles. We have already explained that muscles are com- 
posed of threads, etc., put together in great numbers, forming bundles. 
So numerous are these threads and bundles in some cases, that the 
muscles which are composed of them have a strength truly wonderful. 

Toward the end of the muscle, the fibres cease, and the structure 
is so modified as to become a white cord of great density and strength. 
This cordy substance is fastened to the bone so strongly, that it is 
impossible, except in some rare cases, to detach it. Generally the 
bone will sooner break than this attachment will give way. Some- 
times this cord spreads out like a membrane. It is then called fascia 
or aponeurosis. 

The fibres of a muscle have the peculiar property of contracting 
under a nervous stimulus sent to them by the will. These contrac- 
tions cause them to act as pulleys, and to move the bones, and conse- 
quently the limbs and body, in such direction as the will commands. 
This is the special use of the muscles. All our movements are caused 
by them. They pull us about, not blindly and at a random, but 
under the direction of an intelligent will. 

The manner in which a muscle acts, with the cord attached, may 
be seen by examining the leg or " drum-stick " of a fowl. If the cord 
on one side be pulled, the claws are shut ; if that upon the other 
side be drawn, they will open. If both be pulled, they are held fast 
in one position, neither opening nor shutting. 

An examination of a piece of boiled lean meat will show the 



28 



ANATOMY. 



Fig. 20. 




threads of which it is composed. With proper instruments, these may- 
be unravelled, as it were, until fibres will be found not larger than a 
spider's web. These, covered with sheaths of great delicacy, extend 
beyond the fleshy fibre, and with the cell-substance connecting the 
fibres, are condensed into tendon. 

Millions of these sheathed fibres are gathered into a bundle, and 
covered with a sheath, and thus form what is called a fasciculus. A 
muscle is a number of these fascicula made into a bundle, and cov- 
ered with a sheath called a fascia (Fig. 1). 

The arm is a number of muscles bundled together, and covered, 
likewise, by a fascia. 

The fibres in a fasciculus being parallel, act together. But the 
fasciculous bundles which make up a muscle act in various ways. 

Shape of the Muscles. — Some muscles are fusiform or spindle- 
shaped, so that the attachment occupies but a 
small space (Fig. 20). 

Other muscles are radiate or fan-shaped fFig. 
21). Such is the temporal muscle, the thin 
edge of which is attached to the side of the head, 
without producing an elevation or deformity. 

In some cases the fasciculi are arranged upon 
one or both sides of a tendon. In this way a 
great number may concentrate their action upon 

a single point. Such muscles are called penni- 
form, — being shaped like a feather (Fig. 22). 

In other instances, the fasciculi form circular 
muscles, — orbiculares, or sphincters, as 
These surround certain openings iirto the 
body, which they are designed to close, either in whole or 
in part. They surround the eyelids, the anus, the mouth 
of the womb, etc. (Fig. 23). 

In still other instances the fasciculi are ranged side by side in 

rings, forming muscular 
tubes. By the successive 
contraction of these rings, 
any substance is driven 
through the tube, — as food or drink through the gullet of a cow. 
Fig. 24 is a section of the gullet : a, 6, show the circular fibres ; 
6', the longitudinal. 

Sometimes the fasciculi curve around in parallel layers or inter- 
lace with each other, forming a bag or pouch. By the contraction 
of these fasciculi, the contents of the bag will be turned from side 
to side as in the case of the stomach, or driven out, as in that of the 
heart. Fig. 25 shows the muscles of the stomach : L, represents the 
fibres running in one direction ; c, in another ; e, lower end of gullet ; 
o, pylorus ; D, beginning of duodenum, or second stomach. 



Fig 21 



Fig. 22. 



they are called. 




Fig. 23. 




Fig. 24. 



PI. 8. 




MUSCLES OF THE HUMAN BODY. 



ANATOMY. 



29 



Number of Muscles. — The muscles of the body are as numerous 
as the ropes of a ship, — there being five hundred or more. Some 
anatomists reckon more, some less. 

The}' are divided into those of the head and neek, those of the 
trunk, those of the upper extremities, and those of the lower extremi- 
ties. 

They are too numerous to be named and individually described in 
this brief account of them. A part of them are voluntary, that is, 
under the control of the will; 
while another part are involun- 
tary, moving without reference to 
the will. The heart is of the 
latter kind, it being necessary for 
it to keep moving when the will 
and mind are asleep. 

On the back there are six 
layers of muscles, one above an- 
other. Such a number are neces- 
sary to perform the numerous 
movements of the back, neck, 
arms, etc. Every expression of the human face, as joy, sorrow, love, 
hate, hope, fear, etc., is produced by the gentle pulling of muscles, 
made expressly to indicate these emotions. 

The diaphragm is a large flat muscle, reaching across the great 
cavity of the body, and dividing the chest from the abdomen. It is 
penetrated by the gullet going to the stomach, and by the great 
blood-vessels leading to and from the heart. It is shaped like the 
cover of a dinner-dish, the convex surface being turned up. When 
the breath is drawn in, it sinks down towards a level, thus enlarging 
the chest at the expense of the belly. When the breath is thrown 
out, the reverse takes place. 




Mode of Action. — The eontractibility of a muscle, of which I have 
spoken, is simply its power of shortening itself. The hand is raised 

5 by the shortening of a mus- 
cle in front, attached to the 
bone above the elbow, and 
to a bone below the elbow. 
The contraction of an an- 
tagonistic muscle behind, 
also attached above and be- 
low the elbow, brings the 
hand back to its place. Fig. 
26 shows how all joints are 
moved : 1, is the bone of the arm above the elbow ; 2, one of the 
bones below the elbow; 3, the muscle which bends the elbow: 4. 5, 
attachments of muscles to bones ; 6, the muscle that extends the 




Fig. 26. 



30 



ANATOMY. 



elbow; 7, attachment to elbow; 8, weight in hand. The muscle, 3, 
contracts at the central part, and brings the hand up to 9, 10. 

The complication, variety, and swiftness of motion, executed by 
muscles, are past conception. Every movement which a human be- 
ing makes, from the heavier motions of the farmer in cultivating his 
fields, up to the magic touches of the painter's brush, and the method- 
ical frenzy with which the great master's fingers sweep the piano, are 
all made by muscles obeying an intelligent will. 



The Teeth. 

The teeth are not like other bones, either in composition, method 
of nutrition, or growth. When broken they do not unite, not being 
furnished with the necessary power of reproduction of lost parts. 

Both the upper and lower teeth are set into bony sockets, called 
alveolar processes. These, with the fibrous gums, give the teeth a 
very firm setting. 

Origin. — The teeth have their origin in little membranous 
pouches within the bone of the jaw, which, in their interior, have a 
fleshy bud. From the surface of this the bone or ivory exudes. The 
tooth and the bony socket are developed and rise up together, — the 
former, when sufficiently long, pushing itself through the gum. 

Number. — The first set of teeth are only temporary, and are called 
jnilk-teeth. There are but twenty of them. Between the age of six 
and fourteen, these become loose, and drop out, and the permanent 
teeth appear in their places. Of these there are thirty-two, sixteen 
in each jaw. 

Names. — The four front teeth in each jaw, a, b, Fig. 27, are the 
cutting teeth (incisors) ; the next one, c, is an eye-tooth (cuspid) ; the 




Fig. 27. 



next two, d, e, are small grinders (bicuspids) ; the last three, /, #, 7i, 
are grinders (molars). One appears late on each side, from the age 
of twenty to twenty-four, and is called wisdom tooth. 



ANATOMY. 31 

Composition. — A tooth is composed of ivory and enamel. The 

internal part is ivory, which is harder than bone. The coating upon 
the surface is enamel, which is still harder than ivory. That part 
which rises above the jaw-bone is called the crown ; it is this only 
which is covered with enamel. The part within the jaw is called the 
root or fang ; this is composed of bony matter, through which small 
vessels pass in to nourish the tooth. Small white nerves also pass 
into the tooth, — of the presence of which we have terrible evidence 
in tooth-ache. 

Use of the Teeth. 

The incisors cut the food asunder; the molars break down its 
solid parts, and grind it to a fineness which fits it for the stomach. 

In masticating the food, the lower jaw has two movements, the up- 
and-down motion, like a pair of shears, and the lateral or grinding 
motion. These two movements are performed by different sets of 
muscles. Flesh-eating animals have only the up-and-down motion ; 
vegetable-eating animals have only the lateral or grinding motion ; 
while man has both the up-and-down and the lateral. This seems 
a pretty clear intimation that he is to eat both flesh and vegetables. 

The teeth aid us in articulating words, and they give a roundness 
and symmetry to the lower part of the face. When well formed, and 
kept in good condition, they add much to the beauty of the face, and 
their decay is an irreparable loss. Their proper care and treatment 
are spoken of in another place. 

The Digestive Organs. 

The alimentary organs are the mouth, the teeth, the salivary glands, 
the pharynx, the gullet (oesophagus), stomach, bowels (intestines), 
chyle vessels (lacteals), thoracic duct, liver and sweetbread (pan- 
creas). 

The preparatory process of digestion, the mastication of food, 
takes place in the mouth, where the food is mixed with saliva, a se- 
cretion of the salivary glands. Of these glands there are six, three 
on each side. 

The Parotid Gland lies in front of the external ear. It has a duct 
opening into the mouth opposite the second molar tooth of the upper 
jaw. This is the gland that swells in the disease called mumps. 
Hence the disease is also called parotitis. 

The Submaxillary Gland is inclosed within the lower jaw, in front 
of its angle. Its duct opens into the mouth by the side of the bridle 
of the tongue (frsenum linguae). 

On each side of this string or bridle, and under the mucous mem- 
brane of the floor of the mouth, lies the sublingual gland, which 
pours its saliva into the mouth, through seven or eight small ducts. 



32 



ANATOMY. 




Fig. 28. 



A disease called the frog consists in the swelling of this gland. 

Fig. 28 : 1, the parotid gland ; 2, its duct ; 3, the submaxillary ; 

4, its duct ; 5, the sublin- 
gual. 

The Pharynx is a con- 
tinuation of the mouth, and 
is the cavity just below the 
soft palate. The two pas- 
sages going to the nose 
(posterior nares), the one 
going to the stomach 
(oesophagus), and the one 
going to the lungs (larynx 
and trachea ; all meet in 
this cavity. In Fig. 29: 
1, is the trachea ; 2, the 
larynx ; 3, the oesophagus ; 
4, 4, 4, muscles of pharynx ; 5, muscles of the cheek ; 6, the muscle 
which surrounds the mouth ; 7, the mus- 
cle forming the floor of the mouth. 

The Gullet or oesophagus is a long tube, 
descending behind the windpipe, the 
lungs, and the heart, through the dia- 
phragm into the stomach. It is composed 
of two membranes laid together, like two 
pieces of cloth. The inner one is mucous, 
the outer muscular. The two sets of 
fibres composing the muscular coat are 
arranged circularly and longitudinally 
(Fig. 25). 

The Stomach lies in the upper part of 
the belly, to the left, and directly under 
the diaphragm. It has an upper opening, 
where the stomach-pipe enters it, called 
the cardiac orifice. This is the larger end of the stomach, and lies 
on the left side ; the smaller end connects with the upper bowel, at 
which point it has an opening called the pyloric orifice. In addition 
to mucous and muscular coats, similar to those which compose the 
oesophagus, the stomach has still another over both, a serous coat, 
very strong and tough, to give this working organ additional en- 
durance. Within, it has many glands to secrete the gastric juice. 

The Intestines, or alimentary tube, or bowels, are divided into the 
small and large intestines. 

The small intestine has a length of about twenty-five feet, and is 
divided into three parts, — the duodenum, the jejunum, and the ileum. 

Of these three divisions, the duodenum is the largest, and is about 




fig. 29. 



ANATOMY. 33 

a foot in length. It begins at the pyloric orifice of the stomach, and 
passes backward to the under surface of the liver, whence it drops 
down perpendicularly in front of the right kidney, and passes across 
the belly behind the colon, and ends in the jejunum. 

The Jejunum continues the above, and terminates in the ileum. 

The Ileum is a continuation of the jejunum, and opens, at an obtuse 
angle, near the haunch bone, into the colon. A valve is located here, 
to prevent the backward passage of substances from the colon into 
the ileum. 

At this point the large intestines begin, and here is situated the 
ccecum, a blind pouch, or cul-de-sac, attached to which is the appen- 
dix vermiformis, a worm-shaped tube, of the size of a goose-quill, and 
from one to six inches long. 

The Colon, or large intestine, is divided into the ascending colon, the 
transverse colon, and the descending colon. 

The Ascending Colon rises from the right haunch-bone to the under 
surface of the liver, whence it bends inward, and crosses the upper 
part of the belly, below the liver and stomach, to the left side. This 
portion which crosses over is the transverse colon. From this point, 
on the left side, it turns down to the left haunch, and has the name 
of the descending colon. Here it makes a curve like the letter S, 
which is called the sigmoid flexure. 

The Rectum is the lower portion of the large intestine, terminal 
ing at the anus. 

The Lacteals are small vessels which begin in the villi, upon the 
mucous membrane of the small bowels. From here they pass be- 
tween membranes of the mesentery to small 
glands, from which larger vessels run to 
another collection of glands; and after 
passing, for a space, from one collection of 
glands to another, at each stage of their 
progress increased in size and diminished 
in number, the lacteals pour their contents 
into the thoracic duct. This having passed 
up through the diaphragm, out of the 
belly, makes a sudden turn downward and 
forward, and empties its burden into a 
large vein which ends in the right heart. 
Fig. 30: 1, is the bowel; 2, 3, 4, the 
mesenteric glands through which the lac- Fl °- 30 - 

teals pass ; 5, the thoracic duct ; 7, the spinal column ; 8, the 
diaphragm. 

By the help of a magnifying glass, an infinite number of these 
small vessels may be seen starting from the rough, shaggy internal 
coat of the bowel. 




34 



ANATOMY. 



The mesentery is a thick sheet of membrane, formed of several 
folds of the peritoneum, and spread out from the vertebrae like a fan. 
The bowels are attached to its edge, and are held by it in their place, 
and at the same time have free motion. Between its layers are a 
great number of glands, which sometimes become diseased and swol- 
len in childhood, and prevent the chyle from passing along to the 
thoracic duct. Thus affected, children are not nourished, and waste 
away with a disease sometimes called mesenteric consumption. 

The Liver is a large gland, lying under the short ribs on the right 
side, below the diaphragm. It is convex on the upper surface and 

concave on the under, and is 
composed of several lobes. Its 
office is to secrete bile. It 
weighs about four pounds, 
being the largest organ in the 
body. Fig. 31 represents the 
liver: 1, being the right lobe; 
2, left lobe ; 3,4, smaller lobes ; 
10, gall-bladder ; 17, the notch 
into which the spinal column 
is fitted. 

The GalNBIadder lies on 
the under side of the liver, and receives, it is supposed, the surplus 
bile, which is reserved for special occasions. It opens into the gall- 
duct, which carries the bile along, and pours it into the duodenum. 

The Pancreas, Fig. 32, is a long, flat gland, something like the 
salivary glands. It lies transversely across the back wall of the ab- 
domen, behind the stomach. 
It secretes a colorless, al- 
kaline fluid called the pan- 
creatic juice, the office of 
which is to emulsify the 
different classes of food, 
so that the lacteals can ab- 
sorb it. This fluid is car- 
ried by a duct, and poured into the duodenum just where the bile- 
duct enters. 





Fig. 32 



The Spleen has an oblong, flattened form. It lies on the left 
side, just under the diaphragm, and close to the stomach and 
pancreas. It is supposed to be a reservoir for holding the surplus 
blood of the liver. It was thought by the ancients to be the seat of 
melancholy. The blood in passing through it loses a portion of its 
red globules. 

The Omentum or caul is a doubling and extension of the perito- 
neum. It is a kind of fatty body, which lies upon the surface of the 



ANATOMY. 35 

bowels and is attached to the stomach. Its use seems to be to lubri- 
cate the bowels, and especially to protect and keep them warm. 
Hence it is often called the apron. 

The Urinary System. 

The organs of this system are devoted to separating the urine from 
the blood, and carrying it out of the body. These organs are the 
kidneys, the ureters, the bladder, and the urethra. 

The Kidneys lie one on each side of the backbone, in the lumbar 
region, behind the peritoneum. They are four or five inches long, 
and two and a half broad. They are in shape like the kidney-bean, 
and weigh about half a pound each. In the centre there is a bag 
called the pelvis, which tapers like a funnel, and unites with the 
ureter which conveys the urine to the bladder. The texture of the 
kidney is dense, presenting in its interior two structures, an external 
or cortical, and an internal or medullary. The cortical portion has 
the blood-vessels, the medullary is composed of tubes which carry 
away the urine. 

The Ureters are membranous tubes of the size of a goose-quill, 
and eighteen inches long, which run down the back wall of the abdo- 
men, behind the peritoneum, to the bladder, into each side of which 
they empty their contents. 

The Bladder is located in the pelvis, in front of the rectum. It is 
composed of three coats ; the external is serous, the middle muscular, 
and the internal mucous. The external coat is strong and fibrous ; 
the internal is drawn into wrinkles, which makes it thick and shaggy; 
it secretes a mucus which prevents it from being injured by the cor- 
rosiveness of the urine. The urine is retained in the bladder by 
means of a circular muscle, called a sphincter, which draws the mouth 
of the organ together. When the quantity of urine is so increased 
as to give some uneasiness or pain, this muscle, by a sort of instinct, 
relaxes and lets it out. 

The bladder is attached to the rectum, to the hip-bones, to the 
peritoneum, and to the navel, by several ligaments. In the female 
the bladder has the womb between it and the rectum. 

This organ is wisely provided as a receptacle for the urine ; which, 
without it, would produce a great inconvenience by being constantly 
dribbling away. 

The Urethra is a membranous canal which leads from the neck 
of the bladder. It is composed of two layers, a mucous and an elas- 
tic fibrous. Through this channel, which is curved in its course, the 
urine passes out of the body. 



36 ANATOMY. 



The Respiratory Organs. 

These organs consist of the windpipe (trachea) ; divisions and 
subdivisions of the windpipe (bronchia); air-cells; and the lungs or 
lights. 

The Windpipe (trachea) extends from the larynx — the seat of the 
voice — to the third dorsal vertebra, where it divides into two tubes, 
called bronchia. It runs down the front part of the throat, with the 
oesophagus behind and between it and the spinal column. It is com- 
posed mainly of rings of cartilage, one above another. 

The Bronchial Tubes are, at the division of the windpipe, two in 
number, but they divide and subdivide until they become very nu- 
merous. 

The Air-Cells or Vesicles are small, bladder-like expansions at the 
ends of the tubes. They are elastic and swell out when the air 
passes in. 

The Lungs fill the greater part of the chest, the heart being the 
only other organ which occupies much space in the cavity. The 
size of these organs is large or small, according to the capacity of the 
chest. Each lung — for there are two — is a kind of cone, with its 
base resting upon the diaphragm, and its apex behind the collar-bone. 
They are concave on the bottom, to fit the diaphragm, which is con- 
vex on its upper side. 

The right and left lungs are separated from each other by a parti- 
tion called the mediastinum, formed by two portions of the pleura, a 
smooth serous membrane coming off from the spine and closely en- 
veloping each lung ; the heart, covered by the pericardium, lies 
in the centre, between them. The right lung is divided into three 
lobes ; the left into two. 

Each lobe of the lungs is divided into a great many lobules, which 
are connected by cellular tissue. These lobules are again divided 
into very fine air-cells. Besides these, the substance of the lungs is 
composed likewise of blood-vessels and lymphatics, and is well sup- 
plied with nerves. 

In the foetal state, before the lungs have been filled with air, they 
are solid and heavy, something like other flesh, but after all their 
cells have been filled with air, and breathing has been established, 
they are exceedingly light and spongy, and float upon water. 

In cases where infanticide is suspected, and where it is desirable 
to know whether the child was still-born, or born alive and killed 
afterwards, the specific gravity of the lungs, compared with water, 
will often settle the question. 



ANATOMY. 37 

The Organs of Circulation. 

The food having been digested, changed to chyle, absorbed by the 
lacteals, carried to the veins, poured into the right heart, sent up to 
the lungs, and prepared for nourishing the body, will still be useless, 
if not distributed to every part of the system. The organs for ef- 
fecting this distribution are the heart, the arteries, the veins, and the 
capillaries. 

The Heart is placed obliquely in the chest, with one lung on each 
side, and is enclosed between the two folds of the mediastinum Its 
form is something like a cone. Its base is turned upward and back- 
ward in the direction of the right shoulder; the apex forward and to 
the left, occupying the space between the fifth and sixth ribs, about 
three inches from the breast-bone. It is surrounded by a membranous 
case or sac, called the pericardium. 

The heart is a muscular body, and has its fibres so interwoven that 
it is endowed with great strength. It is a double organ, having two 
sides, a right and a left, which are divided from each other by a mus- 
cular partition, called a septum. The right heart sends the blood to 
the lungs ; the left heart distributes it to the general system. Each 
side is divided into two compartments, an auricle and a ventricle. 

The Auricles have thinner walls than the ventricles, being only 
reservoirs to hold the blood until the ventricles force it along to other 



The Ventricles have within them fleshy columns, called columnce 
cameos. The walls of the left ventricle are thicker than those of the 
right, being required to contract with more force. Each of the four 
cavities will contain from one and a half to two ounces of blood. 

The Tricuspid valves are situated between the auricle and ventricle 
on the right side, and consist of three folds of a thin, triangular 
membrane. The mitral valves occupy the same position on the left 
side. Small white cords, called chordce tendince, 
pass from the floating edge of these to the 
columnse carnese, to prevent the backward press- 
ure of the blood from carrying the valves into 
the auricles. 



The pulmonary artery is the outlet of the 
right ventricle ; the larger artery, called aorta, 
of the left ventricle. At the opening of these 
arteries are membranous folds, called semilunar 
valves. Fig. 33 gives a fine view of the heart : 
1, is the right auricle ; 2, the left auricle; 3, the 
right ventricle; 4, the left ventricle; 5, 6, 7, 8, fig. 33. 

9, 10, the vessels which bring the blood to and carry it away from 
the heart. 




38 ANATOMY. 

The Arteries are the round tubes which carry the red blood from 
the left side of the heart to every part of the body. 

The sides of arteries are stiff and hard, and do not fall together 
when empty. They may often be seen open in a piece of boiled beef. 

The arteries have three coats, — an external, which is cellular, firm 
and strong ; a middle, which is fibrous and elastic ; and an internal, 
which is serous and smooth, being a continuation of the lining of 
the heart. They are surrounded by a cell vestment called a sheath, 
which separates them from surrounding organs. 

The Pulmonary Artery starts from the right ventricle in front of 
the opening of the aorta, and ascends to the under surface of the 
aortic arch, where it parts into two branches, sending one to the right, 
the other to the left lung. Having divided and subdivided to a great 
extent, they end in the capillary vessels, uniting, joining their mouths, 
and becoming continuous with the pulmonary veins just where they 
pass around the air-cells. 

The Aorta is the largest artery in the body. It takes a slight turn 
in the chest, called the arch of the aorta, from which are given off the 
arteries which carry the blood to the head, etc. ; thence it descends 
into the belly along the side of the backbone, and at the bottom of 
the abdomen it divides into two arteries, called the iliacs — one going 
to each of the lower limbs. The branches the aorta gives off a supply 
of red blood to every part of the body. 

The Veins carry the dark or purple blood. Being made red and 
vital by meeting atmospheric air in the lungs, and then conveyed to 
every part of the body in the arteries, the blood loses its redness in 
the capillaries, and comes back to the heart in the veins, dark and 
purple, and unfit to support life. The veins are more numerous and 
nearer the surface than the arteries. They have, likewise, thinner 
walls, and when empty, they collapse or fall together. They begin 
in the small capillaries, and running together, they grow larger and 
larger, and finally form the great trunks which pour the dark blood 
into the right auricle. The veins are composed of three coats, simi- 
lar to those of the arteries, with the exception of being thinner and 
more delicate. These vessels have valves all along their inner sur- 
face, to aid in circulating the blood. 

The large vein which receives all the dark blood from above r and 
pours it into the right auricle, is called the vena cava descendens ; the 
one which takes it from below, and disposes of it in the same manner, 
is the vena cava ascendens. 

The pulmonary veins bring the red blood from the lungs to the left 
auricle, and thus are exceptional in their use, — being the only veins 
which carry red blood. 

The Capillaries are the extremely fine network of vessels between 
the ends of the arteries on the one side, and of the veins on the other. 




PI. 4. 



THE ARTERIES AND VEINS OF THE HUMAN BODY 



ANATOMY. 



39 



They inosculate, or join their mouths to the very small arteries at 
one end, and to the equally small veins at the other. They are the 
industrious little builders of the human frame. Receiving the blood, 
red, and full of life, from the terminal extremities of the arteries, 
they take the living particles out of it, and apply them to the renewing 
and vitalizing of the body, and then pass it along into the hair-like 
beginnings of the veins, dark and bereft of vitality, to be carried up 
for another freight of chyle, and to be again vitalized by being touched 
in the lungs by the breath of heaven. 

In Fig. 34 we have a good ideal illustration of the whole circu- 
lation. From the right ventricle of the heart, 2, the dark blood is 
thrown into the pulmonary ar- 
tery, 3, and its branches, 4, 4, 
carry it to both lungs. In the 
capillary vessels, 6, 6, the blood 
comes in contact with the air, 
and becomes red and vitalized. 
Thence it is returned to the left 
auricle of the heart, 9, by the 
veins, 7, 8. Thence it passes 
into the left ventricle, 10. A 
forcible contraction of this 
sends it forward into the aorta, 
11. Its branches, 12, 13, 13, 
distribute it to all parts of the 
body. The arteries terminate 
in the capillaries, 14, 14. Here 
the blood loses its redness, and 
goes back to the right auricle, 
1, by the vena cava descendens, 
15, and the vena cava ascend- 
ens, 16. The tricuspid valves, 
17, prevent the reflow of the 
blood from the right ventricle 
to the right auricle. The semi- 
lunar valves, 18, prevent the 
blood from passing back from the pulmonary artery to the right 
ventricle. The mitral valves, 19, prevent its being forced back from 
the left ventricle to the left auricle. The semilunar valves, 20, pre- 
vent the backward flow from the aorta to the left ventricle. 

By a careful examination of this diagram, with these explanations, 
the reader may understand the circulation very well. 

The passage of the blood from the right heart, through the lungs, 
and back to the left heart, is called the lesser, or pulmonic circulation ; 
its passage from the left heart through all parts of the body, and back 
to the right heart, is the greater or systematic circulation. 




fig. 34. 



40 



ANATOMY. 




The Absorbent Vessels. 

The vessels which absorb the chyle from the small intestines, and 
convey it onward towards the blood, are the lacteals. They have 
been described. The veins are also supposed to have the power of 

absorption, particularly the small 
commencements of the veins. 
These have likewise been de- 
FIG - ^ scribed. 

The Lymphatic vessels resemble the lacteals. They abound in the 
skin, the mucous membranes, 
and the lungs. They are 
very small at their origin, 

and, like the veins, they in- ^KSB^ ,a 

crease in size, as they dimin- B>i7 

ish in numbers. Like the 
veins, too, they travel to- 
wards the heart, and their 




Fig. 36. Fig. 37. 

contents are poured into it. 
Their walls are composed of 
two coats ; the external is 
cellular, and distensible ; the 
internal is folded into valves, 
like that of the veins. 

These vessels, on their 
way to the heart, pass 
through soft bodies, called 
lymphatic glands, which bear 
to them the relation that the 
mesenteric glands do to the 




ANATOMY. 41 

lacteals. These glands are a collection of small vessels. The 
lymphatic glands are most numerous in the neck, chest, abdomen, 
arm-pits, and groins. They are also found, to some extent, in other 
parts of the body. Fig. 35 shows a single lymphatic vessel, much 
magnified; Fig. 36 exhibits the valves along one of the lymphatic 
trunks ; Fig. 37 shows a lymphatic gland with the vessels passing 
through it. 

Fig. 38 represents the lymphatic vessels and glands. 1, 2, 3, 4, 5, 
6, show these vessels of the lower limbs ; 7, the inguinal glands ; 8, 
the commencement of the thoracic duct, into which the contents of 
lymphatic are poured ; 9, the lymphatics of the kidneys ; 10, those 
of the stomach; 11, those of the liver; 12, 12, those of the lungs ; 
13, 14, 15, those of the arm; 16, 17, 18, those of the face and neck ; 
19, 20, the large veins ; 21, the thoracic duct; 26, the lymphatics of 
the heart. 

A cold will* often cause lymphatic glands to swell. These swell- 
ings are called kernels. They often swell, also, without the irritation 
from cold, and become very much and permanently enlarged, particu- 
larly in scrofula. In scrofulous subjects they sometimes suppurate 
and break, forming bad sores upon the neck. 



The Organs of Secretion. 

The exhalants, the follicles, and the glands are the organs of secre- 
tion. 

The Exhalants are the sweat-glands. These have external termi- 
nations upon the skin, thus communicating with the air, and internal 
terminations upon the surfaces of organs not having an outward ex- 
posure. 

The Follicles are small sacs, located in the true skin and mucous 
membranes. The pores of the skin are the mouths or outlets of these 
little bags. Veins and organic nerves are sent to these vessels. 

Glands are soft organs, having a variety of structure, and perform 
ing many kinds of secretion. A gland is made up of several lobules, 
united in one mass, and each of these lobules 
has a small duct, communicating with a 
main duct which forms the outlet. Fig. 39 
shows a gland ; 2, the small ducts spread 
through its body, and running together; 
1, the large duct, through which the secreted 
substance is carried away. 

The mesenteric and lymphatic glands 
merely modify the fluids which pass through 
them ; others secrete from the blood either 
fluids to be used in the body, or such as are to be cast away. 




42 



ANATOMY. 



The Vocal Organs. 

No sounds touch the heart like those of the human voice, for no 
mechanic, however scientific and skilful, has ever been able to make 
an instrument which could produce sounds as beautiful, tones as 
varied, a timbre as melodious, and inflexions as manifold and agree- 
able. It has been compared to wind, reed and stringed instruments. 
In touching expression, it is most resembled by the concert-horn, the 
bassoon, and the hautboy. 

Vocal sounds, past all question, are produced in the larnyx, but 
these sounds are grouped, or formed into articulate speech, by the 
pharynx, the nasal cavities, the tongue, the teeth, etc. 

The Larynx is a kind of cavity or tube at the top of the windpipe, 
formed by the union of five cartilages, namely, the thyroid, the cricoid, 
the two arytenoid, and the epiglottis. Ligaments bind these together, 
and muscles move them. 

The Thyroid Cartilage is composed of two parts, and has a con- 
nection with the bone of the tongue above, and with the cricoid car- 
tilage below. 

The Cricoid Cartilage is shaped like a ring, and hence its Greek 
name. It is narrowest in front, and broadest behind. It connects 
with the thyroid cartilage 
above, and with the first ring 
of the trachea below. Fig. 40 
gives a side view of the car- 
tilages of the larynx : 1, bone 
at the base of the tongue (os 
hyoides) : 2, the ligament con- 
necting hyoid bone and the 
thyroid cartilage ; 3, the front 
of the thyroid cartilage ; 4, the 
thyroid cartilage ; 6, the cri- 
coid cartilage ; 7, the wind- 

^° ' Fig. 41 is a back view of 

the cartilages and ligaments of the larynx : 1, is the back surface 
of the epiglottis ; 3, 3, the os hyoides ; 4, 4, the lateral ligaments 
connecting the os hyoides and the thyroid cartilage ; 5, 5, the back 
face of the thyroid cartilage ; 6, 6, the arytenoid cartilages ; 7, the 
cricoid cartilage ; 8, the first ring of the windpipe. 

The Arytenoid Cartilages are upon the back part of the cricoid, 
and are connected with the thyroid cartilage by the vocal cords. 

The Epiglottis is a fibro-cartilaginous lid, shaped like a leaf, which 
covers the upper opening of the larynx. It is connected by a carti- 





FlG. 41. 




ANATOMY. 43 

lage to the bone of the tongue (os hyoides) and to the thyroid carti- 
lage. Breathing opens and shuts it ; and in swallowing, it closes 
down upon the top of the larynx, to prevent food and drink from 
passing down the windpipe. 

The Vocal Cords are two ligaments, formed of elastic and parallel 
fibres, enclosed in a fold of mucous membrane. They are about two 
lines in width, and inserted behind into the 
anterior projection of the arytenoid car- 
tilages, and passing forward, are fixed to 
the anterior angle of the thyroid. There 
are four ligaments crossing the larynx, 
two superior and two inferior, — the lat- 
ter being called vocal cords. The interval 
between them is the glottis. The liga- 
ments themselves are sometimes called 
the lips of the glottis. The depression be- 
tween the superior and inferior ligaments 
is the ventricle of the larynx. 

Fig. 42 represents a view of the larynx 
from above : . a, 5, c, the thyroid cartilage, enclosing the ring of the 
cricoid ; A, A, e, e, the arytenoid cartilages connected by the trans- 
verse arytenoid muscle ; t, i, the vocal cords ; o, 0, the crico-arytenoid 
ligaments. 

The muscles which are attached to the cartilages have the power 
of pulling them about so as to change in various ways the shape of 
the laryngeal cavity ; to enlarge or diminish the size of the glottis • 
and to relax or tighten the vocal cords. By these means, and some 
others, the sounds of the voice receive their various modifications. 
Tightening the cords, for example, raises the pitch. 

The Skin. 

The skin is a membrane composed of two layers, covering the 
entire person. The outer layer is the scarf-skin or cuticle ; the inner 
is the true skin or cutis or corium. These layers differ in their struc- 
ture and uses. 

The Scarf-Skin, called also cuticle and epidermis, is a thin mem- 
brane, partially transparent, like a thin shaving of horn. Having no 
blood-vessels or nerves, and consequently no feeling, it appears to be 
a simple covering to protect the true skin from injury by external 
agents. It is thickest on those parts most exposed to friction. 

The scarf-skin is the production of the true skin, — an exudation 
from it in the shape of a fluid which is spread out as a thin layer, 
and dries up into flattened scales. The cuticle is composed chiefly 
of these scales, and is constantly being rubbed off as scurf, while 
new layers are forming underneath. 



44 



ANATOMY. 



The lower, softer layer of the scarf-skin, called the malpighian 
layer, or rete mucosum, is the seat of color. In this part the cells 
contain a pigment incorporated with the elementary granules, which 
gives to the various races their several shades of color. The depth 
of hue is dependent entirely on the amount of this coloring matter. 

The True Skin, which is called cutis, derma or corium, is a kind of 
web, woven of small fibres collected into strands. In the upper por- 
tion, the web is line and firm, but grows coarser below. Connected 

/ / / 




wmmmmmm. 

Fig. 43. 




Fig. 44. 



with its under surface is a fibrous web in which the fat is deposited. 
Upon its upper surface is the sensitive or papillary layer, composed 
of blood-vessels and nerves, doubled into loops, which give little 
prominences called papillae. Fig. 43 gives an ideal view of these 
elevations, composed as they are, of a nerve, an 
artery, and a vein, lying side by side ; 1, 1, 
represent the true skin; 2, 2, the papillary 
layer; 3, 3, the arteries; 4, 4, the veins; and 
5, 5, the nerves of the papillae. 

The arteries, veins, and nerves are spread 
over the true skin in great numbers, — so pro- 
fusely, that it is impossible to push the point of 
the finest needle into it, without piercing a 
blood-vessel and a nerve. 

Fig. 44 gives a view of the skin : a, a, the 
cuticle ; 6, 6, the colored layer of the cuticle ; 
c, <?, d, d, the true skin ; #, e, e, fat-cells ; /, /, /, 
sweat-tubes. 

The lymphatics are very numerous in the skin, besides which there 
are oil-glands and tubes, and sweat-glands and tubes. 

The Oil-Glands are imbedded in the skin, and communicate with 
the surface by small tubes. They are most abundant on the face, 




Fig. 45. 



ANATOMY, 



45 



nose and ears, 
the tube, and c, 



Fig. 45 shows an oil-gland, 
its mouth. 



a, being the gland, b, 




3 2 

The Sweat-Apparatus consists of small tubes which pass down 
through the true skin, and terminate in the meshes at the bottom, 
where it coils upon itself into a kind of bundle, called the perspira- 
tory gland. Fig. 46 gives one of these tubes, with the gland, mag- 
nified forty diameters : 1, being the coiled tube or gland ; 2, 2, the 
two excretory ducts from the gland. These uniting form one spiral 
tube, which opens at 4, which is the surface of the cuticle ; 3, are the 
fat-cells. 

The hair and the nails are appendages of the skin. 



The Nervous System. 

The Nervous System consists of the brain and spinal cord, con- 
nected with each other, and called the cerebrospinal axis ; the cranial 
nerves ; the spinal nerves and the sympathetic nerve. 

The Brain is that mass of nervous matter lodged within the skull- 
bones. It is made up of three prin- 
cipal parts, — the cerebrum, the cere- 
bellum, and the medulla oblongata. 
These are nicely covered and pro- 
tected by three membranes, the dura 
mater, the arachnoid, and the pia 
mater. 

Fig. 47 shows a considerable por- 
tion of the brain, — the skull-bones 
and membranes being removed. 
The scalp turned down is repre- 
sented by A, A ; E, E, E, show the cut 
edge of the bones; c, is the dura 
mater, drawn up with a hook ; f, 
the convolutions of the brain. 

The Cerebrum is the upper and 
larger portion of the brain, and is FlGl 47, 




46 



ANATOMY 



divided into two hemispheres by a fissure. A portion of the dura 
mater dips into this cleft, and from its resemblance to a sickle, is 
called the falx cerebri. The design of this seems to be to support 
each half of the brain, and to prevent it from pressing upon the other 
half when the head reclines to one side. 

The undulating surface of the cerebrum is produced by what are 
called convolutions. The lower surface of this organ is divided into 
three lobes, — the anterior, the middle, and the posterior. 

The surface of the cerebrum is of a gray color, called cortical, or 
cineritious ; the central portion is white and fibrous, and is called 
medullary. 

The Cerebellum is about one-sixth the size of the cerebrum. It 
lies just under the posterior lobe of the cerebrum, and is separated 
from it by an extension of the dura mater, called the tentorium. It 
is composed of white and gray matter; when the former is cut into, 
there is presented the appearance of the trunk and branches of a tree, 
called arbor vitas. 

The Medulla Oblongata is the top of the spinal cord; but being 
within the enclosure of the skull, it passes for a portion of the brain. 
It consists of three pairs of bodies, united so as to form a bulb. 

The Dura Mater is a strong, fibrous membrane which lines the 
skull and spinal column, and sends processes inward to support the 
brain, and forward, as sheaths for the nerves which go out from the 
brain and spinal cord. 

The Arachnoid is a serous membrane, and like all other serous 
membranes, is a closed sac. It is reflected upon the inner surface of 
the dura mater. 

The Pia Mater is a vascular membrane, and lies next to and in- 
vests the whole surface of the 
brain, — dipping into its con- 
volutions. It furnishes nu- 
triment to the brain. 

The Cranial Nerves which 
go out from the brain are in 
twelve pairs. In reading a 
description of them, let the 
reader keep his eye on Fig. 48. 

The First Pair, olfactory 
(6), passes through several 
small openings in the ethmoid 
bone, and is distributed to 
the mucous membrane which 
lines the nose. Destroy this, 
and the sense of smell is gone. 




Fig 48. 



ANATOMY. 47 

The Second Pair, optic nerve (7), passes through the ase of the 

skull, and enters the cavity of the eye where it is expanded upon the 
retina. It is a disease of this nerve which occasions a gradual loss 
of sight, called amaurosis. 

The Third Pair, motores oculorum (9), passes through the sphe- 
noid bone to the muscles of the eye. 

The Fourth Pair, patheticus (10), passes to the superior oblique 
muscle of the eye. 

The Fifth Pair, trifacial nerve (11), like the spinal nerves, has two 
roots, and divides into three branches, one going to the eye, forehead, 
and nose, called the ophthalmie branch ; another going to the eye, 
the teeth of the upper jaw, etc., called the superior maxillary ; and 
the third going to the ear, the tongue, and the teeth of the lower 
jaw, and called the inferior maxillary. It is a painful condition of 
the branches of the fifth pair which constitutes the terrible neuralgic 
affection called tie-douloureux. 

The Sixth Pair, abducentes (12), passes the opening by which the 
carotid artery enters the cavity of the skull, and goes to the external 
straight muscle of the eye. 

The Seventh Pair, portio mollis (13), is distributed upon the in- 
ternal ear. 

The Eighth Pair, facial nerve (14), is distributed over the face. 
It sends nervous filaments to the muscles. 

The Ninth Pair, glosso-pharyngeal nerve (14), passes through the 
same opening with the jugular vein, and is distributed upon the mu- 
cous membrane of the tongue and throat. 

The Tenth Pair, pneumogastric nerve (15), sends its branches to 
the pharynx, larynx, gullet, lungs, spleen, pancreas, liver, stomach, 
and bowels. 

The Eleventh Pair, spinal accessory nerve (16), connects with the 
ninth and tenth pairs, and is distributed to the muscles of the neck. 

The Twelfth Pair, hypo-glossal nerve (17), goes to the tongue, 
and is its motion-producing nerve. It is a nerve of great energy in 
those who talk much. 

The Spinal Cord extends from the medulla oblongata, where it is 
in connection with the brain, down to the second lumbar vertebra. 
The upper end of the cord presents a bulbous swelling, or enlarge- 
ment. Another swelling is found where the nerves are given off 
which go to the upper extremities ; and a third near the end of the 
cord, where the nerves begin which go to the lower extremities. 

Fissures dip into the cord before and behind, and divide it into 
two lateral parts, which are united by a thin layer of white substance. 

These lateral columns are divided by furrows into anterior, lateral, 



48 



anat6my. 




Fig. 49. 



and posterior columns ; — the anterior being supposed to be the motor 
column, the posterior that of sensation, and the lateral divided in 
function between motion and sensation. 

The Spinal Nerves, connecting with the cord, are in pairs, of 
which there are thirty-one. Each pair has two roots, — a motor root, 

C, Fig. 49, arising 
from the anterior 
columns of the 
cord, and a sensi- 
tive root, D, spring- 
ing from the pos- 
terior columns. A, 
is a section of the 
cord, surrounded 
by its sheath. B, 
is the spinal nerve, 
formed by the 
union of the motor and sensitive roots. After the union, the nerve, 
with its motor and its sensitive filaments, divides and subdivides 
as it passes on, and is distributed to the tissues of the several 
organs. 

The thirty-one pairs of spinal nerves are divided into eight pairs of 
cervical, twelve pairs of dorsal, five pairs of lumbar, and six pairs of 
sacral nerves. 

Fig. 50 gives a view of the brain and spinal cord, with the nerves 
given off by the latter: 1, 1, being the two hemispheres of the brain; 
3, 3, the cerebellum ; 4, the olfactory nerve ; 5, the optic ; 7, the 
third pair ; 8, the pons varolii, so called ; 9, the fourth pair ; 10, the 
lower portion of the medulla oblongata ; 11, 11, the spinal cord ; 12, 
12, the spinal nerves ; 13, 13, the brachial plexus ; 14, 14, the lum- 
bar and sacral plexus. 

The Brachial Plexus is formed by the interlacing of the four lower 
cervical and upper dorsal pairs of nerves. It gives off six nerves, 
which are distributed to the muscles and skin of the upper extremi- 
ties. 

The Lumbar and Sacral Plexus is formed by the last dorsal and 
five lumbar nerves, from which nerves go to the muscles and skin of 
the lower extremities, and the last lumbar and four sacral, from 
which nerves are sent to the muscles and skin of the hirjs and lower 
extremities. 

The Sympathetic Nerve consists of a series of knots (ganglia), 
lying along on each side of the spinal column, and forming a knotted 
chain. There is a knot for each intervertebral space, the neck ex- 
cepted. These knots are composed of both cineritious and medullary 
matter. 



ANATOMY. 



49 



Each knot is a distinct centre, and gives off branches upward, 
downward, externally, and internally. All the internal organs are 




Fig. 50 



Fig. 61. 



It is called the 



supplied with branches from the sympathetic nerve, 
nerve of organic life, and is supposed to 
preside over nutrition, secretion, etc., as the 
nerves of the brain and cord preside over 
motion and sensation. 

Fig. 51 is a fine representation of the 
great sympathetic, with its knots, and con- 
nections with other nerves. A, A, A, is 
the semilunar ganglion and solar plexus, 
lying just under the diaphragm and behind the stomach. Its pres- 
ence in this region is the reason why a blow upon the pit of the 
stomach sometimes destroys life. D, D, D, are the thoracic ganglia ; 
E, E, the external and internal branches of the same ; G, F, the 
right and left coronary plexus upon the heart ; I, N, Q, the inferior, 
middle, and superior cervical ganglia; 1, the renal plexus around the 




Fig. 52. 



50 ANATOMY. 

kidneys ; 2, the lumbar ganglion ; 3, the internal branches ; 4, the 
external branches ; 5, the aortic plexus. 

Fig. 52 represents a plexus, showing how the filaments of one 
nerve pass to be enclosed in the sheath of another. In this way they 
change at once the direction of their journey, and their companions 
upon the way. 

The Organs of Sight, 

The organs of vision are the optic nerve, the globe of the eye, the 
muscles of the eye, and the organs of protection. 

The Optic Nerve begins by two roots at the base of the brain, the 
fibres from which meet, as they come forward, and some of them cross 

each other. The two nerves then sepa- 
rate, and enter the back part of the 
globe of the eyes, and then spread out 
into a kind of membrane. In Fig. 53 : 
1,1, show the globe of the eye ; 2, the 
crossing of the optic nerve ; 8, the 
origin of two pairs of cranial nerves. 

The Globe of the Eye is a better 
constructed optical instrument than 
man ever made. Its interior is filled 
with what are called refracting humors 
f™- 53 - or mediums, which are surrounded and 

held in their place by membranes, called coats. 

The Coats are the sclerotic and cornea ; the choroid, iris, and ciliary 
processes ; and the retina. 

The Sclerotic Coat is a fibrous membrane, covering the largest 
portion of the globe. To this the muscles are attached. It is the 
part which is called the white of the eye. It has a beveled edge in 
front, into which the cornea is fitted. 

The Cornea is a transparent layer which projects in front, and forms 
about one-fifth of the globe. It is shaped like a watch-glass. Its 
blood-vessels are too small to receive the red particles of blood. 

The Choroid Coat is a vascular membrane. Its color is brown ex- 
ternally, and black within. It is connected with the sclerotic coat 
externally, and internally with the retina. It is composed of three 
layers. 

The Iris is named from its having a variety of colors in different 
persons. It is the partition between the anterior and posterior cham- 
bers of the eye, and has a circular opening in the centre called the 
pupil. Of its two layers, the fibres of the anterior one are radiating, 
and dilate the pupil, while those of the other are circular, and cause 
its contraction. 




ANATOMY. 



51 



The Ciliary Processes are a number of folds formed from the in- 
ternal layer of the choroid coat. 

The Retina has three layers. The external is extremely thin ; the 
middle is nervous, being an expansion of the optic nerve ; the in- 
ternal is vascular, and consists of a ramification of minute blood 
vessels. 

The divided edge of their coats may be seen in Fig. 54, namely, 
the sclerotic, the choroid, and the retina : 2, is the pupil ; 3, the 
iris ; 4, the ciliary process ; 5, the scolloped border of the retina. 




Fig. 54 



Fig. 55. 



The Humors of the Eye are the aqueous, the crystalline, and the 
vitreous. 

The Aqueous or watery humor is situated in the chambers of the 
eye. It is an albuminous fluid, with an alkaline reaction, and a spe- 
cific gravity a little greater than distilled water. 

The Crystalline Humor is immediately behind the pupil. It is a 
lens, and is convex both on the posterior and the anterior surface. 

The Vitreous Humor is also an albuminous fluid something like the 
aqueous humor, but more dense. 

In Fig. 55 we have in E a good view of the cornea fitted into the 
sclerotic coat ; A, is the choroid ; B, the pigmentum nigrum , C, 
the retina ; K, the vitreous humor ; D, the optic nerve ; I, the lens ; 
C, the Iris, painted on the backside with pigment; F, the aqueous 
humor. 

The muscles of the eye, six in number, are attached to the bones 
of the orbit behind, and to the cornea in front, by their tendons. 
These tendons give the eye its pearly appearance. In Fig. 56, 
five of the muscles are indicated by a, b, c, d, e; /, is the optic 
nerve. 

If the internal muscle be too short, the eye is drawn in towards 
the nose, and the squinting called " cross-eye " is produced. 



52 



ANATOMY. 



The Orbits are bony sockets which enclose the eye. The optic 
nerve passes through a large hole at the bottom. 

The Eyebrows are the projecting arches above, covered with short 
hair. They prevent the sweat from running down into the eyes, and 
also shade them from strong light. 

The Eyelids are the curtains which rise and fall in front. The 
smooth membrane which lines them is called the conjunctiva. It 
secretes a fluid which makes the eyelids open and shut easily. 




fig. 56. 



Fig. 57. 



The Lachrymal Gland is at the upper and outer angle of the 
orbit. Several small ducts open from it upon the upper eyelid, 
through which the tears run down upon the conjunctiva. 

The Lachrymal Canals begin near the internal angle of the eye, 
by two small-tear points, which communicate with the sac at the 
upper part of the nasal duct. 

The Nasal Duct is a canal about three-quarters of an inch long, 
which runs down to the inferior channel of the nose. 

Fig. 57 shows these organ : 1, being the lachrymal gland ; 2, the 
ducts leading to the upper eyelid; 3, 3, the tear-points (puncta 
lachrymalis) ; 4, the nasal sac ; 5, the termination of the nasal duct. 



The Organs of Hearing. 

The External Ear is composed of the pavilion of the ear (the pinna), 
and the auditory canal (the meatus auditorius externus). 

The Pinna surrounds the entrance to the auditory canal. It stands 
out from the head, and is in common language called the ear. 

The rieatus Auditorius in a canal about an inch long, partly bony 
and partly cartilaginous, which goes from the pavilion of the ear to 
the drum of the ear. 

The Drum of the Ear (membrana tympani) is an oval-shaped thin 
membrane, inserted into a groove around the auditory canal. 



ANATOMY. 



53 




The Tympanum is a cavity within the temporal bone. 

The Eustachian Tube is a 

channel of communication be- 
tween the tympanum and the 
upper part of the pharynx. 
The object of this is to convey 
air to the drum of the ear, as 
without air no sound can be 
produced. 

The Labyrinth is a series of 
chambers through the petrous 
bone — embracing the vestibule, 
a three-cornered cavity within 
the tympanum ; the semi-circu- 
lar canals, communicating with 
the vestibule, and the cochlea, FlG - 58 - 

which makes two and a half turns around an axis, called the 

modiolus. 

In Fig. 58, a, is the pa- 
vilion of the ear ; e,' the 
auditory canal ; g, the mem- 
brana tympani ; k, the tym- 
panum ; e, the bones of the 
ear ; b, the semicircular ca- 
nals ; /, the cochlea; h, the 
vestibule ; i, the eustachian 
tube ; d, the auditory nerve. 
In Fig. 59, we have a 
view of the labyrinth laid 
open, and highly magnified : 
1, 1, being the cochlea; 2, 
3, the channels that wind 
around the central point 
(5) ; 7, 7, the vestibule ; 8, 
the foramen rotundum; 9, 
the fenestra ovalis ; 4, 6, 10, the semicircular canals, 




PHYSIOLOGICAL LAWS OF LIFE AND 
HEALTH. — HYGIENE. 



Life, the Infancy of Being. 

It may be stated as a general truth that man has but just learned 
to live when he is ready to die. We expend a large portion of our 
lives in searching out our mistakes, and in striving to undo the mis- 
chiefs they have occasioned. This is true in reference both to our 
moral and our physical life ; and I draw from it the conclusion that 
the present must be only the infancy of our being, and that our blun- 
ders and consequent sufferings here will cause us, in the great here- 
after, to place a higher value upon knowledge, and to struggle with 
new fortitude to rid ourselves of every bondage. 

A life which has just begun to take shape and symmetry, cannot 
be permitted, I think, under the rule of a benevolent Creator, to be- 
come extinct. We shall certainly be permitted to take up the broken 
thread of life, and, in the clearer light of the future, with the warning 
experience of the past, and surrounded by better guards, to try again. 
In the meantime, while here, the sooner we become acquainted with 
the laws of life, and the better we obey them, the more we shall en- 
joy- 

The Nervous System. 

Man is brought into connection with the outward world through 
the senses of feeling, seeing, hearing, etc. These communicate with 
the brain and mind through the nerves of sensation. 

The nervous system is divided into two great central portions, 
the brain and the spinal cord ; and these together are called, by the 
learned, the cerebrospinal centre. There are numerous pulpy white 
cords, called nerves, which at one end are connected with this great 
axis or centre, and from thence run to all parts of the system. A 
portion of these nerves start from the base of the brain and run to 
the eye, the ear, the tongue, etc. (Fig. 48) ; while another, and a 
larger part spring from the cord which runs through the backbone, 
and are distributed over the body and the lower extremities (Figs. 
50 and 60). One portion of these cords produce feeling ; another 
part, motion. The former we call sensitive ; the latter, motor. Both 
kinds are widely distributed over the body. Those which spring 
from the spinal cord have two roots, one uniting with the back, the 

54 



1 £r' 










Copyright, by Bradley & Woodruff, i8q: 




Copyright, by Bradley & Woodruff, 1802. 



/ 



/ 



/ 



HYGIENE. 



55 



other with the front part of the cord. Cut off the back root, and the 
part to which it is distributed loses its feeling. As we say in com- 
mon language, it be- 
comes numb, though it 
may move as well as 
before. Cut the front 
root, which is motion- 
producing, and the part 
to which it goes cannot 
move. It is palsied. 
though it may still feel 
acutely. The numerous 
nerves that spring from 
the spinal column are 
pretty well represented 
in Fig. 60. 

If the cranial nerves 
of motion which go to 
the face be cut, no emo- 
tion or passion can be 
expressed. The features 
will all be immovable, 
like statuary. To smile, 
to laugh, to frown, to 
give expression to the 
feeling of pity, or an- 
guish, or love, is alike 
impossible. And yet a 
breath of air upon \he 
face will be felt as readi- 
ly as before. Paralysis, 
or palsy, as it is called, 
partial or general, is the 
result of injury uponfew 
or many of these motion- 
producing nerves. Neu- 
ralgia, tic douloureux, 
etc., arise from some 
disease, perhaps inflam- 
mation, of the nerves of fig. eo. 
sensation. 




How the Mind gets Knowledge. Everything the mind knows 
of the external world, it learns through the the organs of sense, which 
communicate with it through these nerves. Thus, the nerves are 
acted on by external agents, and then they act on the brain and cause 
sensations. When the hand is burned the nerves of sensation run 
with the intelligence to the brain, which, quick as thought, through 



56 HYGIENE. 

the nerves of motion, despatches orders to the muscles to repel the 
injury. 

Comparison. — The arrangement and operation of the nervous 
system are like those of the electric fire-alarm system of a city. 
The brain is the intelligent centre, like the central office. The 
nerves of sensation which carry to the brain, with electric speed, 
intelligence of what is going on outside, are like the wires which run 
to the central station from the several boxes. The quick earry- 
ing to the brain of any information of injury done to some part of 
the body, is like sending to the central station from an alarm-box 
the intelligence of fire in one of the districts. The rapid transmis- 
sion of orders from the mind to the muscles is like flashing the alarm 
over the wires to every part of the city. And, finally, the powerful 
action of the muscles in warding off danger is like the dashing of 
firemen over the pavements and the energetic playing of the 
engines. 

Sensations. 

An effect produced on the mind through a nerve is called a 
sensation. Hunger is a sensation. It is an effect produced upon the 
mind through a certain nerve by the condition of the stomach. 
Thirst, pain, heat, cold, are sensations in a similar sense. Nausea 
is a sensation produced by some injurious substance acting upon the 
coats of the stomach. 

Strength of Sensation. — Some sensations are much stronger 
than others ; some are very intense. A ver} T strong sensation is 
called a feeling. It is common to say, "I feel cold," or, " I feel hot." 
We simply mean by this, that the temperature of the weather makes 
a very powerful impression upon us. 

Kinds of Sensation. — Sensations are either pleasurable or pain- 
ful. Pleasurable sensations arise from the proper exercise of some 
healthy part of the body ; and they are a suitable reward for any 
care the mind may take of the corporeal organs. 

The sensations arising from a proper amount of exercise are 
pleasurable. The muscles find a sort of enjoyment in action. He 
who leads a sedentary life, either from choice or necessity, loses much 
enjoyment. Hence, there is pleasure in labor ; and the working-man, 
though often pitied by the wealthy, is generally the happiest of men.* 
The eye and the ear, when directed to agreeable sights and sounds, 
derive the most agreeable sensations from exercise. The air of a 
beautiful spring-morning gives impressions which none can describe, 
but which all know to be delightful. These impressions are well 
fitted to reward us for taking at that season, in the open air, the ex- 
ercise we so much need. 

Moral Uses of Sensations. — How little we reflect upon the 
amount of happiness it is in our power to create by making agreeable 



HYGIENE. 57 

impressions upon others. A civil and polite address makes a pleasant 
impression. A kind word, fitly spoken, makes the heart glad. Heads 
of families might do much to increase the happiness of their domes- 
tics in the kitchen by meeting them with a pleasant countenance, and 
dropping in their ear, now and then, a word of approval. Such, little 
acts of benevolence are easily performed, and they make the most 
agreeable and lasting impressions upon persons in the lower stations 
of life, — creating attachments, in fact, which end only with death, 
and which in hours of future sorrow, which come to all, may refresh 
us like springs of water in the desert. 

" Full many a shaft at random sent, 
Finds marks the archer little meant; 
Full many a word at random spoken, 
May heal a wounded heart that's broken." 

Sir Walter Scott. 

In aiming to make agreeable impressions upon domestics, we should 
be governed by the simple desire to create happiness. Their sources 
of happiness are comparatively few. They spend their days below 
stairs, — shut out from a portion of the light of day, and from the 
refining influences of the drawing-room, — having little time for rest 
or for recreation. How unfeeling to treat such persons with harshness, 
to wear a frowning face in their presence, and thus wither the few 
flowers of happiness which bloom around them! 

Every human being is endowed with the beautiful nervous organ- 
ism of which I have spoken, and is daily receiving impressions, pleas- 
urable or painful, from thousands of sources. In all the relations of 
life, it should be our aim to touch delicately this sensitive structure. 
Wives may add much to the happiness, and I may say, to the affec- 
tion of their husbands, by always wearing a pleasant face ; and the 
heart of the wife may be made light and glad by gentle words from 
the husband. We cannot but love those who make pleasurable im- 
pressions upon us, and we necessarily dislike such as impress us pain- 
fully. Most of the coldness and alienations which grow up between 
the heads of families, spring from the habit of one of the parties, of 
saying, or doing, or looking something which painfully impresses the 
other. A woman who habitually wears a "sour" face cannot be 
loved either by her husband or her children. The man or the woman 
who desires to be loved, must cultivate a manner, a look, a speech, a 
life, the whole scope of which is fitted to make pleasurable impres- 
sions upon others. It is against nature to love what gives us pain. 

Agreeable Sensations a Source of Health. — Pleasurable sensa- 
tions not only beget love, and increase happiness, but they add much 
to health. They exhilarate the spirits and drive away melancholy. 
Travelling promotes health and prolongs life, by the number and 
variety of the pleasing impressions it makes upon the mind. 

Care of the Sick. — If the above statements be correct, how im- 
portant that the sick should be so dealt with as to have none but 



58 HYGIENE. 

agreeable sensations made upon them. Many a life has been sacri- 
ficed to the peevish temper of a nurse. When the nerves are weak 
from disease, even slight causes make powerful impressions ; and if 
these impressions are of a painful kind, the results are most deplora- 
ble. To treat harshly the sick, especially those whose nervous system 
is broken, implies either great thoughtlessness or extreme cruelty. A 
single harsh word, which would scarcely move one when well, may 
send the same person, when sick, almost to distraction. Every word 
spoken to persons in sickness should, therefore, be gentle and sooth- 
ing. Every feature of the face should express either cheerfulness, 
or tenderness and pity. 

As the painful impressions which disease is making tends to de- 
press the spirits and create melancholy, it is not expected that persons 
when sick will exhibit as amiable tempers as when well ; and for 
this all due allowance must be made. 

Effect upon the Disposition. — This leads me to say that pleasur- 
able sensations improve the temper and disposition. This is a fact of 
very great importance, and parents should never lose sight of it in 
dealing with their children. There are few children but would grow 
up amiable and useful members of society, were they dealt with in 
the gentle and tender manner which their young and impressible 
natures require. From the moment the young mind wakes to intelli- 
gence, it will be occupied with something. Parents and guardians 
should aim, therefore, to turn it to all those things which will impress 
it pleasantly, and at the same time do it no harm. Exercise, songs, 
playthings, flowers, — to these and other entertainments it should be 
led by gentle hands. No thoughtful parent will ever pain a child 
by harsh threats and denunciations, or shock it by an oath. 

Bad Effect of Unpleasant Sensations. — If pleasurable sensations 
improve the health and temper, unpleasant ones do just the opposite. 
They break down the health and spoil the disposition. 

They are intended to give us a warning of impending injury. 
Thus, we have painful sensations when we have overworked the body 
or mind. The sensation of weariness tells us that the muscles have 
worked as long as their good requires, and that they need rest. Were 
this sensation unheeded, exhaustion and entire prostration would be 
the result. 

When fatigue begins to be felt, either of body or mind, the sensa- 
tion may be dissipated by strong tea, or intoxicating drink, or opium; 
but to drive it away in this manner, for the purpose of working longer, 
is wrong, and leads, in the end, to disease or exhaustion. It was said 
that one of the most brilliant advocates of recent times was dependent 
upon opium for the stimulus to carry him through his extraordinary 
flights of eloquence; but his restless motion and nervous face reminded 
one that he had bent his bow very nearly to the snapping point, and 
that a sudden collapse of his vital powers, at no distant day, might 
be feared as the result of such tension. 



HYGIENE. 59 

Persons in affliction, whose spirits are depressed and broken by 
sorrow, should have their thoughts turned away from all sombre ob- 
jects and contemplations. They should be taken into the open sun- 
light, and be diverted by the beautiful things of nature. They 
should visit cheerful society, and open their hearts to pleasurable im- 
pressions. 

When we permit any part of the body to remain idle, neglecting 
to use it as much as we ought, unpleasant sensations remind us of 
our fault. The muscles, when unused, waste away and become 
feeble. This is sure to produce an uneasy, nervous state of feeling, 
which says to us as plainly as a sensation can, that the muscles are 
hungry for exercise, and that it is injurious to let them rest longer. 

Need of a Healthy Brain. — In order that we may get correct 
ideas of the external world, it is necessary that the brain, the nerves, and 
the organs of sense through which sensations are made upon the 
mind, should be in a healthy condition. It is evident that if the in- 
struments of sensation be diseased, the sensation cannot be natural, 
and will make a false report to the mind. It is of the highest im- 
portance, therefore, that the brain should be sound. 

Improper Intermarriages. — This organ, like every other, 'may 
inherit disease from parents. Insanity, which springs from a dis- 
eased brain, is often hereditary. When both parents are diseased, 
the offspring are of course more liable to partake of their defects. 
Among the wealthy, and particularly among the royal families in 
Europe, nervous diseases and sterility are very common. This 
arises, in a great part, from intermarriages among blood relations, — a 
practice under which any people will degenerate, and finally perish. 
The wisdom of the Old Testament prohibition of marriage within 
certain degrees of consanguinity has been established by the obser- 
vation of philosophers and the experience of mankind. Let those 
who will transmit to their descendants a sound mind in a sound 
body, observe the laws of life, and avoid all marriages with blood 
relations. 

Need of a Good Supply of Blood. — For a proper performance 
of its duties, the brain requires and receives a larger supply of blood 
than any other part of the system. One-tenth of all the blood goes 
to this important organ. If the quantity or quality be materially 
lessened or changed, great disturbance of the brain follows. A large 
loss of blood occasions dizziness and fainting. If an atmosphere 
charged with too much carbonic acid gas be breathed, as in a deep 
well, the blood is not vitalized in the lungs, so as to sustain the 
brain, and unconsciousness soon follows. If the air be vitiated in 
any way, or have its oxygen extracted, as in large assemblies, where 
it is breathed over several times, it becomes unfit to support the 
brain, and the result is languid feelings, inability to apply the mind, 
headache, fainting, hysterics, and other nervous manifestations. 



60 HYGIENE. 

Ventilation. — This shows the great necessity of having dwellings, 
churches, and school-houses well ventilated. 

Were a good system of ventilation adopted in all our churches, 
ministers would seldom preach to sleeping audiences. A congrega- 
tion sitting in one of our places of public worship, where the air in 
a single afternoon is as many times used over as the minister's ser- 
mons are in a lifetime, can neither hear with attention, nor compre- 
hend with clearness. 

In many of our school-houses, the ventilation is quite as bad, and 
the consequences worse, because they are occupied six hours of the 
day instead of three, and five days of the week in place of one. In 
the small school-houses which our children filled to overflowing in 
former years, in which there was no ventilation, unless they happened 
to be blessed with an old-fashioned chimney and fire-place, the effects 
upon the nervous system of the children was deplorable. Many of 
the diseases which afflict the present generation of men and women 
had their origin in the bad air of those crowded nurseries of edu- 
cation. 

Our dwellings were partly ventilated in olden time, when the 
open fire-place received the " back -log," the « top-stick," the " fore- 
stick," and other sticks to match ; but since we have been warmed 
by the stove and the .furnace we have known little of the luxury of 
pure air at the domestic hearth. 

Need of Exercise for the Brain. — Health requires that the 
brain should be properly occupied with vigorous thought. The 
same reasons may be given for this as for the exercise of the muscles. 
It is governed by the same laws which apply to other parts of the 
system. Use improves its strength and vigor ; idleness causes it to 
grow feeble. Of course the labor it is put to should be only reason- 
able in amount, and should not be too long continued at any one 
time. With the weakening of the brain, the whole bodily forces, 
and indeed the whole mental and moral character, fall into feebleness 
and decay. It is a great mistake to suppose that the cultivation and 
even vigorous use of the mind impairs health and shortens life. 
Just the opposite is true. Many of the most eminently intellectual 
men, who have worked their brains hard all their lives, have been 
distinguished for long life. 

Bad Effect of Change in Circumstances. — No class of persons 
suffer more from nervous diseases and general ill-health than those 
who, having worked hard in early life, with little or no cultivation 
of the mind, are suddenly raised to wealth, and immediately drop all 
exercise, and fall into habits of indolence and luxury. The condition 
of such persons would be much less pitiable, did they take up books 
when they lay by the hoe or the broom. But they seldom do this. Many 
a woman, in early life, has felt the glow of health in every limb, 
and a thrill of pleasure, too, while scrubbing -the floor on her hands 






HYGIENE. 61 

and knees, who has, in subsequent years, reclined in misery upon 
her damask-covered lounge, and wondered that she could not have 
the health of other days. Let her cultivate her brain, live temper- 
ately, and exercise in the open air, and life may again have real 
pleasures for her. 

Discretion in Exercising the Brain In exercising the brain 

we must use discretion. We must not sit down in the morning, and 
ply it with work during the whole day, without rest. This would 
soon bring upon it disease, or premature decay. It should be worked 
only until it begins to show symptoms of fatigue. Then it should be 
permitted to rest ; or, what is better, be turned to some new subject, of 
a lighter, or a different character. Tins often rests the brain better 
than to entirely suspend its action. 

Overworking the Brain in Childhood. — Great care should be 
used not to exercise the brain too much in early life. Like other 
parts of the system, it is tender in childhood, and will not bear pro- 
longed exertion. As a general thing, children are put to school too 
early, and made to work their brains too hard. Great mischief arises 
from this source. Children are born with larger brains now than 
formerly ; and it is no uncommon thing to see upon a child of ten 
years, a head equal in size to that of an adult. Children run to 
brain. Precocity in development of brain and mind is common. 
The results of stimulating and hastening the unfolding of such minds 
are deplorable. In such children, the brain should be the last thing 
to be cultivated. We do not need to urge its growth. It will come 
forward fast enough in spite of us. Our chief aim should be to harden 
and fortify the general constitution, so that the brain which it is 
required to bear up and sustain may long be its crown and glory. 

Yet parents are proud of their precocious children, and often re- 
verse this rule. They do it thoughtlessly, and would be terribly 
startled could they suddenly look into the future and see the results 
of their folly. Could they do so, they would see inflammation and 
softening of the brain, epilepsy, insanity, paralysis, apoplexy, with all 
the horrors of undescribed and indescribable nervous affections, which, 
though without a name, have a terrible reality. 

Old People's Brains. — Persons in advanced life should be par- 
ticularly careful not to overwork the brain. In middle life it re- 
covers easily from great fatigue. In the decline of life, its powers 
of recovery are feeble. A single exhaustion may cause its fatal col- 
lapse. Old age should be distinguished for gentleness and modera- 
tion. The journey of the down-hill of life should be made by short 
and easy stages, through regions of diversified beauty. 

A Supply of Blood. — Every part of the system, when hard at 
work, needs and must have a very large supply of pure blood. 
Without this, it is torpid and inactive. To cause the blood to flow 
to any particular part, it must be exercised. The lumberman, when 



62 HYGIENE. 

in the forest in extreme cold weather, stamps his feet violently upon 
the ground, or beats them against a log, and whips his hands around 
his body, and in this way makes them red and warm with a new 
supply of blood. The stomach, when it has received a supply of 
food, begins earnestly to turn it over ; and by this exercise, and the 
stimulus which the food supplies, it invites large quantities of blood 
to its vessels, and thus increases its power to work. But just in 
proportion that it draws the vital current to itself, and augments its 
oiv n vital force, it diminishes the blood in other organs, and for the 
time being, unfits them for work. The same may be said of the 
brain and all other working organs. 

From this it follows that only one organ, or set of organs, can 
work effectively at the same time, and that it is improper to put the 
brain to hard work immediately after a full meal, because the 
stomach then wants the blood to enable it to digest the food ; and if 
the blood be called off to the brain, digestion will stop. Nor should 
the stomach be loaded with food directly after long and hard 
thinking ; for the brain will yield up the blood to it only after its 
own excitement has had time to subside. 

Sympathetic Nervous System. 

The object of this system seems to be to bind all parts of the 
body together, and to combine and harmonize their actions. It takes 
care that no part of the system acts in such a way as to injure any 
other part. It exerts a controlling influence over digestion, nutrition, 
absorption, the circulation, etc. These are natural processes which 
need to go on while the brain is asleep and cannot attend to them. 
The nervous system, of winch I speak, presides over all those func- 
tions which are called involuntary, — so called because no act of the 
will is needed for their performance. Secretion, absorption, digestion, 
and the circulation of the blood, all have to go on while we sleep, as 
well as while we wake. Were an act of the will necessary to their 
performance, as in walking, eating, conversing, etc., then they would 
have to cease the moment the brain fell asleep, and death would be 
the result. 

The sympathetic nerves apprise each part of the system of the 
condition and wants of every other part. When the lungs are in- 
flamed, the stomach seems to be aware of it, and will receive no food, 
because this would aggravate the disease of the neighboring organs. 
Well would it be if human beings would exercise a like forbearance, 
and abstain from those acts of self -gratification which they know will 
injure their neighbors. 

Effects of Nervous Diseases. — Before closing these observations, 
I wish to add a few words respecting the terrible effects of nervous 
diseases which characterize the present time. 

That they are far more numerous and afflictive than in former 



\ 



HYGIENE. 63 

years, must be apparent to the most careless observer. They are 
nothing more nor less than the price we pay for a high civilization, 
and especially for our democracy. Among us, every man feels his 
individuality, and has a motive for thinking and doing his best. 
Thought and action are here unfettered ; and if the race is not to 
the swift, nor the battle to the strong, every man acts as though he 
thought it was. The great excitement which the struggle for wealth 
kindles and inflames, deranges and shatters the nervous system to a 
shocking degree. 

And wealth, when obtained, does its full share to weaken the 
nerves. It brings with it high living, indolence, loss of energy, dis- 
sipation, and a weakening of the whole moral and physical powers. 
It need not do this ; but, in most cases, it does. 

The result is, that, at least, every other person has some nervous 
disease, which makes life a misery rather than a blessing. The brain 
and nerves are too much developed in comparison with the develop- 
ment of the muscles. Half our boys and girls have heads as large 
as men and women. It is common to see a boy or a girl at ten talk- 
ing and acting like a man or woman. I do not mean by this, that 
they imperfectly imitate the actions of older persons. It seems to be 
natural to them. Their brains are prematurely developed, and their 
acts and thoughts have the maturity of adult life. 

What is Coming ? — What will be the result of this state of 
things, no man can predict. I sometimes think the race will break 
down ; that that which was intended to be its ornament and strength 
will be its destruction. I hope not. Yet there is danger of it. 
Nothing can save us but the wisdom to adopt such means as will 
develop all parts of the system alike. No race of men can stand for 
many generations such a strain upon the nervous system, unless bet- 
ter means are adopted to counterbalance its evil effects than are now 
used in the United States. We have got to pause in our swift 
career, and look after our health, or we shall become a nation of 
maniacs. No proof is needed of what is here said. 

Hopeful Considerations. — It is proper to say, the considerations 
here presented, terrible as they are, are mitigated in some measure by 
others of a more hopeful character. 

Physiology and the laws of life are now better understood than at 
any former period. These subjects are getting into our common 
schools, and are engaging the attention of our youth. Declining 
health has already made us think more of the means of preserving 
it, — such as diet, exercise, bathing, travelling, and amusement. To 
encourage and intensify this hopeful direction of the public mind, I 
propose to devote a few pages to these subjects. 



64 HYGIENE. . 

Food and Digestion. 

From the earliest dawn of existence to the last moment of life, our 
bodies are constantly changing. Old particles of matter, when they 
are worn out, leave their places and are thrown out of the system. 
Were this the whole of the matter, our bodies would soon waste 
away, and that would be the end of us. But as fast as the old mate- 
rials are thrown away, new ones take their places ; and it is solely 
out of our food that these new materials are formed. 

In order that the food may be well digested, it must first be broken 
into small particles in the mouth. The act of chewing it is called 
mastication. During this act, if it be well performed, a large quan- 
tity of spittle, called saliva, flows out of a number of glands, called 
salivary glands, and mixes with the food, forming with it a soft mass. 
In this condition, it is thrown backward into the top of the throat, 
called the pharynx. Here, a little cartilage, called the epiglottis, 
drops down upon the opening into the top of the windpipe, and pre- 
vents its entrance into the breath-passage ; and it is pushed along 
into the gullet, a tube which runs down behind the windpipe and 
lungs, and which physicians call the oesophagus. Here a succession 
of muscular bands, circular in shape, contract upon it, one after 
another, and force it down into the stomach. 

It is important that two things should be secured while the food is 
in the mouth, namely, that it should be reduced to a good degree of 
fineness by chewing, and that a proper amount of saliva should be 
mixed with it. If the chewing were not necessary, teeth would not 
have been given us ; and the salivary glands would certainly not have 
been put in the mouth, if the mixing of water with our food would 
serve the purposes of digestion as well. 

Eating too Rapidly. — Americans have fallen into a pernicious 
error in eating their food too rapidly. Time is not given to chew it 
sufficiently to excite a full flow of saliva ; and as it cannot be swal- 
lowed in a dry state, it is not uncommon to see persons taking a sip 
of water after every second mouthful, to enable them to force it into 
the stomach. It is a habit we Americans have of cheating ourselves 
both of the pleasures and the benefits of eating ; for the only real 
pleasure of eating arises from the flavor of food while retained in the 
mouth, and the only benefit we can derive comes in consequence of 
its proper digestion. 

The food when received into the stomach is in the same condition 
as when taken into the mouth, except that it is, or should be, ground 
fine by the teeth, and well mixed with saliva. 

The Gastric Juice. — The stomach, like the mouth, the windpipe, 
and the gullet, is lined by a mucous membrane. The chief office of 
this membrane is to secrete, or take out of the blood, a fluid which 
we call gastric juice, which means stomach juice, from the Greek 



HYGIENE. 65 

name of stomach, yaa-rep (gaster). This fluid has not much smell 
or taste, and looks like spring water. It has a powerful effect upon 
food, which, when mixed with it, soon undergoes an important 
change, which is apparent to the taste, the smell, and the sight. The 
nature of the gastric juice and how it produces its effect upon food 
are not certainly known ; but it contains two active elements, — a 
free acid and pepsin, whose function is to dissolve the nitrogenous 
parts of the food and convert them into albuminose or peptone. The 
albuminose is absorbed by the coats of the stomach and enters 
directly into the circulation ; while the sugar and fat pass on to the 
duodenum to 'be acted upon by the bile, the pancreatic juice, and 
other secretions of the bowels. 

Too Much Cold Water at Meals. — There are some interesting 
facts connected with the formation of this fluid, of which it is im- 
portant that every person should be apprised. 

Its quantity and quality depend on the amount and healthfulness 
of the blood which flows to the stomach during the first stage of 
digestion. It is, therefore, injurious to drink large quantities of very 
cold water with, or immediately after, our meals ; as this will chill 
the stomach, and repel the blood from its vessels, so that but little 
of the juice can be formed. Digestion, in such case, must be im- 
perfect. 

This Fluid not Secreted Without Limit. — This fluid does not 
flow into the stomach continuously, but only when we swallow food, 
and then not as long as we please to eat, but merely till we have taken 
what the system requires. If, in the amount we take, we go beyond 
the wants of nature, there will not be fluid enough formed to dissolve 
it, and the whole will be imperfectly digested, and be a source of in- 
jury rather than benefit. This should teach us to be careful that our 
food be only reasonable in amount. 

Not Secreted in Sickness. — When we are sick, the gastric juice 
is either not formed at all, or only in small quantities. Whatever 
may be our feelings of lassitude, and however much we may appear 
to need food, at such times, it is useless to take it, for it cannot be 
digested, and will only aggravate our disease. If the illness be only 
slight, the fluid will be formed to some extent, and food may be 
taken in proportion. 

Its Secretion Favored by Cheerfulness. — A cheerful disposition, 
and a happy, lively frame of mind, are highly favorable to the pro- 
duction of the gastric juice ; while melancholy and anger and grief 
and intense thought of business, at the hour of meals, greatly hinder 
its natural flow. 

This should teach us to go to our meals with light hearts, and to 
make the family board a place of cheerful conversation, and of a light 
and joyous play upon the mirthful feelings of all present. Should 
any of the family circle be in the habit of using vinegar as a condi- 



66 HYGIENE. 

ment, we should never be guilty of compelling them to extract it 
from our faces. A vinegar face is not easily excused anywhere ; at 
the table it is unpardonable. A single countenance of this description 
will throw a gloom over a tableful of naturally cheerful persons ; and 
if habitually present at the board, may finally spoil the digestion of 
half a dozen, and entail dyspepsia upon them for life. 

The stomachs of the sick pour out but very little of this fluid, and 
they can take but a small amount of food. It is cruel to deprive 
them of the power of digesting that little by treating them harshly, 
and filling them with gloomy and desponding feelings. I therefore 
repeat the substance of the advice given on a previous page : Deal 
gently with the sick. 

How all this is Known. — As the stomach is wholly concealed 
from view, the reader will very naturally ask how it is known that 
the gastric juice is poured into it in certain states of the mind, etc., and 
withheld in others. It certainly could not have been so accurately 
known, had it not been for an accident which opened the living and 
working stomach to the inspection of Dr. Beaumont, a United States 
Surgeon. A young man by the name of Alexis St. Martin, a Cana- 
dian by birth, but then in the State of Michigan, had a large part of 
his side torn away, and a hole of considerable size made into his 
stomach, by the accidental discharge of a gun. To the surprise of 
his surgeon, St. Martin recovered ; and the edges of the wound in the 
stomach refused to grow together, preferring rather to fasten them- 
selves to the borders of the breach in the side, thus leaving the pas- 
sage open. A kind of curtain grew down over this, which prevented 
the food from falling out. Dr. Beaumont, taking advantage of this 
state of things, instituted a series of valuable experiments, by lifting 
the curtain, and inserting various articles of food, and witnessing the 
process of digestion. 

Movement of the Stomach. — The presence of food in the stom- 
ach causes its muscular coat to contract and throw it about from side 
to side, mixing it thoroughly with the gastric juice, and reducing it 
to a pulpy mass, called chyme. This, as fast as it is properly pre- 
pared, passes through the pylorus into the upper bowel, or duodenum, 
called also the second stomach. 

Chyme. — A certain witty professor of anatomy and physiology 
was in the habit of asking his class if they ever saw any chyme ; and 
when they answered, no, as they often did, he called their attention 
to what is occasionally to be seen in the morning, upon the sidewalks, 
where drunken men have held themselves up by lamp-posts, and left 
the contents of their stomachs. 

The pylorus, or opening into the bowel, has a very singular and 
wise instinct, which is worthy of remark. When a piece of food, 
which has not been digested, attempts to pass into the bowel, the 
moment it touches the inner surface of this orifice, it is instantly 



HYGIENE. 



67 




Fig. 61. 



thrown back by an energetic contraction ; though a portion of well- 
prepared chyme, touching the same opening immediately after, is 
allowed to pass unchallenged. 

Chyle. — The chyme, when it reaches the duodenum, seems to 
cause the liver to secrete bile, and 
the pancreas to produce pancreatic 
juice. These two fluids are con- 
veyed into the upper portion of the 
second stomach, and there are mixed 
with the chyme, and cause it to 
separate into a delicate, white fluid, 
called chyle, and a residuum, which, 
being worthless, is pushed onward, 
and thrown out of the body. 

Bile in the Stomach. — Most 
persons suppose that the bile is gen- 
erally found in the stomach ; but 
this is a mistake. It is thrown up 
by vomiting, because in that act, the 
action both of the first and the second stomach is reversed, and the 

bile is forced up from the duodenum, 
— taking a direction the opposite of 
its usual course. 

Destination of the Chyle. — The 

chyle being separated from the dregs, 
is pushed onward in its course by the 
worm-like motion of the intestine ; 
and as it passes along, it is gradually 
sucked up by thousands of very small 
vessels, whose mouths open upon the 
inner surface of the bowel. These 
little vessels are called lacteals, from 
the Latin word lac, which means milk, 
because they drink this white, milky 
fluid. Fig. 61 shows a section of the 
small bowel, turned inside out, and 
covered with the villi, or root-like fila- 
ments, closely set upon its surface, for 
absorbing the chyle, and at the bottom 
of which the lacteals take their rise. 

In these lacteals, and in the mesen- 
teric glands, the chyle is gradually 
changed, so as to approach nearer and 
nearer to the nature of the blood ; but 
precisely what the change is, or how 
it is effected, is not known. Several 




Fig. 62. 



68 HYGIENE. 

learned men have published their theories upon these points, and the 
writer has opinions upon them ; but it is not worth while to trouble 
the reader with them. It is sufficient to say that the fluid is carried 
by the lacteals to the thoracic duct, through which it is conveyed into 
a large vein at the lower part of the neck, where it is poured into 
the blood, and becomes, after going through the lungs and experi- 
encing another and a vital change, the material out of which our 
bodies are daily and hourly new-created. 

Fig. 62 gives a general idea of the stomach, bowels, etc. : 9, being 
the stomach ; 10, 10, the liver; 1, the gall-bladder; 2, the duct which 
conveys the bile to 4, which is the duodenum ; 3, is the pancreas ; 5, 
the oesophagus ; A, the duodenum ; B, the bowels ; C, the junction of 
the small intestines with the colon ; D, the appendix vermiforrnis ; 
E, the coecum ; F, the ascending colon ; G, the transverse colon ; H, 
the descending colon ; I, the sigmoid flexure ; J, the rectum. 

Nature and Destination of Food. 

The food which man requires for his support and development is 
of two kinds, inorganic and organic. The first of these embraces 
certain mineral substances, as common salt, sulphur, phosphorus, 
iron and lime, either in combination or separate. 

These are not generally reckoned as aliments, and yet no human 
being can live without them. In their absence, the body decays, dis- 
integrates, and perishes. Common salt is composed of muriatic acid 
and soda. The first is an important ingredient in the gastric juice, 
and the latter promotes the secretion of bile. Sulphur is found in 
several of the tissues, particularly in the muscles. Phosphorus, 
united to fatty matter, is highly honored in forming a portion of 
the brain and nerves, and is also combined with oxygen and lime to 
make the earthy or hard part of bones. 

Found in Food. — These articles it is not necessary often to intro- 
duce into the system in a separate state. They are contained, in 
larger or smaller proportions, in most articles of food ; and man al- 
ways suffers, as all animals do, from their absence. Common salt is 
found in the flesh of animals, in milk, and in eggs. It is not very 
abundant in plants ; and we all know how eagerly domestic animals 
devour it when it is given to them, and how constantly wild cattle 
resort to the salt springs, which, in the great West, are called u buffalo 
licks." Lime exists in nearly all animal and vegetable substances. 
In wheat flour we get it in combination with phosphoric acid, that 
is, as phosphate of lime. Lime exists too, in the state of carbonate 
and sulphate, in all hard water. Iron is found in the yolk of eggs, 
in milk, in animal flesh, in potatoes, pears, cabbages, mustard and 
other articles. Sulphur we get in flesh, eggs and milk ; and, as 
sulphate of lime, in spring and river water. Phosphorus is derived 
from eggs and milk ; and flesh, bread, fruits, and husks of grain, 



HYGIENE. 



69 






£ '• % 5 



commonly called bran, contain even a larger proportion than we need 
in our diet. 

Organic Food. — The organic elements of man's food, which in 
bulk embrace almost the whole of it, remain to be considered. In the 
animal economy they serve two great purposes. A part of' the arti- 
cles which compose them are blood-formers, out of which all the 
tissues are made, — the other part produces fat, which serves to warm 
the body by being burned with oxygen. These articles are derived 
partly from the vegetable and partly from the animal kingdom. 

Divided into Four Groups. — For convenience, these articles may 
be divided into four groups. For the 
first, sugar stands as a type. We there- 
fore call it the saccharine group. It em- 
braces starch, gum, and the fibre of wood. 
These articles may all be converted into 
sugar by a simple chemical process. 
Figure 63 gives a microscopic view of 
the granules of starch. 

The second group we call the oleaginous. 
It is composed of oily substances, from 
whatever source derived, whether the an- 
imal or the vegetable world. 

The third group is the albuminous. A 
good type of it is the white of egg. 

The fourth is the gelatinous, or jelly group. 

First and Second Groups, Supporters of Respiration. — The ar- 
ticles composing the first and second groups are analogous in com- 
position, all containing oxygen, hydrogen, and carbon. They are what 
Liebig calls supporters of respiration ; the meaning of which is, in 
more comprehensible terms, that they are supporters of combustion. 
They are the fuel which warms us. They keep the fires going, from 
which arises all the heat we have in our bodies. But they are desti- 
tute of nitrogen, and, on this account, they are not blood-formers, and 
cannot be worked into flesh. Hence, man cannot live on them. 

The food articles embraced in the third and fourth groups also 
contain oxygen, hydrogen, and carbon ; and to these they add nitro- 
gen. This fourth component part, which forms only a small portion 
of them, gives them, for some reason never explained, the peculiar 
quality of producing blood and flesh. They are the raw materials, 
out of which our bodies are reconstructed from day to day. 

Feed a man ever so largely upon sugar, starch, gum, and oils, and 
he will starve as certainly as if he were allowed nothing but water. 

Names of Two Great Divisions of Food. — The possession or non- 
possession of nitrogen, then, is what distinguishes from each other 
the two great classes of food-articles. Those which contain nitrogen 



'Wm 



Fig. 63. 



70 HYGIENE. 

have been called nitrogenized, and those which are destitute of it, 
nonrnitrogenized compounds. As nitrogen is often called azote, the 
former class are more frequently named azotized ; the latter, non- 
azotized. 

Let the reader now fix it in his mind that the azotized articles of 
food produce blood and flesh ; the non-azotized, heat ; and he will 
have the key to understand much of what is to be said, and likewise 
to unlock many of the mysteries of diet. 

Nutrition Table. — Taking human milk as the standard, and ex- 
pressing the amount of nitrogen it contains by 100, the following 
table shows the relative amount of nitrogen in the principal flesh- 
producing articles of food, and consequently their power of forming 
the tissues : — 

VEGETABLE. 

Rice 81 Potatoes 84 

Rye 106 Turnips 106 

Com 125 Carrots 150 

Barley 125 Peas 239 

Oats 138 Beans 320 

Wheat 144 

ANIMAL. 

Human Milk 100 White of Egg 845 

Cows' Milk 237 Herring 910 

Oyster . . 305 Haddock 816 

Yolk of Eggs 305 Pigeon 756 

Cheese 331^47 Lamb 833 

Eel 428 Mutton 852 

Pork-Ham 807 Veal 911 

Salmon 610 Beef 942 

Other Standards of Value. — We must not infer that tnose articles 
which have most nitrogen are necessarily best adapted for human 
diet because they are the most effective blood-producers. In deciding 
the value of an article for food, other things are to be looked at be- 
sides its nutritive qualities. Those which are poor in nitrogen, are 
rich in carbon and hydrogen, and are well fitted to serve the double 
purpose of nourishing and warming the body at the same time. The 
fitness of an article for diet depends very much upon the ease or 
difficulty with which it is digested and assimilated. If an article 
having a great deal of nitrogen, and being very nutritive, is with 
great difficulty reduced in the stomach by the digestive process, it 
may be much less desirable for food than one which is digested and 
assimilated easily, but is much poorer in nutritive qualities. 

Heat-generating Food Articles. — The reader has before him the 
principal blood and tissue-forming food articles. Those which we 
reckon as fuel, or heat-generators, are chiefly oils, sugar, starch, farina, 
sago, arrowroot, tapioca, gums, etc. These are less essential than the 
others ; for the blood-forming articles have within them the ele- 
ments out of which fat is formed in the process of assimilation ; for 



HYGIENE. 



71 



many of them contain starch ; and this, in the human organism, is 



changed into fat. 
as follows : — 



The amount of starch in some of these articles is 



Wheat flour, sood quality, 100, contains 65 to 66 parts in 100 pure starch 

Wheat 108 

Barley meal 119 

Barley ....... 130 

Rye ' Ill 

Buckwheat 108 

Indian Corn 138 

Rice 171 

Peas 69 

White Beans 59 



" 53 « 


' 56 


64 ' 


' 65 


37 ' 


' 37 


44 ' 


< 47 


" 43 ' 


'44 


65 ' 


< 66 


85 ' 


'86 " " 


" 38 « 


' 39 


37 ' 


< 38 



In the Nutritive Food Articles, there is a fixed relation existing 
between the elements of the tissue-formers and the heat-producers 
which they contain. Out of a few of them Baron Liebig has con- 
structed the following table : — 



For every ten parts of blood and tissue-formers there are, — 

In Wheat flour, 10 46 In Barley, 

In Rye meal, 10 57 In Rice, 

In Oatmeal, 10 50 In White potatoes, 

In Buckwheat, 10 130 In Blue potatoes, 



10 57 

10 ...... 123 

10 86 

10 130 



Diet a Complex Subject. — From the facts and tables now pre- 
sented, it appears that the question of diet is one of complexity; and 
that the determination of its several points requires that a number of 
things should be taken into the account. First, in deciding the use- 
fulness of any article, we may inquire respecting — 

Its Digestibility. — If an article be not digestible, it is of little 
consequence how much or how little albumen, starch or nitrogen it 
may contain. The first and most important inquiry respecting it is, 
is it digestible ? If not, it is to be rejected ; for, whatever other quali- 
ties it may have, it can only injure the stomach and embarrass the 
whole system. 

The following table will be useful to the reader, though I do not 
set it down as reliable in all cases. There is often a great difference 
in the ease with which different stomachs will digest the same food. 
Many stomachs are afflicted with what is called an idiosyncrasy, — a 
habit, peculiar to itself, of rejecting or refusing to digest some one 
or more articles which are acceptable to all other stomachs. This 
table shows the length of time required for digesting the several ar- 
ticles in the stomach of St. Martin, as shown by the experiments of 
Dr. Beaumont; — 



72 



HYGIENE. 



Articles. 


Preparations. 


Time. 


Articles. 


Preparations. 


Time. 


Rice 


Boiled 


h. m. 
1 — 


Pork, recently salted 


Raw 


h. m. 
3 — 


Pig's feet, soused 


Boiled 


1 - i 


Soup, chicken 


Boiled 


3 — 


Tripe, soused 


Boiled 


1 — 


Oysters, fresh 


Roasted 


3 15 


Trout, salmon, fresh 


Boiled 


1 30 


Pork, recently salted 


Broiled 


3 15 


(< (< (i 


Fried 


1 30 


Pork steak 


Broiled 


3 15 


Apples, sweet, mellow 


Raw 


1 30 


Corn bread 


Baked 


3 15 


Venison, steak 


Broiled 


1 35 


Mutton, fresh 


Roasted 


3 15 


Sago 


Boiled 


1 45 


Carrot, orange 


Boiled 


3 15 


Apples, sour, mellow 


Raw 


2 — 


Sausage, fresh 


Broiled 


3 20 


Cabbage, with vinegar 


Raw 


2 — 


Beef, fresh, lean, dry 


Roasted 


3 30 


Codfish, cured, dry 


Boiled 


2 — 


Bread, wheat, fresh 


Baked 


3 30 


Eggs, fresh 


Raw 


2 — 


Butter 


Melted 


3 30 


Liver, beef's fresh 


Broiled 


2 — 


Cheese, old, strong 


Raw 


3 30 


Milk 


Boiled 


2 — 


Eggs, fresh 


Hard boiled 


3 30 


Tapioca 


Boiled 


2 — 


4 1 <( 


Fried 


3 30 


Milk 


Raw 


2 15 


Flounder, fresh 


Fried 


3 30 


Turkey, wild 


Roasted 


2 18 


Oysters, fresh 


Stewed 


3 30 


it n 


Boiled 


2 25 


Potatoes, Irish 


Boiled 


3 30 


" domesticated 


Roasted 


2 30 


Soup, mutton 


Boiled 


3 30 


Potatoes, Irish 


Baked 


2 30 


" oyster 


Boiled 


3 30 


Parsnips 


# Boiled 


2 30 


Turnip, flat 


Boiled 


3 30 


Pig, sucking 


" Roasted 


2 30 


Beets 


Boiled 


3 45 


Meat hashed with / 
vegetables | 


Warmed 


2 30 


Corn, green, and beans 
Beef, fresh, lean 


Boiled 
Fried 


3 45 

4 — 


Lamb, fresh 


Broiled 


2 30 


Fowls, domestic 


Boiled 


4 — 


Goose 


Roasted 


2 30 


tt << 


Roasted 


4 — 


Cake, sponge 


Baked 


2 30 


Veal, fresh 


Broiled 


4 — 


Cabbage-head 


Raw 


2 30 


Soup, beef, vegeta- | 


Boiled 


4 — 


Beans, pod 


Boiled 


2 30 


bles, and bread j 


Custard 


Baked 


2 45 


Salmon, salted 


Boiled 


4 — 


Chicken, full-grown 


Fricasseed 


2 45 


Heart, animal 


Fried 


4 — 


Apples, sour, hard 


Raw 


2 50 


Beef, old, hard, salted 


Boiled 


4 15 


Oysters, fresh 


Raw 


2 55 


Pork, recently salted 


Fried 


4 15 


Bass, striped, fresh 


Broiled 


3 — 


Cabbage, with vinegar 


Boiled 


4 30 


Beef, fresh, lean, rare 


Roasted 


3 — 


Ducks, wild 


Roasted 


4 30 


" steak 


Broiled 


3 — 


Pork, recently salted 


Boiled 


4 30 


Corn cake 


Baked 


3 — 


Suet, mutton 


Boiled 


4 30 


Dumpling, apple 


Boiled 


3 — 


Veal, fresh 


Fried 


4 30 


Eggs, fresh 


Boiled soft 


3 — 


Pork, fat and lean 


Roasted 


5 15 


Mutton, fresh 


Broiled 


3 — 


Suet, beef, fresh 


Boiled 


5 30 




Boiled 


3 — 


Tendon 


Boiled 


5 30 



This table may be considered as giving a general idea of the rela- 
tive digestibility of the food-articles contained in it. If not found 
exactly right in each individual case, it can be rectified by experience. 
The experience of no other individual's stomach will ever be found 
precisely like that of St. Martin's, — though in its general features, 
it may be sufficiently similar to make his valuable. The general 
principles of conduct may be learned from the experience of others. 
The particular application must come from our own experience and 



reason. 



Digestibility Influenced by Amount. — The rapidity with which 
any article is digested will vary with the amount taken. A larger 
quantity than is called for by the wants of the system will be di- 
gested more slowly than the proper amount ; while, on the other 
hand, an insufficient supply begets an inability to reduce in the 
stomach even the small quantity taken. We may err in taking too 



HYGIENE. 73 

little food as well as in taking too much ; though the former error is 
much less likely to occur than the latter. 

Choosing Food in 111 Health. — But in deciding the kind and 
amount of food we must be guided not only by its digestibility, but 
by the state of the health. 

If we find the stomach apparently in good working condition, capa- 
ble of dissolving properly whatever is submitted to its action, and 
yet we are for some cause losing flesh and strength, we should resort 
not only to the most nutritious of the albuminous group of the azo- 
tized articles, but likewise to the oleaginous group of the non-azo- 
tized. We want a great amount of nutriment, and we need oils to 
make fat. This is the kind of food generally wanted in constitu- 
tional consumption. 

In fevers, but little food can be disposed of at best ; and that little 
must be chosen with reference to its mildness and its unstimulating 
qualities. Generally the farinaceous or starchy articles are most 
suitable, because they have no stimulating and irritating qualities, 
and especially because they furnish fuel to be burned with oxygen, 
and thus take the place of the animal tissues, which are being rapidly 
consumed with this devouring element. In fever, oxygen is literally 
burning up the body. In this state of the system, this element ac- 
quires, by some means, a singular affinity for the tissues ; and, unit- 
ing with them rapidly, forms a true combustion. The physician who 
throws to this devouring agent some of the mild, non-azotized articles 
which offer it stronger affinities than it finds in the tissues, is as wise 
as he who tosses his dog to a hungry lion to avoid being devoured 
himself. 

Exercise to be Considered. — In deciding the diet, the amount of 
exercise is not less important to be considered than the health. The 
farmer, who works in the open air, and uses his muscles a great deal, 
wants considerably more nutritive, as well as more combustive, food 
than one who leads a sedentary life. Of course there is a great deal 
more waste of the tissues, and he requires more of the flesh-forming 
articles ; and as he breathes deeper, and takes in more oxygen, he 
needs more of the supporters of respiration, — the sugars, oils, and 
starchy aliments. 

Beans. — By turning to the table which shows the amount of nitro- 
gen in the different food-articles, the reader will see that beans are 
rich in this element. They are, therefore, excellent food for working 
men, who are obliged to make great use of their muscles. Our 
fathers, who broke and subdued the rocky soil of New England, 
showed wisdom even in their instincts in taking so large a portion 
of their aliment from the bean, — especially as they oiled it with the 
fat of pork. But for the hard-working student, who daily makes 
heavy drafts upon his brain and nervous system, beans and peas .are 
an improper diet. They contain no phosphorus^ in the shape of 



74 HYGIENE. 

phosphate of lime ; and no brain can work hard without a due supply 
of phosphorus, which forms a part of its substance. 

Unbolted Wheat Flour, — For the man who uses his brain a great 
deal, there is no other one article of food equal to bread made from 
unbolted wheat flour. Fine wheat flour is little better for him than 
beans, because the miller has robbed it of much of the phosphorus, 
which is found chiefly in the hull or bran. 

I mention only two or three articles of food as specimens. By 
looking over the tables furnished, and reasoning upon the whole in 
the way I have done upon these few, the reader can give every arti- 
cle something like its proper value in most circumstances. 

Climate. — If health and exercise should influence us in choosing 
the kind and the amount of food, climate must do so quite as much. 

In the frigid climate of high latitudes, it is necessary that a great 
deal of heat be produced in the body, in order to avoid perishing 
with cold. There is no mystery now, as there once was, about the 
production of tins heat. It comes from the burning of carbon and 
other substances in the body, where they unite with oxygen, and 
make just as real a fire as that which warms our houses. Oils, sugar, 
starch, gums, etc., are largely composed of carbon, and readily unite 
with oxygen in the body. This is the reason they are reckoned as 
fuel, and are called supporters of combustion. And for this reason, 
they require to be largely consumed in very cold climates. The in- 
stincts of men seem to lead to the same conclusion, for the dwellers 
in all high latitudes consume great quantities of oils and fats. The 
amount of train-oil, tallow, the fat of seals and other animals, devoured 
by the Laplanders, Kamtschatkans, and other northern people, is truly 
wonderful. 

In hot countries, the fundamental rule for preserving the health is 
to keep the body cool. Without observing this rule, the strongest 
will often fall victims to the climate in low latitudes. But to keep 
cool, of course all the heat-producing articles of food should be 
avoided. Particularly all alcoholic drinks, which are powerful sup- 
porters of combustion, should be rejected. Rice and the various fruits 
form the most suitable articles of diet. 

The great sacrifice of life witnessed among the early emigrants to 
California, was the result chiefly of using ardent spirits and heat- 
producing food while crossing the Isthmus, which, to a northern 
constitution, is much like a vast oven, heated to a temperature suit- 
able for baking bread. There are few persons, with tolerable health 
and strength, but could safely endure the hottest climate if they 
would avoid alcoholic liquors and confine themselves to an abstem- 
ious vegetable and fruit diet. 

Bayard Taylor's Opinion, — The distinguished traveller, Bayard 
Taylor, reports that while spending a few days in a heated part of 
Africa, he lived as the inhabitants did, pretty much entirely upon the 



HYGIENE. 75 

flesh of well-fatted sheep ; and that he enjoyed, meantime, excellent 
health and strength. From this he concludes that animal food is as 
suitable in hot climates as in cold. 

It is a pity a man of such excellent parts as Mr. Taylor should 
have allowed himself to rear so tall a structure upon so narrow a 
foundation. That he could live on flesh in so hot a region, and not 
be made sick, only proved that he had a fine constitution, and that 
his health was not easily disturbed ; and when he attempted, from 
his limited experience of a few days, to reason against the established 
facts of science, and against the well-attested laws of life, he did it 
evidently without reflecting that he was in a field of thought which 
he never had occasion to cultivate. 

The great Jewish Lawgiver doubtless had a reason for prohibiting 
pork to the Jews. Whatever that reason was, the prohibition had a 
wise bearing upon the health of the people. Palestine has a hot 
climate, in which pork-fat is an improper diet. 

More Fat in Winter, — It follows from what has been said, that a 
more fatty as well as stimulating diet is needed in winter than in 
summer. But the change should be made gradually. When cold 
weather approaches, the food should become more nutritious and 
warming by little and little. The exercise should likewise be in- 
creased. 

Even the lower animals act upon this plan. In the fall, squirrels 
eat nuts, which are full of oil, and grow fat upon them. 

The instincts of men move in the same direction. It is in the fall 
that the hog, the ox, and the poultry are killed ; and in the winter 
that they are largely feasted upon and enjoyed. Upon such food, 
combined with various sorts of starch, man fattens ; and a good sup- 
ply of fat, deposited in the cells, is equal, in keeping out cold, to a 
layer of cotton batting, — to say nothing of the fire kept up within 
the body by the burning of such fuel. As hot weather comes on, we 
gradually lay aside these fattening articles (or ought to), and return 
to the watery vegetables and fruits, such as squash, string-beans, 
strawberries, currants, etc. 

Few of us, I apprehend, would suffer from heat in summer, if we 
could persuade ourselves to abandon stimulating and fire-producing 
food, and confine ourselves pretty much to a cooling and succulent 
diet. Diarrhoeas in summer are not induced by eating wholesome 
vegetables, but by combining them with large quantities of animal 
food. 

The State of the Mind. — This should by no means be over- 
looked in choosing the kind and the amount of food. If we have 
lost friends, or heard desponding news, or experienced calamities of 
any kind, we must, during the first hours of the shock, or even during 
the first days, if the affliction be heavy, partake very sparingly of food. 
The stomach is in no condition to receive it. The brain lies pros- 



76 HYGIENE. 

trate under the stroke, and the stomach, in sympathy with it, asks 
for a day of sorrow and fasting. Disturb it not. 

Heat-producing Food Incompatible with Excitement. — It is 

folly to take heat-producing aliment when laboring for days under 
high excitements. During political campaigns, when the blood of 
politicians is at the boiling point, the diet should be unstimulating, 
— containing very little animal flesh, and not much combustive food. 
Many a man has died of apoplexy, or of heart-disease, by putting on 
the steam when his blood was up. Whenever we have a day of un- 
common excitement to pass through, we should always begin and 
end it with an unusual degree of abstinence as to the amount of food 
taken, and with special care that the articles be of the highest kind. 

Anger Demands Abstinence. — Anger is a passion which espe- 
cially unfits the stomach for doing much work. If it occur often, or 
be protracted, but little food should be taken. Those who indulge it 
have a double cause for abstinence. Both their folly and their stom- 
achs call for a fast. 

Food Adapted to Different Periods of Life. — Food must vary in 
different periods of life. The infant needs a fattening diet ; and this 
has been supplied in the milk of the mother, which contains more 
hitter (the fattening portion) than the milk of any other animal. 
But as the infant has much less exercise than the young of animals, 
its flesh is not wasted, and it does not require so much azotized food, 
that is, the reader will remember, food with nitrogen in it. Accord- 
ingly, it will be seen by looking at the table on page 70, that human 
milk has much less of this element than that of the cow. As the 
child grows up, and begins to take active exercise, indoors and out, 
it wants more solid food, and teeth make their appearance to masti- 
cate or chew it. 

In Youth and flanhood, the great amount of exercise usually 
taken calls for larger supplies of azotized aliment, — beef, mutton, 
pork, fowl, fish, wheat-flour, corn-meal, rye-meal, potatoes, turnips, 
peas, beans, etc. This is the working part of life, when the tissues 
are rapidly wasted by action, and the flesh-forming aliments are 
wanted to keep them good. 

In Old Age, the exercise is diminished, the blood circulates more 
slowly, and the body grows cold. Now is the time to resort to noiv- 
azotized food, — oils, fats, the various kinds of starch, sugar, and the 
like. These will furnish fuel to warm the sluggish blood, and will 
invest the body with fat, which will serve the purpose both of a cush- 
ion and a garment. Wine, beer, porter, and distilled spirits are never 
needed by young persons in health ; but the aged are frequently bene- 
fited by them, if taken in small quantities. They are chiefly com- 
posed of oxygen, hydrogen and carbon, and are properly ranked with 



HYGIENE. 77 

the supporters of combustion. They are likewise stimuiant, and add 
to the comfort of the old by quickening their circulation. Like tea 
and coffee, they diminish the waste of the body, and thereby lessen 
the demand for food. 

The smallest amount of aliment upon which a healthy adult person 
ever lived for any length of time, was twelve ounces a day. Upon 
this small daily allowance, Lewis Cornaro, a noble Venetian, sub- 
sisted in perfect health, during the protracted period of fifty-eight 
years. This he was able to do only by adding daily to his food 
about twelve ounces of light wines. I shall have occasion to refer 
to this case again. 

Cost of Food. 

One other consideration must ever influence the great majority of 
men in selecting their food. I mean its cost. It is a matter of great 
importance to the poor, to know what kinds of food they can subsist 
upon with least expense. Sometimes provisions are so high that 
persons in poor circumstances greatly need advice in this matter. 
Let me endeavor to furnish some information which shall be of ser- 
vice to the reader. 

Milk is supplied by nature to be our first food, and is a good type 
of all alimentary substances. It contains 
curd, which has nitrogen, and is equivalent 
to albumen and fibrin, and represents the 
blood-formers. It has butter and sugar. 
These represent the heat-formers. It has 
salts, which contain potash, soda, phospho-l 
rus, etc. Fig. 64 is a microscopic view of I 
good milk ; Fig. 65, of poor milk ; and Fig. 
66, of milk adulterated with calf's brains. 

Food will be valuable in proportion as 
it combines, in due proportion, the articles 
contained in the four groups, represented FlG 64 _ 

by albumen, fat, sugar, and salts. 

Albuminous Group. — Albumen, fibrin, casein, and gluten, all en- 
ter into the substance of animal and vegetable bodies, and are all 
composed of the same elements, namely, 48 parts carbon ; 36 of 
hydrogen ; 14 of oxygen ; and 6 of nitrogen. In containing nitrogen 
they all differ from the other three groups. Albumen being a good 
type of them, they are called albuminous compounds. Albumen 
forms a large portion of the serum, or colorless part of the blood. 
It is the leading principle in alimentation. It is worked up into the 
tissues of our bodies. It forms our muscles, our membranes, a por- 
tion of our nerves, etc. It is the bricks of which the house we live 
in is made. All the articles, therefore, which are chemically consti- 
tuted like it, may well be termed albuminous. 




78 HYGIENE. 

These bodies, consisting of the four organic elements named above, 
have been called quaternary compounds. Besides these elements, they 
have a minute portion of sulphur and phosphorus. They are also 
called protein or proteinaceous compounds. 

Albumen is a very unstable compound, — tending strongly to de- 
composition. This is owing to the complexity of its composition, 





Fig. 65. Fig. 66. 

and to its union with the tickle element, nitrogen, which forms chemi- 
cal compacts reluctantly, and breaks them without remorse. Sub- 
stances which coagulate or fix albumen in an insoluble compound, 
or preserve the tissues of the body, which are made from it, from 
decomposition or putrefaction, are called a)itisep)tics. 

Fatty Group. — The next group, represented by fat, performs very 
important offices in the system, — the most important of which is a 
union with albumen in the formation of cells. All animal and vege- 
table life begins with the cell, — the tiny cup, with which nature dips 
all the streams of life out of the great fountain of inorganic matter. 
No cell is formed without a minute particle of oil. The portion not 
used in forming cells, is either burned as fuel to keep us warm, by 
uniting with oxygen, or it is stored away in the cellular tissues, add- 
ing to the bulk of the person. If, then, the very beginnings of life 
are dependent upon fat, it is of great importance as an article of diet. 
So necessary is it in the economy of life, that when not taken in the 
food, it is formed out of albumen in the processes of assimilation. 

The Starch and Sugar Group, composed of several kinds of sugar, 
gum, etc., is never used in forming the tissues, but they perform im- 
portant offices in the changes going on within the human organism. 
Thus, sugar of milk is decomposed, and forms lactic acid, so called 
from being found in sour milk. This acid plays a very important 
part in the process of nutrition. 

Pure starch is a snow-white powder, having a glistening aspect. 
It is composed of grains from T fo to T( ^ nj of an inch in diameter in 
the different grains ; being largest in the potato and smallest in 
wheat. When examined with the microscope, they appear as in Fig. 
63. 



HYGIENE. 



79 



The Salts Group are sufficiently spoken of in another place. 

A wise philosopher in ancient time said, " I do not live to eat and 
drink ; I eat and drink to live." If we intend to eat to live, we must 
combine, in our food, the four groups above explained ; and if we 
would live at as small expense as possible, we must take those arti- 
cles which are low in price and rich in nutritive matter. The fol- 
lowing table will help the reader make his selections : — 

Table of the relative value of articles of food arranged according to their proportions of 
nutrient matter in each of the four groups of elements concerned in vital changes. 



In 100 pounds of 



Grains: 

Wheat . . 

Barley . . 

Oats . . . 

Rye . . . 

Indian Corn 

Buckwheat 

Rice . . . 
Pod Plants: 

Beans . . . 



Roots : 

Potato 

Turnip 

Carrot 

Beet (mangold wurzel) 

Long red 

Short red 

Sugar beet . . . . 

Parsnip 

Leaf: 

Cabbage 

Meal : 

Wheat flour . . . . 

Ryemeal 

Barleymeal 

Oatmeal 

Wheat bran . . . . 



15 
15 

15 
15 
13.1 



$a 



ttO 



5* 2** 

BS'O 
ftgfi 



15 

15 

20 

10 to 20 

6 
25 

3 

8 to 11 



4 

2 

3 

2 

3.03 

3.31 

2 

1.5 



4.63 



55 



10 to 19 
12 to 15 
14 to 19 
10 to 15 
11 



24 to 28 
24 

2.1 
1.5 
1.5 
2 

0.48 
0.26 

2.5 

30 to 35 

10.8 

8 

6.3 
12.6 
19.3 



If 



52" 

5*o 



2 to 4 

2 to 3 
5 to 7 

3 to 4 
8.1 
0.4 
0.7 

2 to 3 
2.1 

0.6 
0.3 
0.4 



0.35 



2 
2 

2.4 
5.6 

4.7 



55 
60 
60 
60 
74 
50 
79 

40 
50 

18 
9 

10 

11 

10.36 
12.46 

13 

16 



70.5 
73 

74 
64 
.6 



2 
3 
4 

2 

1* 

4 

e* 

3 
3 

I tol| 
1 to 4-5 
Hto2 
to 1 

li 

.75 

h 



2 

2 
3 
7.3 



The following tables have an admirably practical bearing upon 
economy in food : — 



100 lbs. 



Barley 

Beans 

Beets 

Buckwheat . . . 

Carrots 

Corn 

Oats 

Peas 

Potatoes 

Turnips (field) . . 
Do. (Swedish) . . 
Wheat Flour . . . 
Wheat Bran . . . 
Cheese (whole milk) 
Cheese (skim-milk) 



Muscle- 
forming 
Elements, 
in lbs. 



14 
26 

2 
8 

a 

12 
17 

24 

2 

I 

11 

18 

28.4 
49.8 



Fat-forming 

Elements, 

in lbs. 



64 
42 
12 
54 
10 
77 
66 
52 
19 

9 
12 
79 

6 
51.1 

6.3 



Relative Propor- 
tion of each, 
in lbs. 



lto4* 
1 tol| 
1 to 6 
lto6| 
lto6$ 
1 to6£ 
lto4 
lto2i 
1 to 9$ 
1 to 6 
1 to 5fc 
1 to 7 
1 to £ 
ltolf 
1 to£ 



Husky, or 

Woody fibre, 

in lbs. 



15 

10 

(?) 

25 

3 

6 

20 

8 

4 

o 



80 



HYGIENE. 



Articles. 



Barley . . . : 

Beans 

Corn 

Oats 

Peas 

Potatoes .... 
Turnips . . . . 
Flour (fine) . . 
Flour (unbolted) 



Cost. 



$1.00 per 


bu. 


8.4 lbs 


1.80 ' 




16.6 " 


0.50 ' 




6.7 " 


0.35 ' 




5.2 " 


1.00 ' 




14.3 " 


0.85 ' 




1.6 " 


0.50 ' 




1.2 " 


5.00 per 


bbl. 


22.0 " 


4.50 ' 




24.8 " 



Muscle-producing 
Elements. 



Cost of Muscle-pro- 
ducing Elements. 



12c. per lb. 

lie. " 

7*c. " 

7c. " 

7c. " 

53c " 

41c. " 

23c " 

18c " 



These tables will well repay study, for their practical use will save 
many dollars to the poor. Let it be remembered that producing 
muscle is the same thing as producing strength, or labor-power. 
Bearing this in mind, the following table will be very interesting : — 



One pound 


of labor-power 


from Potatoes costs 53c. per lb 


" 


" 


" " 


" Fine Flour, 23c. 


" 


" 


<< (i 


" Unbolted do., 18c. 


" 


• 


" " 


" Turnips, 41c. " 




' 


i< n 


" Barley, 12c. " 






n << 


" Corn, 7£c. " 


" 


' 


" " 


" Beans, lie. " 


a 


' 


<< (< 


" Peas, 7c. " 


" 


i 


" " 


" Oats, 7c. " 



Meats are omitted in the table. So far as their nutritive qualities 
are concerned, it is of little consequence which are taken. Some are 
more digestible than others, and this consideration should influence 
those with weak stomachs in selecting. Every person, of course, 
knows their relative cheapness. 

Among the vegetables given in the table, there is a wider range 
for choice. Let us consider them in course. 

Wheat. — In this, the four groups are represented in excellent 
proportion. When not deprived of the bran, it is perhaps the very 
best supporter of animal life. So high have been the regards of men 
for it, and so generously have they awarded to it their acknowledg- 
ments, that its product, bread, has been everywhere called " the staff 
of life." The settlement and cultivation of the immense prairies of 
the West have within recent years so increased the production of 
wheat, that its cost is now less than half what it was fifty years ago, 
and it is indeed within the means of all in America. 

Barley. — This has the four groups represented in nearly the same 
proportions as wheat. It is, therefore, nearly as valuable an alimen- 
tary grain. Unfortunately it is not so toothsome as wheat, and can 
never be so popular an article of diet. The Scotch, however, feed 
upon it with apparent relish, and doubtless think it strange that for- 
eign palates are not better pleased with it. 

Oats. — This grain, strange to say, has more albuminous, or nutri- 
tive matter, more fat, more starch, and more salts than wheat. In 
uniting a large quantity of the four alimentary groups, it surpasses 



HYGIENE. 81 

every other vegetable substance. In albumen, it is not quite as rich 
as peas and beans, and in starch it falls a trifle below fine wheat 
flour ; but in fat it is exceeded only by Indian corn. This grain is 
likewise consumed largely by the Scotch, — a people whose claims to 
shrewd common sense are well supported by, as their hardy constitu- 
tions vindicate, the choice. This grain might well be permitted to 
take the place of rice. It affords several times as much nutriment, 
while it costs only about one-fifth as much. There is good reason 
why the horse should thrive upon oats. Most stable-keepers think 
their horses will do more work upon corn-meal, but this must be a 
mistake. In using oats for horse-feeding, a large portion of the nu- 
triment is lost by not grinding them. 

Rye. — This is also a grain of considerable nutritive value. It is 
much cheaper than wheat ; and rye meal has long been a standard 
article of diet in New England, — particularly in connection with 
Indian meal, as " brown bread." It is useful for relieving costive- 
ness, in the form of " hasty-pudding," with molasses. 

Indian Corn. — This staple article of American produce needs no 
praise from me. It is comparatively cheap, nutritive, and wholesome. 
It abounds in fat and starch, and has a fair amount of albumen, 
though not as much as the oat, the barley, or the wheat. In salts, it 
is rather deficient. Indian corn is strictly an American plant, and is 
perhaps the most popular grain in the country. It has emphatically 
a national reputation, and is perhaps worked up into more savory 
dishes than any other. At the South it is an institution. It is there 
made into hoe-cake, corn-cake, batter-cakes, batter-bread, muffins, corn- 
pone, etc. At the North, we have johnny-cake, Indian and pumpkin- 
cake, baked Indian pudding, boiled Indian pudding, beside the well- 
known rye and Indian bread, and other preparations. Give an in- 
genious Southern or Northern housewife a few simple adjuncts, such 
as lard, milk, sugar, eggs, cream of tartar, and soda, and she will 
make a pretty respectable larder from this single grain. If molasses 
be substituted for sugar, and a little stewed pumpkin be thrown in 
by way of garniture, we may have several preparations which are 
very nourishing as well as cheap. 

Buckwheat. — Poor in nutritive matter, fat, starch, and sugar, but 
tolerably well supplied with salts. Jt will do very well for batter- 
cakes in winter. When brought smoking upon the table, and served 
with sugar or molasses and butter, these cakes are a luxury, in which 
the rich may indulge if they choose ; but for the poor, the amount of 
nourishment they afford is too small for their cost. 

Rice Much like buckwheat, except that it has more fat, sugar, 

and starch, and less salts. As an article of diet, it has had too high 
a reputation. Those who would live on small means cannot afford 
it. Boiled in plain water, it is excellent for a relaxed state of the 
bowels; and this about all the commendation to which it is entitled. 



82 HYGIENE. 

Beans. — The richest in nutritive matter of all vegetable substances, 
except cabbage and oats. They have more albumen than wheat, or 
corn, or barley, or oats ; but in fat and starch they are lower in the 
scale. Add to them salt pork, and the highest of all nutrient com- 
pounds is obtained. During not less than four generations, pork 
and beans, as the principal diet, nourished an iron-sided race of men 
in New England. Bean-porridge was like honey upon the tongue of 
the founders of New England institutions. They ate it morning, 
noon, and night ; and thanked God for it every time. And well they 
might thank Him ; for, with Indian corn, it furnished them with a 
diet better adapted to their condition than any other. 

Peas. — Not quite as rich as beans in albumen, but more rich in 
starch, is of about the same value on the whole. The Canadian French, 
in Lower Canada, feed on peas to about the same extent that the 
New Englanders did on beans. Pea-soup, as prepared by the best 
cooks among them, is a dish of great nutritive excellence ; and, in 
my judgment, more palatable than bean-soup. 

The Potato. — Three-quarters of this root is water, and it is poor 
in all the elements of nutrition. It is a palatable article, and most 
persons are much attached to it. As bulk is of some consequence in 
food, the potato is not without value. Men do not often live entirely 
upon potatoes, — not even in Ireland. Milk, butter-milk, and espe- 
cially cabbage, are united with them. 

Turnips, Carrots, Beets, Parsnips. — These are much alike, — 
being all poor in nutritive qualities. They serve to please the pal- 
ate by furnishing a variety ; but in our city markets they are expen- 
sive, and do not furnish an economical diet. 

Cabbage. — It is interesting to observe how the instincts of men 
have in all ages led them to select those articles of diet which their 
circumstances have demanded. The poverty of the Irish has led 
them to subsist largely upon the potato, — a root which the soil of 
their country } T ields profusely. But as this root has but little nutri- 
tive matter, necessity required that it should be united with some 
other vegetable. The natural instinct selected the cabbage ; and 
when chemical science came, at length, to pass judgment upon the 
correctness of this instinct, it turns out that the cabbage is the richest 
in albumen of any known vegetable. The cabbage, then, is the nat- 
ural complement of the potato ; and the Irish had the sagacity, with- 
out science, to bring the two together. It is said the Irish have a dish 
named " kohl-cannon," consisting of boiled and mashed potatoes and 
cabbage, seasoned with pork fat, pepper, and salt, and that it is a 
truly savory dish. It certainly is a nourishing and a cheap one. The 
ambassador who was sent to tamper with the patriotism of a Roman 
who had dined on beans, was asked if he was silly enough to think 
gold and silver could bribe a man who was satisfied with so plain a 



HYGIENE. 83 

fare, and desired no other. We come to the conclusion then, that 
bean-porridge, pea-soup, suet-pudding sweetened with molasses, oat- 
meal, and barley-bread, with " kohl-cannon " for those who can digest 
it, will furnish, for hard-working men, the most substantial diet, at 
the smallest possible expense. To render these dishes savory, and 
to make the table on which they are spread an inviting board, the 
deft housewife must employ her best skill in serving them. With 
the thousand " fixings, with which a New England matron knows 
how to garnish them (or would know how if they came within her 
culinary operations), they are well fitted to leave savory impressions 
upon tongues which would praise them to the end of life. I speak 
of these articles as furnishing a cheap diet for working men. The 
indolent, the sedentary, and the effeminate from various causes, could 
not digest them. 

The Amount of Food Taken. 

We have already explained that this should be governed, in part, 
by the amount of exercise taken, by the condition of the health, by 
the state of the mind, by the climate, by the season, etc. It remains 
to add a few words in a general way, respecting the absolute amount 
required by an adult man. 

It is plain enough that most men eat too much. We come very 
near, in this country, being a nation of gormands. A principal rea- 
son of our over-eating is, that we eat so fast. When the food is well 
and slowly masticated and swallowed, the gastric juice has time to 
mix with it ; and at the proper moment the appetite ceases. But 
when our food is bolted rapidly, nature, rinding her laws disregarded, 
and all her purposes frustrated, stands back, and lets us learn to stop, 
too late, alas ! from a sense of fullness in a stretched and abused 
stomach. 

It has already been stated that Lewis Cornaro lived fifty-eight 
years, namely, from the age of forty-two to one hundred, on twelve 
ounces of solid food a day, with about the same amount of light 
wines. At the age of eighty-four he wrote a book, in which he 
praises " divine temperance " in terms which are sometimes eloquent 
and often enthusiastic. Indeed it is very rare that a man at that 
age retains such clearness of intellect, and especially such freshness 
of feeling as he evinces in his book. Probably but few could live on 
the amount of food which he found sufficient. Yet it is said the 
distinguished John Wesley lived on sixteen ounces a day, which, as 
he took no wine, and had to derive the combustive materials for 
warming the body from the food, was quite as scanty a fare as that 
of Cornaro. Considering that he led a most extraordinarily active 
life, both of body and mind, being half his Avaking hours in the sad- 
dle and preaching almost daily, this is probably the most remarkable 
case of absteminousness on record. Jonathan Edwards did not. I 
think, exceed the same amount of food, but he was not so active a 
man. 



84 HYGIENE. 

Putting aside such exceptional cases as these, we may say in round 
numbers, that a laboring man requires, to keep him in health, about 
two or two and a half pounds of solid food per day. For ministers, 
lawyers, doctors, authors, and merchants, one pound and a half is 
amply sufficient. The amount should be increased a little by a se- 
lection from some of the fuel-formers, if no fermented or alcoholic 
drinks be taken, and slightly diminished if they are used. The rea- 
son is that these drinks furnish fuel to be burned in breathing, 
which has to be drawn from the food when they are not employed. 
This furnishes no motive for using ardent spirits : for there is fuel 
enough to be had in the oils, starches, and sugars. 

Dyspeptics. — It is said that dyspeptics eat more than persons in 
health ; and, in many cases, the remark may be true. The appetite 
of a person suffering from this disease is almost always morbid, and 
the information it gives respecting the real wants of the sj'stem can 
seldom be trusted. If we allow a diseased stomach to dictate to us 
when and what and how much we shall eat and drink, our misery 
for life is a foregone question. A sick stomach is like a spoiled child, 
— it cries for what it should not have. If the dyspeptic will live, 
and enjoy any amount of peace and comfort, he must follow this 
simple rule : To eat no more than can be digested, even though the 
amount be only an ounce a day. 

Animal and Vegetable Food. 

It has generally been supposed that it was intended man should 
subsist on a mixed diet, consisting of both animal and vegetable 
substances. Within the last fifty years, however, a school of physi- 
ologists have appeared, who affirm that a vegetable diet is alone 
consistent with the laws of health. They declare that animal food is 
not adapted to man's organization, — that it unduly stimulates the 
blood, predisposes to fevers, consumptions, diarrhoeas, choleras, apo- 
plexy, and numerous other diseases, and of course shortens life. 
That such a school should have come into existence in tins country, 
where animal food is more largely consumed than in any other part 
of the world, in proportion to the number of people, is not surprising. 
We do, undoubtedly, eat too much flesh. So enormous is the consump- 
tion, that notwithstanding the vast herds of cattle raised in all our 
agricultural states, and especially on the western plains, the demand 
keeps up with the supply so well that beef brings, on an average, 
about twenty cents per pound, - — at least twice its full value as a 
blood-former. 

Facts show that man may live upon flesh alone, upon vegetables 
alone, or upon flesh and vegetables combined. Is it best he should 
subsist upon vegetables only, or upon a mixed diet ? A mere affirm- 
ation upon these points is of little consequence. To cite facts avails 
nothing. Men have a way of making their own affirmations, and of 



HYGIENE. 85 

looking at facts with eyes which sometimes see clearly enough on 
both sides of them, but totally ignore their existence. 

Man's Structure Settles the Question. — To settle this matter, we 
must appeal to man's organization. His structure will tell us some- 
thing we need not mistake. All the works of God show design. 
Everything he has made has a use, and is so contrived as to be 
adapted to that use. Lions, tigers, and other animals, for example, 
which feed on flesh alone, have a short second stomach, — it being 
only about three times the length of the animal's body. Animals 
which eat no flesh have a long second stomach, — that of the sheep 
being from thirty to thirty-five times the length of its body. A very 
remarkable difference of anatomical structure ! 

This is the meaning of the difference : Vegetable food has a great 
deal of waste matter in it. Woody fibre makes quite an item in its 
composition. This waste portion must be carefully separated from 
the nutritive part, and this must all be done in the second stomr.„h. 
It takes time to do it. It must not be done in a hurry. The nutri- 
tive materials are destined to build a living structure, whose dura- 
tion, like that of all other fabrics, will depend on the care with 
which the materials are selected and put together. The second 
stomach of the sheep is long, that there may be ample time for the 
mixed mass of chyme, when it passes out of the first stomach, to be 
changed to chyle, and then to be carefully separated into the two 
parts, the useful and the useless. Animal food is in its composition 
just like our own flesh, — there is little waste matter, and not much 
time is required for its separation ; hence, the second stomach of 
flesh-eating animals is short. Nearly the whole alimentary mass is 
quickly taken up by the lacteals, and there is no occasion f6r its 
travelling through a long second stomach. 

Man's second stomach is in length midway between that of the 
flesh-eating and the vegetable-eating animals. If there be design in 
the works of the Creator, and if that design in the structure* of the 
flesh and vegetable-consuming animals has now been correctly inter- 
preted, it is plain that man is best nourished when he eats both kinds 
of food. The structure of his teeth and the motions of his jaws 
(see p. 30), confirm the same conclusion. 

Americans Eat too Much Meat. — Yet, as I have said, there is no 
doubt the Americans eat too much meat. Sedentary persons require 
but very little. Less is wanted in summer than in winter, — in warm 
climates than in cold. People of wealth, whose circumstances im- 
pose no bodily hardships, need less than the poor, who are much 
exposed, and work hard; whereas, they consume more. Those who 
do not labor with their hands, should never taste meat more than 
once a day. 

It is painfully-amusing (if such a compound word is admissible) 
to hear a nervous female, whose sole exercise consists in going from 



8b HYGIENE. 

the parlor to the kitchen once or twice a day, and in making a brief 
shopping excursion once a week, complain that she cannot maintain 
her strength unless she eats freely twice a day of meat, and takes her 
free potations of strong coffee and wine. 

A like opinion prevails generally among the feeble who are not 
obliged to labor. The child in its nurse's arms must daily, it is 
thought, suck a piece of chicken or beefsteak in order to thrive. 
Children thus fed have their blood constantly inflamed, and stand a 
poor chance when attacked by scarlet fever. The little master or 
miss who attends school complains of headache, and grows pale, 
feeble, and nervous. The books are blamed and thrown aside for 
what the dishes have done. The doctor is called in and assured 
that the dear child can eat nothing but a little fat broth, a custard, 
or cake ; and if he prescribe a diet of plain bread and milk, he is 
believed to be heartless, and his prescription is not followed. 

The Majority of Mankind Eat no Flesh. — All such misguided 
persons should be apprized that the great majority of mankind eat 
no flesh, because they cannot afford it. And they do not appear to 
suffer from its loss. Millions of Irish do not taste of flesh or fish 
from one month's end to another. Potatoes, oatmeal, and cabbage 
constitute their chief diet. Rice, poor as it is in nourishment, 
sustains, when combined with vegetable oil, millions of people in 
Asia. The Lazaroni of Naples, with active and finely moulded 
forms, live on bread and potatoes. These facts do not afford ground 
for altogether rejecting animal food, any more than Bayard Taylor's 
statement respecting whole tribes in Africa who live upon flesh 
furnishes a reason for excluding vegetable aliment. Man may live 
and enjoy health upon either, but his organization implies the use 
of both. 

Proportions of Animal and Vegetable Food. 

Upon this subject, it is impossible to fix any absolute rules. This 
is a point which must be determined by the temperament, the state 
of the health, the constitution, etc. Persons of a scrofulous habit 
should eat freely of animal food. But an inflamed stomach should 
never be tormented with flesh. Meat is stimulating, and will be 
almost sure to do mischief when there is heat and tenderness at the 
pit of the stomach. There are cases of inflammation of this organ, 
in which it may be necessary to live on bread and milk, with articles 
of the starch group, for months, and even for years. 

On the other hand, when the system has run low from some 
exhausting disease, which excites no feverish action, it may be 
necessary at times to take a diet almost exclusively animal. 

It is absurd to talk of the same diet as adapted to all persons, even 
when in health. As well might we expect one shoe to fit every 
foot, or one coat every back, or one color every eye, or one doctrine 
every mind. 









HYGIENE. 87 

Temperance the Main Thing. — After all, the great thing to be 
aimed at is temperance. It is not so necessary to reject one article 
and use another, as to partake of all with moderation, " I do not 
live to eat and drink ; 1 eat and drink to live," said a wise philoso- 
pher of the olden time. One would think the moderns have 
reversed this rule. A modern table has the appearance of being 
spread for the purpose of inducing men to eat all their stomachs will 
hold. A man who can dine daily, for half a dozen years, at one 
of our first-class hotels, and then find himself free of dyspepsia and 
all other diseases, must have a fine constitution, as well as most 
admirable control over his appetite. Mr. Addison said, " When I 
behold a full table set out in all its magnificence, I fancy I see 
gout, cholic, fevers, and lethargies lying in ambuscade among the 
dishes " ; to which he adds, with much truth, in another place, 
" Abstinence starves a growing distemper." 

Good Results of Temperance. — A temperate diet has always 
been attended with excellent results, and always will be. There are 
times of great anxiety, when abstinence should be pushed to the 
extreme verge of endurance. During the siege of Gilbraltar, Lord 
Heathfield, its gallant defender, lived eight days on four ounces 
of rice per day. Dr. Franklin, when a journeyman printer, lived 
two weeks on bread and water, at the rate of ten pounds of bread a 
week, and was stout and hearty. Dr. Jackson, an eminent physician 
in the British army, says, "I have wandered a good deal about the 
world, and never followed any prescribed rule in anything; my 
health has been tried in all ways ; and, by the aid of temperance and 
hard work, I have worn out two armies, in two wars, and probably 
could wear out another before my period of old age arrives." 

Lord Bacon was right in the opinion that intemperance of some 
kind or other destroys the bulk of mankind, and that life may be 
sustained by a very scanty portion of nourishment. Cornaro, whom 
I have before mentioned as having lived fifty-eight years on twelve 
ounces of solid food a day, wrote as follows respecting himself in 
his eighty-fifth year : " I now enjoy a vigorous state of body and 
of mind. I mount my horse from the level ground ; I climp steep 
ascents with ease ; and have written a comedy full of innocent mirth 
and raillery. When I return home, either from private business or 
from the senate, I have eleven grand-children, with whose education, 
amusement and songs I am greatly delighted; and I frequently 
sing with them, for my voice is clearer and stronger now than ever 
it was in my youth. In short, I am in all respects happy, and quite 
a stranger to the doleful, morose, dying life of lame, deaf and 
blind old age, worn out with intemperance." Howard, the philan- 
thropist, fasted one day in the week ; and Napoleon, when he felt his 
system unstrung, suspended his meals, and took exercise on horse- 
back. 

Nothing can be plainer than the duty of fasting, when the 
stomach, having been overworked, is disinclined to receive food. 



88 HYGIENE. 

Brutes invariably follow this suggestion of nature ; they never eat 
when sick, — probably because they have no silly nurses to coax 
them to swallow stimulating aliments. The habit of putting high- 
seasoned food into the stomach when it is inflamed and feverish is 
about as wise as directing streams of blue, violet, or red light into 
the eye when it is red and swollen with inflammation. 

Tea and Coffee. 

It is proper, before closing this chapter upon diet, that something 
should be said respecting the beverages of tea and coffee. 

Some years ago, a meeting was held by the leading physicians 
of a city in the old world, in which the merits of tea and coffee were 
discussed. In this discussion each man first stated his experience 
in the use of these articles, and then constructed his argument 
according to that experience. The amount of what the reader could 
learn from the discussion was that Dr. A. had used tea all his life, 
and been benefited by it, while coffee had uniformly injured him ; and 
that he thought tea should be used, while coffee should be rejected ; 
that Dr. B. had taken coffee at breakfast, and found it an excellent 
support to the stomach and nervous system, while tea had disturbed 
his digestion and his mind ; and that the former was a beverage 
of excellent qualities, while the latter was detestable ; that Dr. C. 
had always drank both tea and coffee, and recommended them to 
everybody ; and that Dr. D. had himself never been able to indulge 
either tea or coffee, and would have them both expelled from every 
household. 

The discussion was not creditable to the learned and really able 
men who participated in it. The arguments were all based upon the 
miserably narrow basis of single individual experiences. They were 
no more valid than that of the man who should hold up a shoe, de- 
claring it fitted his foot the best of any he ever had, and recommend- 
ing all men to have their shoes made upon the same last. 

The truth is, there is but one thing which can be affirmed univer- 
sally of the effect of tea and coffee. They both, when taken, tend to 
prevent waste in the body, and, consequently, less food is required 
when they are used. This may be affirmed of them in their applica- 
bility to all persons, but nothing further. The truth is, some can 
drink tea but not coffee, and some coffee but not tea ; some can use 
both, and some neither. Every man's susceptibility to the effects of 
these beverages is his own, as much as his susceptibility to the effects 
of light, or heat, or atmospheric changes ; and these effects, each per- 
son must learn from experience. Coffee often produces, and gener- 
ally aggravates, a bilious habit, — an effect which cannot, I believe, 
be traced to the use of tea. I have no doubt but that many cases of 
confirmed dyspepsia are traceable to the use of coffee alone. 



HYGIENE. 89 

Water. 

There is one universal beverage ; it is water. All men are fond 
of it. In sickness and in health, in joy and sorrow, in summer and 
winter, in cold climates and in hot, man loves and drinks water. The 
stomach, abused and made sick by stimulating food and drinks, and 
repelling everything else, still gratefully opens itself to water. Wher- 
ever man exists, therefore, or wherever he should exist, water is 
found, either in the form of springs, or running brooks, or rivers, or 
ponds, or lakes ; and even where it is not found in some of these 
forms, it is periodically dropped down from the clouds. As there is 
no element in nature more necessary for man's existence than water, 
so there is none more universally diffused. 

Pure Water Essential to Health. — But water varies very mate- 
rially, both in its physical qualities, and in its adaptation to its pur- 
poses. Pure water is as essential to health as pure air. When either 
of these fluids is rendered impure by mixture with foreign matters, 
disease will be a frequent result. The ancients must have been in- 
fluenced by this fact, or they would not have incurred such heavy 
expenses in procuring pure water from great distances. The strong 
aqueducts through which, for many miles, large streams of water are 
even at this day poured into Rome, attest the freeness of the expendi- 
tures she made for this purpose in the day of her greatest renown. 
We may pity the ancient Romans for being governed in their military 
operations by the opinions of augurs and soothsayers, and certainly 
these things were silly enough ; but in other things, at first view 
equally superstitious, they showed practical wisdom. Vetruvius re- 
ports that in selecting the sites of their cities, they inspected the 
livers and spleens of animals to learn the salubrity of the waters and 
the alimentary productions of the region. The size and condition of 
these organs do in fact indicate the nature of the pasturage and the 
qualities of the water with which animals are supplied. No people 
can enjoy good health when subjected to the double influence of bad 
water and impure air. 

Division of Water. — The simplest division of water is into two 
kinds, soft and hard. Rain, river, pond, and snow water is soft: 
well and spring water is generally hard. Soft water contains but 
little impurities, and when used for washing, forms a good lather 
with soap. Hard water contains at least one of the salts of lime, 
often more ; mixed with soap, it curdles and turns white. The reason 
of this is, that the oily acids of the soap unite with the lime, and 
form a compound which the water will not dissolve. Such water is 
not suitable for domestic purposes. 

Chemical Nature of Water. — Water contains, reckoning the ele- 
ments of which it is composed in volumes, two volumes of hydrogen, 
and one volume of oxygen. These two gases, the unlearned reader 



90 HYGIENE. 

will please remember, are highly subtle bodies, not visible to the eye ; 
and yet, when chemically united, they form a liquid which covers 
two-thirds the entire surface of the globe, — floating upon its bosom 
the navies and merchant ships of all nations, and by its unmeasured 
depths and vast breadths and sublime movements, fills the thoughtful 
mind with conceptions of creative Power, which words never attempt 
to express. Should the two gases which compose this vast body of 
water cease to love each other, and fall asunder, the first lighted taper 
would set the world on fire, and not a living being upon its surface 
could escape destruction. 

Impurities in Water. — It is not surprising that a fluid with as 
great a solvent power as water, should often dissolve and hold in 
solution a great many impurities. In passing along through the 
earth, before it comes up in springs and wells, it is filtered through 
various mineral earths, and becomes contaminated accordingly. In 
running through beds of limestone, it takes up a little carbonate of 
lime. Salt-beds impart to it common salt (muriate of soda), while 
sulphur and other ores tinge it with salts of various kinds. 

Water=Supply. — At the present time all large cities and most of 
the towns in this country are supplied with water for domestic pur- 
poses, either from ponds or lakes, or from artesian wells, of greater 
or less purity, but in almost all cases superior to the common well- 
water, so liable to contamination by cesspools and sewage. The re- 
sult is that the health of the people has been materially improved, 
and fevers, particularly those of a typhoid type, have diminished both 
in prevalence and fatality. The decaying vegetable and animal mat- 
ter, which formerly was washed into the soil, and percolated into and 
poisoned the wells, is now washed away by copious supplies of pure, 
fresh water. 

Lead Pipes. — In cities, water is usually conveyed through the 
dwellings in leaden pipes, — a practice fraught with a danger, to 
avoid which various expedients have been devised. That lead does 
often become oxidized and impart its poisonous properties to water 
when long in contact with it, is a well-known fact. Let a number of 
persons drink every morning from the the first water drawn from the 
pipes, and a portion of them will be attacked with some form of lead 
disease. The pipes should be emptied every morning before using 
the water for domestic purposes, and then there is little danger. Tin- 
lined pipes have been found to be almost entirely free from danger 
of lead-poisoning. 

Physical and Other Properties of Water. — Good water is with- 
out smell, is perfectly clear, and in the mouth has a soft and lively 
feel. When poured from one vessel to another, it should give out 
air-bubbles. Boiled and distilled waters have a vapid, flat taste. 
This is owing to their containing no carbonic acid gas or atmospheric 



HYGIENE. 91 

air, — these being driven off in the act of boiling and distilling. A 
hundred cubic inches of good river water contain about 2i of carbonic 
acid, and 1^ of common air. 

Carbonic acid is what gives to mineral, or soda water, its brisk, 
and even pungent taste. Without a portion of this acid and atmos- 
pheric air, water is perfectly insipid, and not fit to be used as a bev- 
erage. Hence, if it be boiled or distilled to clear it of earthy matters, 
we must expose a large surface of it to the air, and shake it, that it 
may re-absorb from the atmosphere what it has lost, and thus recover 
its taste. 

Rain Water is the Result of Distillation on a large scale, and 
would be insipid, like other distilled water, only that, after being 
distilled off from the waters upon the surface of the earth, it recovers, 
while ascending as vapor, the carbonic acid and atmospheric air. 

Fishes breathe air as well as land-animals, and hence, lakes upon 
the tops of high mountains, where but little oxygen can be absorbed 
into the water from the air, are not inhabited by the finny tribes. 

The Saltness of the Ocean is simply the accumulation of the saline 
substances washed out of the bowels of the earth. 

The water which for thousands of years has been distilling off as 
vapor from the surface of the ocean is nearly pure. Being carried 
by the winds to the continents, it falls as rain, sinks into the earth, 
is filtered through mineral substances, comes to the surfaces in springs, 
is collected into rivers, and, with all its freight of mineral salts, is 
borne back to the ocean. Everything that water can dissolve, and 
carry down from the continents, finds a great depository in the ocean; 
and as this has no outlet, the accumulation must go on without limit. 
Rivers which flow into the ocean contain from ten to fifty grains of 
salts to the gallon, — composed chiefly of common salt, sulphate and 
carbonate of lime, magnesia, soda, potash and iron ; and these are 
the constituents of sea-water. 

Cleansing of Impure Water. — Impure waters should be cleansed 
before being used for domestic purposes. Distillation is the most 
perfect method of purification. Filtration through sand is a good 
method. It removes all suspended vegetable or animal matter, and 
all living animals. Boiling likewise kills all animals, and throws to 
the bottom carbonate of lime. It is this which constitutes the crust 
which lines tea-kettles in all regions where limestone exists. 

•Settlers in a new country should make it a prime object to find 
good water. This is of great moment. Their own health and the 
health of their posterity is dependent upon it. Any soil, good or 
bad, is not worth half price, if it yield impure water. 

Reasons for Prizing Water. — Finally, we ought all to prize water 
very highly, for it composes nearly eight-tenths of our entire bodies, in- 
cluding our flesh, blood, and other fluids. Nay, we owe to it the very 



92 HYGIENE. 

softness, delicacy, and smoothness of our persons. Our muscles, 
nerves, blood-vessels, glands, cartilages, etc., all play smoothly upon 
each other in consequence of water. Take all the water out of us, 
and we should be dry sticks indeed. All our comeliness would be 
gone. Nobody would or could love us. We should be walking 
reeds, shaken and sported with by every wind. Let us never forget 
how much we are indebted to water. 

Exercise. 

Animal life is conditioned upon exercise. Without it health can- 
not exist, or life -itself be continued for any great length of time. 

Proper exercise communicates motion to every part susceptible of 
it. It expands the chest, contracts and relaxes the muscles, quickens 
the motion of the blood, moves afresh all the other fluids, and stirs to 
the centre of the whole frame. More easy and perfect digestion, the 
nutrition of every part, and the proper performance of all the secre- 
tions and excretions, are the results of such exercise. 

A distinguished physician said : " I know not which is most neces- 
sary to the support of the human frame, food or motion." Some of 
the finest talents in the world are probably lost for the want of 
exercise ; for without it the mind loses its keen perception and its 
bounding energy, its power of application and its general scope. If 
men of great talents would give attention to exercise, the world 
would reap a larger harvest from their written thoughts. 

The arrangements of modern society have very much abridged the 
facilities for taking exercise ; but if Trenck in his damp prison, 
with fetters of seventy pounds weight upon him, could preserve his 
health by leaping about like a lion, most persons could do as much 
with the fetters of modern society upon their limbs. 

Must be Regular. — Exercise, to be of much service, must be regu- 
lar, — not taken by fits and starts, — a good deal to-day and none to- 
morrow ; but in reasonable measure every day. Occasional efforts, 
with intervening inactivity, only does mischief. 

Must be Pleasurable. — It should be connected, too, if possible, 
with some pleasing occupation or pursuit. The movement of the 
limbs should carry us towards some place or end in which the mind 
feels an interest ; exercise will then do us most good. Hence botan- 
ical pursuits, the cultivation of a garden, and the like, are often pre- 
ferable to a solitary and aimless walk. t 

Must not be Excessive. — Exercise should never be carried so far 
as to produce great fatigue. Extremes are injurious ; and too much 
exercise, especially by a sick or feeble person, may be as injurious as 
too little. 

No clothing should be thrown off after exercise, nor should one 
cool off by sitting in a draft of air. Very serious consequences often 
follow this practice. 



HYGIENE. 93 

Not to be Taken After Meals. — It is not best to take exercise im- 
mediately after meals. The reasons for this caution have been ex- 
plained. It is true many laboring men go at once to their work after 
eating, without apparent injury. Yet they are strong, and can en- 
dure what those who use their brains chiefly could not. And even 
they do not labor as easily and cheerfully immediately after dinner. 

Active and Passive. — Exercise is properly divided into active and 
passive. Walking, running, leaping, dancing, gardening, various 
sports, etc., are active. While sailing, swinging, and riding in car- 
riages are passive. Riding on horse-back is of a mixed nature, — 
being both active and passive. 

A few remarks upon these several kinds of exercise will have a 
practical value to some of the readers of these pages. 

Walking is one of the most gentle, easy, and generally one of the 
most useful of the active exercises. It is within the reach of all who 
have the use of their limbs, and is indulged at the expense only of a 
little shoe-leather. To make it agreeable, the face is only to be 
turned to some favorite locality, and the mind put in communion 
with the voices of nature. 

To walk with the best advantage, the body should be kept upright, 
the shoulders thrown back, the breast projected a little forward, so as 
to give the lungs full play, and the air an opportunity to descend to 
the bottom of them. This attitude places all the organs of the body 
in the most natural position, and relieves them from all restraint. 
Walking then becomes a source of pleasure. The artist who bends 
over his pallet, and gets into a cramped position, is by this kind of 
walking relieved, and his body kept upright. Females, particularly 
of the wealthier class, are much more apt to neglect this species of 
exercise than males. 

It is not so in England. There it is no uncommon thing for ladies 
of high rank to walk ten miles a day ; and they do it in shoes of suf- 
ficient thickness to protect their feet from all dampness, and in 
clothes large enough to give their muscles full play. As a conse- 
quence, they enjoy excellent health, and in many cases even retain 
their freshness and beauty to old age. 

A master of one of the vessels of our navy who spent some time, 
lately, in the British Channel, was several times invited to spend the 
evening at Lord Hardwick's, where he made the acquaintance of two 
daughters of his lordship, who, in the drawing-room, he thought the 
most accomplished ladies he ever saw. Yet those young women, on 
two occasions, in company with other friends, walked miles to visit 
his vessel, once on a rainy day, clad in thick, coarse cloth cloaks which 
no rain could penetrate, and caring as little for wet weather as a 
couple of ducks. 

Good for the Studious. — For the studious, walking is a most capi- 
tal exercise. It varies the scenes so constantly, and brings the mind 



94 HYGIENE. 

in contact with so many objects, that the monotony of in-door life is 
admirably broken. It was a maxim of Plato, that u he is truly a -crip- 
ple, who, cultivating his mind alone, suffers his body to languish." 

Good in Cold Weather. — Walking is valuable in cold weather, 
because it exposes one to the cold atmosphere, and hardens the person 
against frosty weather, — a consideration of great consequence in 
countries which are subject to extremes of cold. 

Running and Leaping are forms of exercise which should be in- 
dulged with prudence even by the young and healthy. For the feeble 
and the aged, they are entirely inadmissible. Used cautiously, in a 
system of regular training, they may help raise the bodily powers to 
a high degree of agility and endurance. The North American Indian, 
who was bred to the chase, ran with surprising swiftness, and for en- 
durance was scarcely excelled by his faithful dog. What training 
has done for the Indian, it may do for the white man, who may 
chance to inherit as good a constitution. 

The Game of Base - Ball requires very active running, and for the 
young, it Is an exceedingly healthful amusement. It fills the whole 
frame with a bounding spirit, and sets the currents of life running 
like swollen brooks after heavy rains. 

Gymnastics. — The more active species of exercise have generally 
been included under the term gymnastics. Among the Greeks and 
Romans, feats of strength and endurance were supposed to confer 
honor. For this reason, and because war was a laborious calling, re- 
quiring bodily endurance and strength, their youth were trained in 
the most active exercises. Gymnastic games were with them at once 
the school of health and the military academy. 

In England, during the middle ages, acts of Parliament and royal 
proclamations were employed to regulate and foster those manly 
sports and exercises, which fitted the people for the activity required 
on the field of battle. 

Those preparations for brutal wars would be unsuited to the pres- 
ent state of the world ; but the capacity for endurance which these 
trainings produced, could be most usefully employed in the laborious 
and scientific researches which modern advancement requires. Very 
few of our scientific men have sufficient hardness of frame to sustain 
them in their laborious studies. 

The heart-diseases which prevail so extensively are the result, 
many of them, of violent exercise, taken, perhaps, from necessity, and 
proving injurious because not a matter of every-day practice. Violent 
exercise, more than any other kind, must be regular in order to be 
borne. 

Needed by Young Women. — Gymnastic exercises and calisthenics 
are particularly needed by our young women, to give them something 
of the robustness of our mothers, a few generations back. For the 



HYGIENE. 95 

« 

want of them, they are dwindling away, and becoming almost worth- 
less for all the purposes for which they were made. 

In view of this want of exercise the introduction of the bicycle 
offers an excellent means of development for ladies, and it is very 
gratifying to note its increasing use. It brings into play many of 
the muscles of the body, while affording an exhilarating enjoyment 
of fresh air and changing scenery. But caution must be used, not to 
overdo one's self. Short rides only should be taken at first, increas- 
ing the distance as the muscles become hardened. 

Moderns Physically Inferior to the Ancients. Reason for it. — 

It is evident that the moderns are inferior in bodily strength to the 
ancient Greeks and Romans. Before the introduction of Christianity, 
men knew very little about the future, and therefore strove to make 
the most of the present. Hence, they took measures to ensure health 
and long life. It is true that a due regard to the welfare of the fu- 
ture need not, and should not, prevent a care for the present ; but 
from various causes, to be referred to on a subsequent page, such has 
been the practice, to the manifest physical injury of the race. 

Dancing, when hedged about with proper restrictions and limita- 
tions, has great advantages as a physical training for the young. 
There are very few forms of exercise which give so free a play to all 
the muscles, and at the same time so agreeably interest the mind. 
Begun in early life, and pursued systematically, dancing imparts a 
grace and ease of motion which nothing else can give. For this rea- 
son alone, it should be cultivated as an art. 

Every man and woman is often placed in circumstances in life 
where the possession of an easy carriage of body, and an unembar- 
rassed manner, would be prized above gold. One's personal influence 
in the world is greatly increased by an easy, graceful manner. We 
all know how a polite manner wins, while a rough and uncouth one 
repels us. 

Warning against Excess. — While dancing has many things to 
recommend it, there are also several considerations which should warn 
us against using it to excess, particularly in the ball-rooms of fashion- 
able life. So many muscles are called into play, the breathing is so 
much quickened, and the air breathed is often so impure, that the 
circulation of the blood is hastened almost to fever excitement. And 
when to this we add the use of wines and cordials, alternated with 
ices and iced drinks, and the exposure, on returning home from balls, 
to the chilly night air, under the insufficient protection of light cloth- 
ing, we have drawbacks enough to abridge, if not to annihilate the 
benefits derived from this otherwise healthful and elegant exercise. 

But then it will be said, and truly enough, that these are the abuses, 
not the uses of dancing. To these abuses, no parent should permit 
the health of a child to be exposed. In the parlor at home, with a few 
young friends gathered in to spend an evening ; or, in a well-venti- 



96 HYGIENE. 

lated hall, under the instruction of a master of known character and 
refinement, dancing is of high utility, and much may be said- in its 
favor. An amusement for which there is so general a fondness, one 
may say, passion, must be fitted to meet some want of the animal 
economy, and perhaps of man's higher nature. 

Grace of motion gratifies our sense of the beautiful, and in its na- 
ture is allied to poetry. Turning away from the abuses of dancing, 
let the reader thankfully use it as one of the very best physical, so- 
cial, and sesthetical educators of youth. 

But if dancing is salutary, it is only when every limb and muscle 
is allowed to participate naturally and without restraint in the general 
motion. When performed in a dress so tight as to restrain all free- 
dom, not only is every grace destroyed, but injury of a serious char- 
acter may be the result. 

The Cultivation of a Garden is also a species of exercise highly 
conducive to health. To the poor it should have a double attraction. 
It is not only a healthful exercise, but it yields, in its season, many 
wholesome vegetables, the price of which, when they have to be pur- 
chased, frequently puts them beyond their reach. It is pleasant to 
know that in many of our manufacturing towns the workmen own 
small pieces of ground which they cultivate as gardens, — deriving 
health both from the labor, and from the vegetables raised. This is 
one of the kinds of exercise which are more beneficial from having 
an end in view. The man who works in his garden derives pleasure 
from the improvement he is making upon his ground, and from the 
prospect of advantage to himself and family. 

Other Active Exercises. — To the exercises already spoken of may 
be added those which are mostly taken indoors, — the dumb-bells, 
jumping the rope, battledore, etc. They may be resorted to when 
the weather is stormy, or when any other cause may prevent one 
from going into the open air. Nevertheless, as promoters of health, 
they are inferior to those exercises which take one out under the 
open sky. They are too mechanical in their nature, and have too 
little aim, to be allowed to take the place of the preceding. 

Passive Exercises. 

Sailing. — This, to many persons, is among the most pleasurable 
and exciting of the passive exercises. But the excitement arising 
from the motions of a boat, sometimes, in case of timid persons, de- 
generates into fear, which is injurious. Young gentlemen who man- 
age the boat upon sailing excursions, should never put on too much 
sail in a brisk wind, and torment the ladies by exciting their fears, as 
their own amusement may be in this way purchased at the cost of 
others' health, — a result far enough from their thoughts or inten- 
tions, but not the less real. 



HYGIENE. 97 

Swinging. — The sick may sometimes indulge in this exercise, when 
capable of enduring no other. To swing gently has a soothing effect, 
and often allays nervous irritability in a way which nothing else can. 
It is like the lullaby motion of the cradle. It calms and soothes. 

Nervous children and grown persons in feeble health are some- 
times, by roguish boys, swung too high, and very much excited and 
alarmed. This is wrong. It may do great injury. Very few boys 
would do it if they knew the evil consequences. Boys and girls are 
generally kind-hearted ; and though they may like to hector others, 
they will seldom knowingly injure them for their own amusement. 

Carriage=Riding, — The advantages to be derived from this species 
of exercise are probably rated too high. For feeble persons, just re- 
covering from illness, who cannot endure walking or riding on horse- 
back, it is valuable, particularly if taken in an open carriage. But for 
those who have more strength, it is less desirable than many other 
exercises. True, it is generally an agreeable mode of locomotion, and 
for this reason, it is more serviceable than the small amount of exer- 
cise afforded by it would lead one to suppose. 

Carriages are luxuries, and like all other luxuries, they are apt to 
bring on debility, and perhaps shorten life. A man is apt to order 
his carriage to the door at the time when increasing wealth enables 
him to retire from the active pursuits of life, — the very moment when 
he is most in need of some exertion to take the place of that to which 
he has been accustomed. Yet so it is, luxury comes to enfeeble, at 
the time when we need something to harden us. 

Could rich men be persuaded to let their luxuries consist, in part, 
in doing good, and, like Howard, find pleasure in travelling on foot 
to visit those who are sick and in prison, they would be surprised to 
see how their happiness would be increased. 

Close carriages are generally used by the wealthy. They at best 
contain but little air, which is breathed over and over, and becomes 
unfit for respiration. The windows of such carriages should always 
be open, except in rainy weather, when the latticed windows only 
should be used. 

Riding in Sleighs furnishes an agreeable excitement, and may be 
indulged in to some extent with advantage. Yet it can be had only 
in cold weather, and persons who partake of its pleasures should be 
careful to wear clothing enough to protect themselves against the 
frost. This is the more necessary, as very little motion is communi- 
cated to their bodies by the sleigh. 

Horseback Riding. — This form of exercise may fairly rank next 
to walking ; in some states of the system it is preferable. It justly 
holds a high rank as an exercise for consumptive persons. Many a 
man, and woman too, has been benefited by it when suffering from 
lung disease. For those who have hernia, or falling of the bowel, it 
is not proper, as the most serious consequences may result from its 
use. 



98 HYGIENE. 

The Horse should be Owned, — A feeble man who rides on horse- 
back, should, if possible, own his horse ; for, becoming attached to 
him, as he generally does, he will be able to ride farther than upon 
an animal in which he feels less interest. A horse is a noble crea- 
ture, and a man who loves him will sometimes acquire a passion, 
almost, for beingupon his back, and witnessing his splendid perform- 
ances. 

Pleasurable Exercises most Beneficial. — Finally, those exercises 
are most beneficial, and can be longest endured, in which we feel the 
greatest interest. Place before even a feeble man some desirable ob- 
ject, and he will endure a great deal to reach it; or engage the mind 
of a very tired person in something which greatly interests it, and 
considerably more exertion will be easily borne. This is well illus- 
trated by the story told by Miss Edgeworth of a certain father, who 
had taken a long walk with his little son, and found the boy appar- 
ently unable to walk further, some time before reaching home. 
" Here," said the shrewd-minded father, " ride on my gold-headed 
cane." Immediately the little fellow was astride the cane, which 
carried him as safely home as the freshest horse. 

Mental Co=operation is of the highest importance in all exercise. 
Men who are paid by the job, work with far more spirit than those 
who are paid by the day. One would dig in the earth with very 
little spirit, if he had no motive for doing it ; but if expected with 
every shovelful of earth to bring up gold-dust, he would not only 
work with a will, but would endure a great deal more labor. From 
these considerations we may infer that those farmers and manufac- 
turers who pay their men the highest wages, make the most money 
on their work. 

The best time for taking exercise is that in which it does us most 
good. For most persons the morning hours may be considered most 
favorable. But there are many who cannot take exercise in the early 
morning, without suffering from it through the whole day. Some 
are able to walk miles in the afternoon, who would be made sick by 
similar exertions immediately after rising. 

Persons often injure friends who have this peculiarity of constitu- 
tion by urging them out in the morning. They do it from good mo- 
tives, but are, nevertheless, blameworthy for attempting to advise in 
matters which they do not understand. 



Rest and Sleep. 

Our bodies are like clocks ; they run down and are wound up once 
every twenty-four hours. Were they obliged to work on uninter- 
ruptedly, they would wear out in a few days. It is a merciful pro- 
vision that periods of repose are allotted to us. Everything has its 



HYGIENE. 99 

proper place. Rest is not less a luxury after exercise, than exercise 
is after rest. They both confer happiness at the same time that they 
promote our well-being. 

Sleeping Rooms. — The largest part of our rest is taken in sleep. 
Of course the kind of room in which we sleep is worthy of considera- 
tion. Hufeland says : " It must not be forgotten that we spend a 
considerable portion of our lives in the bed-chamber, and consequently 
that its healthiness or unhealthiness cannot fail to have a very im- 
portant influence upon our physical well-being." It should at least 
be large. That is of prime importance, because, during the several 
hours that we are in bed, we need to breathe a great deal of air, and 
our health is injured when we are obliged to breathe it several times 
over. We should at least pay as much attention to the size, situa- 
tion, temperature, and cleanliness of the room we occupy during the 
hours of repose, as to the parlors, or drawing-room, or any other 
apartment. And yet how different from this is the general practice 
of families. The smallest room in the house is commonly set apart 
for the bed and its nightly occupants. 

The sleeping-room should have a good location, so as to be dry. 
It should be kept clean, and neither be too hot nor too cold. And, 
more important still, it should be well ventilated. 

One bed, occupied by two persons, is as much as should ever be 
allowed in a single room ; though, of course, two beds in a large room 
are no more than one in a small one. Both are objectionable. 

Fire in Sleeping Rooms. — As to having fire in a sleeping room, 
that is a matter to be determined by the health of the occupant. 
Persons who have poor circulation, and are feeble, had better have a 
little fire in the bed-chamber in cold weather. For those in good 
health a cold room is preferable. 

Open Windows in Sleeping Rooms. — In the hot weather of sum- 
mer, it is better to keep the windows open to some extent, through 
the night, but not on opposite sides of the room so as to make a draft 
across the bed. 

There is a difference of opinion as to the safety of this practice, 
but the experience of those who have used it prudently and persever- 
ingly has generally sanctioned its employment. It is presumed that 
night-air is made to be breathed; and if we breathe it habitually, 
there is no good reason why it should be considered hurtful. At all 
events we have got to do one of three things, — either breathe it, or 
be poisoned by air which is breathed several times over, or use very 
large sleeping-rooms, and thus lay in a stock to last over night. 

An Open Fireplace in a bed-chamber will do much towards its 
purification. It carries off foul air. But many persons board up this 
outlet as if bad air were a friend with whom they could not think of 
parting. At the same time they will carefully close all windows and 
doors, as if fresh air were an enemy not to be let in. 



100 HYGIENE. 

Beds. — It is a pleasant thought that while so many things which 
injure health are coming into fashion, some which have a like effect 
are going out. Among the injurious things which are silently with- 
drawing are feather-beds. 

In earlier times, a bed made of eider-down was thought to be a 
great luxury «, to be carefully preserved, and handed down from mother 
to daughter. Beds made of hen's feathers, and other coarser kinds, 
were thought to be only fit for children. With due deference to 
these earlier judgments, it must be said that feather beds, whether 
downy or coarse, are not even fit for children. They are composed 
of animal matter, and by a slow process of decay, are always, when 
stirred, sending up an exhalation which it is not healthful to breathe. 

By their softness, too, they increase the general tendency to effemi- 
nacy. In warm weather they are too heating. To sink down into 
them, and lie nearly buried all night, is to insure a feeling of lassi- 
tude and debility in the morning. Only the strongest persons can 
endure it without being made conscious of the evil effects. 

Beds must not be too Hard. — On the other hand, it is almost 
equally unwise to choose a bed of absolutely unyielding hardness. 
When very tired, we may rest even upon a board ; but sleep will 
generally be more sound as well as refreshing, if the bed be some- 
what yielding. The hair mattress is the very best bed yet used. It 
is healthful and easy. No person once accustomed to it will ever 
return to feathers In summer, it is a luxury ; in winter, it is suffi- 
ciently warm, though a little more covering is needed than with 
feathers. 

Bedding. — In hot weather, linen sheets are preferable to cotton, 
and of course will be used by those who have ample means. But 
cotton ones are good enough, and in winter are decidedly the more 
desirable of the two. Cotton is best, too, for those who suffer with 
rheumatic affections. For external covering, comforts are objection- 
able, because they do not let the insensible perspiration pass off as 
freely as it should. They are light, however, and so are rose blankets, 
which have the additional good quality of being porous. We should 
sleep under as few clothes as possible, consistently with comfort. 

Night-Dress, — The flannel, cotton, linen, or silk, worn next the 
skin through the day, should always be replaced, on retiring, by a 
suitable night-dress. The undershirt should be of the same ma- 
terial with that which is taken off, but thinner. If we wear flannel 
through the day, we need it quite as much at night. 

Do not Cover the Face. — The practice of sleeping with the face 
entirely covered with the bed-clothes is very injurious. It compels 
one to breathe the air over several times. 

Natural Position for Sleep. — The most natural position in which 
to sleep is upon the right side. This affords the easiest play to the 



HYGIENE. 101 

internal organs. It is best, however, to learn to sleep in different 
positions, and to change occasionally from side to side. Upon the 
back is not so easy a position. To lie in this way obstructs the cir- 
culation of the blood, by the pressure of the stomach, bowels, etc., 
upon the large blood-vessels which pass down and up in front of the 
backbone. It is very tiresome and injurious to lie with the hands 
above the head. 

Amount of Sleep. — The average amount of sleep required by 
persons in health is from seven to eight hours. Occasionally we find 
persons who get along very well with six, or even five hours ; while 
some, even in health, require nine. There is no absolute standard 
for all persons, in the amount of sleep, any more than in that of 
food. It depends on the temperament, the constitution, the amount 
of exercise, and the exhausting nature of the mental application. 

The object of sleep is to repair the energies, the extent to which 
they are wasted, and the recuperative power possessed, will measure 
the amount required. 

Late Suppers. — These are a bar to all sound and healthful sleep. 
The last meal should always be taken at least three hours before re- 
tiring and should be light. During sleep the stomach should have a 
chance to rest. It will work the better on the morrow. Some per- 
sons boast that they can sleep perfectly well after a heavy supper. 
Perhaps they can, but, as Franklin has wisely suggested, they may 
by and by " have a fit of apoplexy, and sleep till doomsday." This 
will be sleeping too well! 

Preparation for Sleep. — Dr. Franklin left behind the record of 
a wise life, as well as many excellent moral and philosophical direc- 
tions. A good conscience was his prescription for quiet sleep and 
pleasant dreams, — a most excellent direction. Sleep is promoted, 
too, by withdrawing the mind, a short time before retiring, from all 
hard study and exciting themes of conversation, and turning it to 
calmer subjects of reflection, such as the moral attributes of God, and 
particularly his love and paternal character 

Objects of Clothing. 

The clothes we wear are intended, or should be intended, to secure 
three objects, — warmth in winter, coolness in summer, and health at all 
times. 

It has already been shown that our bodies are warmed by their 
own internal fires. In the lungs, in the skin, and indeed in all parts 
of the body, oxygen unites with carbon and other combustible mat- 
ters, producing heat in the same way that it is produced in a grate 
where coal is burned ; and as our temperature always needs to be kept 
to about 98° Farenheit, it follows that this combustion must always 
be going on. 



] 02 HYGIENE. 

Now, the atmosphere which surrounds us is always receiving into 
itself the heat which comes to the surface of our bodies, and thus 
robbing us of our warmth. In summer, the atmosphere, full of the 
rays of a burning sun, may impart heat, instead of taking it away ; 
while in winter it takes more than it gives, and would cause us to 
perish with the cold, were it not for the protection afforded by our 
clothing. 

Clothes, of course, have no power to manufacture or impart heat. 
They only retain, and keep in contact with our bodies, that which is 
generated within us. If we have on a single garment which is made 
tight at the bottom and top, so that no current can pass up or down, 
there will be a layer of air between it and the body, which, becoming 
immediately heated, and being retained there, helps keep us warm, or 
rather, prevents us from being cold. With every additional garment 
put over this, there is another layer of heated air, adding still more 
impenetrable guards against either the intrusion of cold, or the escape 
of internal heat. 

Bad Conductors of Heat. — But, that our clothes may thus retain 
our warmth, and prevent its dispersion, they must be bad conductors 
of heat, — that is, they must not readily take up the heat and convey 
it away from the body. They must slowly absorb the caloric into 
their own substance, and then retain it tenaciously. 

Linen, which is so universally popular in temperate climates, as 
an article to be worn next the skin, is unfortunately a good conduc- 
tor of heat. It does not afford a warm garment. It conducts heat 
rapidly away from the body. Hence it always 
feels cool to the touch. It is really no colder in 
itself than other kinds of cloth, but it is solely 
the rapidity with which it conducts heat away 
from the body, that gives it the feeling of cold- 
FlG<67 - ness. It has other qualities winch compensate, 

in some measure, for this defect. The fibres of which it is composed 
are round and pliable, which makes linen cloth smooth and soft, and 
the sensations produced by it on the skin altogether agreeable. Fig. 
67 represents a fibre of linen, as it appears under a microscope which 
magnifies it 155 times. 

Cotton is warmer than linen, because it is a icorse conductor of 
heat. The perfection to which its manufacture has been carried, 
makes it almost a rival of linen in softness and pliability. It does 
not absorb as much moisture as linen, and there- 
fore better retains its powers as a non-conductor. 
But then the fibres of cotton are not round and 
smooth, like those of linen, but flat and spiral, 
with sharp edges. Fig. 68 represents two of its 
fibres, magnified 155 times. This renders cotton 
irritable to some very delicate skins. This is the reason why linen 






HYGIENE. 103 

is better than cotton for binding up wounds, where there is tender- 
ness of the surface. 

Silk has a round fibre, like linen, which is even softer and smaller. 
It absorbs less moisture than cotton, and in its power of retaining 
warmth, it is superior to both the preceding. It forms the most de- 
sirable fabric for clothing that we have ; but its cost makes it inacces- 
sible to the great body of the people, except as a holiday dress for 
the ladies. Its culture in our country, if extensively established, 
would be a source of national wealth. 

The Fibre of Wool is quite rough, almost scaly, and highly irrita- 
tive to delicate skins. Fig. 69 shows fibres magnified 310 times. It 
is not possible for some persons to wear it next 
the skin. But where this cannot be done it may 
be worn outside the linen or cotton ; and being a 
good nonrconductor, it will in this way preserve 
the warmth of the body, without either irritating 
the skin, or disturbing its electricity. 

Wool, in cold climates, is one of the very best 
materials of which clothes can be made. In New 
England, and, indeed, in all cold and temperate 
regions, it should be worn by delicate persons, in 
the form of thick or thin garments, all the year round. It does not 
readily absorb moisture, and is a dry, warm, and wholesome material 
for clothing. 

Hair. — Though not precisely in the line of these remarks, hair 
may as well be introduced here. Wool is in fact hair. Every part 
of the skin, with the exception of that upon the soles of the feet, and 
the palms of the hands, is intended to produce hairs. On most parts 
of the body, they are short and fine, hardly rising above the surface. 
Upon the head and the face, they grow to considerable length. 

Hair, like wool, is a bad conductor of heat ; and, as growing upon 
the head and face, is doubtless intended for some useful purpose. 
That it was designed as a warm covering, can hardly be doubted. 
The beard, when permitted to grow, is a natural respirator, guarding 
the lungs against cold and dust. It has been noticed that black- 
smiths who have allowed their beards to grow, had their mustache 
discolored by iron-dust, which lodged among the hairs, and very 
justly inferred that the dust must have found its way into the lungs, 
and done mischief, had it not been arrested by this natural respirator. 

That the Beard, when long, does ward off a great many colds and 
throat troubles, is too well known to be denied. It has required moral 
courage on the part of those who have broken away 
from the universal practice of shaving, for which they 
should be honored rather than ridiculed. For those 
who do not suffer from throat or lung complaints, espe- 
cially if they are getting advanced in life, it may not be 
thought worth while to abandon the razor. Yet the change would 




1 04 HYGIENE. 

not be regretted. Fig. 70 is a human hair, magnified 250 times, 
showing its scaly surface. 

The Color of our Clothing is a matter of some moment. The dark 
colors absorb the light, the sun's rays, and heat, much more than the 
lighter ones ; and as those bodies which absorb heat well are likewise 
good radiators, the dark colors have the highest radiating power. White 
reflects heat and rays of light, and is a bad absorber and bad radiator. 
In summer it prevents the sun's rays from passing inward to heat the 
body, and in winter, interrupts the heat of the body in its passage 
out. In summer, it makes the coolest garment ; in winter the warmest 
one. These facts can be very simply illustrated, by laying, side by 
side, upon the snow, when the sun shines, two pieces of cloth, the 
one black, the other white. Lifting them up, after a time, the snow 
will be found considerably melted under the black cloth, but not under 
the white. 

It is now seen that the object of clothing is not to impart heat to 
the body, but to prevent its loss ; that it is not to create it, but to 
furnish the occasion for increasing its degree. It appears further, 
that clothing protects the body against the evil effects of changes of 
temperature, and that white garments, by reflecting, instead of ab- 
sorbing heat, guard it against the heat of summer. 

Clothing should be Porous. — All articles used for garments should 
be porous, and permit the free passage of insensible perspiration. The 
skin receives oxygen through its pores, and gives back carbonic acid. 
It performs a sort of subordinate respiration. India-rubber garments, 
worn next to it, interrupt this, and must do mischief. Shoes made 
of this material soon cause the feet to become damp and cold. The 
dampness is occasioned by the insensible perspiration, which cannot 
escape through the rubber. Such shoes worn in the open air, should 
be immediately taken off on entering the house. 

Thin Shoes. — The defective way in which American females pro- 
tect their feet from cold and wet, is a sore evil; and he who persuades 
them to adopt a wiser fashion, and cover their feet with better guards 
against colds and consumption, will deserve the gratitude of the na- 
tion. We are in many things too fond of copying foreign fashions : 
but if our ladies would, in this matter, follow the excellent example 
of English women, they would live longer, and leave a hardier pos- 
terity behind them. 

The shoes worn by our females, high and low, rich and poor, are 
not thick enough to walk with safety upon a painted floor, hardly 
upon a carpet in an unwarmed room ; and yet they walk with them 
upon cold brick sidewalks, upon damp and frozen ground, and even 
in mud. 

The result is, that they suffer from colds, sore throats, pleurisies, 
lung-fevers, suppressions, inflammations of the womb, and many other 
ailments, which in early life rob them of their freshness and beauty, 



HYGIENE. 105 

of their health and comfort, of their usefulness to their household 
and the world, and leave them helpless in the arms of their friends, 
with a patrimony of suffering for themselves while they live and a 
legacy of disease to hand down to their children. Would that they 
were wise in season ! Some, to their honor be it said, have already 
adopted a safer course. It is hoped the evil will be gradually cor- 
rected. 

Never attempt to mould the Form by Dress. — Parents commit a 
great error when they attempt to mould the forms of their children, 
particularly their daughters, by their dress. This cannot be done. 
It is the work of nature, and she wants no assistance in it. The 
great object of dress in childhood, as well as in adult life, is to pro- 
mote health. With this, there is not much difficulty in preserving 
the symmetry ; without it, deformity is almost a matter of course. 

The fact cannot be too often repeated, nor too seriously urged upon 
parents, that while the foundation of all graceful and just proportion 
of the different parts of the body must be laid in infancy, it cannot 
be done by tight bands, and ligatures upon the chest, and loins, and 
legs, and arms. Upon all these points, the garments of children 
should set easy, leaving the muscles at liberty to assume the fine 
swell and development which nothing short of unconstrained exercise 
can give. Could infants tell all the horrors they suffer from the re- 
straints put upon them by tight dresses, it would make many a 
mother's heart bleed. 

In these brief remarks, the principles are given which should guide 
us in the selection of our clothing. The intelligent reader will be 
able very easily to fill up the outline. 

Bathing and Cleanliness, 

Aristotle calls cleanliness one of the half virtues ; and Addison, 
in the Spectator, recommends it as a mark of politeness, and as analo- 
gous to purity of mind. Both in the Jewish and Mohammedan law, 
it is enforced as a part of religious duty. Its requirement as a pre- 
requisite to christian communion would be wiser than the demands 
sometimes made. A dirty Christian may perhaps be found, but not 
among those who mean to be intelligent. 

The importance of keeping the skin clean is not generally appreci- 
ated. The motive for cleanliness is often a lower and meaner one 
than should be allowed to have place in the mind. Many persons 
would be mortified to have their hands, or face, or neck dirty, who 
do not wash their whole body once a year. That they may appear 
well in the eyes of others, is the only motive with such for keeping 
clean. 

Offices of the Skin. — If we look a little at the offices of the skin, 
we shall better understand the need of keeping it clean. 



106 HYGIENE. 

The skin is not merely a covering to protect us from' the weather. 
It is a living structure, curiously wrought, with a large extent of sur- 
face, and having important duties to perform in the animal economy. 
Its structure is more particularly explained under the head of " Anat- 
omy " and " Skin Diseases." It has been already said, that it helps 
the lungs in breathing. It does many other things on which the health 
is dependent. 

Number of Perspiratory Tubes. — The skin performs several 
kinds of secretion, — that is, it separates several things from the 
blood, — one of which is the perspiration, or sweat. The sweat is 
formed in small glands, situated just under the skin, and is brought 
to the surface in small ducts, or tubes, like the hose through which 
firemen throw water. These little tubes are spiral, as seen in cut 44, 
and run up through the two skins. 

These spiral canals are very numerous, covering every part of the 
human frame, — there being about 2800 of them upon every square 
inch throughout the body ; and as a man of ordinary size has about 
2500 square inches of surface, the number of tubes in the skin of one 
man is seven millions. 

The mouths of these tubes are called the pores of the shin. Each 
one of these tubes is extended just below the skin ; and there, among 
the cells where the fat is deposited it, or rather the two branches into 
which it is divided, is wound into a coil, called the sudoriferous or 
sweat gland. These ducts are each about a quarter of an inch in 
length, which make an aggregate length of tubing in the human skin 
of about twenty-eight miles. 

Insensible Perspiration. — Through each of these seven million of 
quarter-inch hose, there is poured out, day and night, as long as a 
man lives, a stream of sweat in the form of vapor. When this is 
thrown off very rapidly, as happens when active exercise is taken, it 
accumulates in drops, and is called sweat. Ordinarily it does not 
thus accumulate ; it is then called insensible perspiration, — not 
being recognized by the senses. 

This transpiration may be proved very beautifully by inserting the 
naked arm into a long glass jar, and closing up the space around it 
at the mouth so that no air can get in. The inside of the glass will 
soon be covered with a vapor, which will grow more and more dense 
until it is converted into drops. Boerhaave says : " If the piercing 
chill of winter could be introduced into a summer assembly, the in- 
sensible perspiration being suddenly condensed, would give to each 
person the appearance of a heathen deity, wrapped in his own sepa- 
rate cloud." 

Now, this continual exudation of sweat through these millions of 
tubes is for a wise and necessary purpose. It is to take out of the 
blood and other fluids various salts, which would do mischief if 
allowed to remain longer, and particularly carbonic acid, which is 



HYGIENE. 107 

poisonous, — the same matters, in fact, which are thrown out by the 
lungs. The skin, in truth, is a kind of helper of the lungs ; and a 
lady, by covering herself with garments which have no pores, and 
will neither admit air nor let off insensible perspiration, may be 
strangled almost as certainty as by putting a cord around her neck, 
and closing her windpipe. Almost twice as much fluid passes off 
through the skin as through the lungs. 

Keep the Pores Open. — It is obvious from what has now been 
said, that the pores of the skin should be kept open to preserve 
health. When bathing is neglected, and the undergarments are not 
changed sufficiently often, the insensible perspiration accumulates 
and dries up upon the skin, mingling with the oily matter secreted 
by the oil-glands, and with the shreds of the scarf-skin, and form- 
ing a tenacious gluey matter, which closes up the pores. By this 
misfortune, that large quantity of worn-out matter which usually 
goes off with the fluid through the pores is retained to poison and 
embarrass the living current of blood, or seek an outlet through lungs 
or kidneys, which are already burdened with quite as much as they 
are able to do. How important, then, that these channels through 
which the body is purified should be kept open ! that the skin should 
be kept healthy and in working order ! 

The Bath, the Great Purifier. — But this can only be done by 
daily washing. The bath is the great purifier of the human skin. 

The antiquity of bathing is very great. The practice is supposed 
to reach back to the infancy of the race, or certainly to a very early 
period. The inhabitants of Middle Asia are said to have been the 
first to use the bath for the specific purposes of purification and 
health. Domestic baths are represented as having been used by 
Diomed and Ulysses. Andromache prepared warm water for Hector 
on his return from battle. Penelope banished sorrow by unguents 
and baths. 

The Baths of the Medes, the Persians, and the Assyrians were 
much celebrated. Alexander, though familiar with the voluptuous 
baths of Greece and Macedon, was astonished at the magnificence of 
those of Darius. 

Roman Baths. — As luxury and refinement advanced, the means 
of luxurious bathing were multiplied, until establishments were 
built by the Romans, the very remains of which excite wonder at 
this day. Among these are the Thermae of Agrippa, of Nero, of 
Vespasian, of Titus, etc. One of the halls of the building con- 
structed for baths by Diocletian, forms at this day the church of the 
Carthusians, one of the most magnificent temples in Rome. 

Number and Character. — According to Pliny, baths were intro- 
duced into Rome about the time of Pompey ; their first erection 
Dion attributes to Msecenas. Agrippa increased their number to 



108 HYGIENE. 

one hundred and seventy ; and within two hundred years they were 
multiplied to about eight hundred. These establishments were so 
vast that one writer compares them to provinces. They were paved 
either with crystal, or mosaic, or plaster, and were adorned by sculp- 
ture and painting to the very highest degree. They added not 
merely to the health and luxury of the people, but contributed to 
their culture in the highest departments of art and taste. 

Names of Baths. — To the apartment of their dwelling in which 
they washed their bodies in warm or hot water, the Romans gave 
the name of balneum, or bath ; to the public establishments, that of 
balnea, or baths. The apartment which held the vessels was called 
vasarium. In this were the three immense vessels which contained 
the cold, warm, and hot water. There were instruments of bone, 
ivory, and metal, for scraping the skin, with a groove in the edge, 
through which the impurities of the skin might run off. 

On the north front of the thermse was a reservoir of cold water 
large enough for swimming, called by Pliny the younger, baptisterium. 
In the centre was a spacious vestibule, and on each side, warm, cold, 
and vapor baths, with apartments for cooling, dressing, and refresh- 
ments. There was the frigidarium, a vaulted room, a cooling room 
midway between the warmer and the open air ; the tepidarium, with 
a temperature midway between the above and the hot bath; and the 
calidarium, or the vapor bath. 

Then there was the room where the body was rubbed over with a 
great number of ointments and essences of the most precious kinds ; 
and another in which it was sprinkled over with powder ; and also a 
room which held the clothes, in which the bathers undressed and 
dressed at pleasure. 

All these apartments were double, the two wings being appropri- 
ated to the sexes. 

Open to all. — These baths, thus numerous and magnificent, were 
open to all classes of the people, and contributed largely to the gen- 
eral health and physical endurance for which the Romans were con- 
spicuous. 

The Bath Neglected under the Christian System. — When Jesus 
of Nazareth came into the world, he found man's nature cultivated 
in a most defective way. The moral element had sunk down to the 
lowest place, while the physical had risen to the highest, — just the 
reverse of the true order of things. This Divine Teacher came, not 
to recommend a neglect of the body, but a new cure for the imper- 
ishable part. Mankind were for the first time systematically taught 
to forgive injuries. Prostrate liberty and degraded woman became 
the wards of Christianity. 

Unfortunately, under the new order of things, the lower element 
of man, which had been exalted and worshipped, was cast down and 
abused. What the Pagan had pampered, the Christian persecuted. 



HYGIENE. 109 

The body, which had been bathed, and scrubbed, and anointed, and 
perfumed, was thenceforward, in consequence of the improper inter- 
pretation of certain texts, scourged, and fasted, and clothed in rags. 
Thousands believed, and thousands do to this day, that to torment 
the body is to please God. Under this feeling, the public and pri- 
vate baths were neglected ; and to this day no Christian nation has 
fully appreciated the necessity of cleanliness, and of sanitary meas- 
ures for the maintenance of the public health. To a considerable 
extent, the body is still under disabilities ; still the subject of perse- 
cution ; and where this is not the case, it is too often regarded only 
as a loose outside garment, to be thrown over the traveller to the 
celestial city, and is expected to be well soiled with mud and dust. 
The teachings of the Great Master will by and by cease to be per- 
verted, and will be applied to raise up man's body, as they have 
raised his mental and moral nature, and will make a well-developed 
and harmonious being. 

In the meantime, it is the duty and the privilege of the physician 
to urge a return, not to the magnificence of the ancient regimen for 
training the body, but to its real efficiency in a simpler form. 

Cold Bathing. — Water applied to the skin at a temperature below 
75° of Farenheit, is called a cold bath. If applied to a person with 
sufficient constitutional energy to bear it, it is a decided and very 
powerful tonic. By this is meant that it promotes the solidity, com- 
pactness, and strength of the body. 

The first effect of the application of cold water to the skin, is the 
sudden contraction of all its vessels, and the retreat of the blood 
towards the internal organs. The nervous system, feeling the shock, 
causes the heart to contract with more energy, and throw the blood 
back with new force to the surface. 

This rushing of the blood back to the skin, is called a reaction ; 
and when it occurs with some energy, it is an evidence that -the sys- 
tem is in a condition to be much benefited by the cold bath. When 
this does not take place, but the skin looks shrunken, and covered 
with " goose flesh," and a chilliness is felt for a longer or shorter time 
after bathing, then the inference should be, either that the water has 
been used too profusely, or that the bather has too little reactionary 
power for this form of the bath. The latter con elusion must not be 
accepted until cold water has been tried with all possible guards, — 
such as beginning with tepid water, and gradually lowering the tem- 
perature ; bathing for a time, at least, in a warm room ; beginning 
the practice in warm weather ; and applying the water at first with a 
sponge out of which most of it has been pressed by the hand. With 
some or all of these precautions, most persons may learn to use the 
cold bath. It is always to be followed by brisk rubbing with a coarse 
towel or flesh-brush. 

The Sponge Bath. — A wet sponge is the simplest, as well as the 
best mode of applying water to the surface of the body. With per- 



110 HYGIENE. 

sons who are feeble, a part only of the body should be • exposed at a 
time, — which part, having been quickly sponged and wiped dry, 
should be covered, and another part exposed, and treated in a like 
manner. In this way, all parts of the body may successively be sub- 
jected to the bracing influence of water and friction, with little risk, 
even to the most delicate, of an injurious shock. The only furniture 
required for carrying out this simple plan of bathing, is a sponge, a 
basin, and a towel. There is no form of bathing so universally appli- 
cable as tins, or so generally conducive to health. 

The Shower Bath requires a brief notice. The shock to the ner- 
vous system produced by it [is much greater than that from sponging. 
Beside the sudden application of coldness, there is a concussion of 
the skin by the fall of the water. This form of the bath is excellent 
for those who are strong and full of vitality, but is fraught with some 
danger for the feeble and delicate. This, however, depends on the 
judgment with which it is used. In the form of a delicate shower, 
and with tepid water, the frailest body might bear its shock. 

The Warm Bath. — A temperate bath ranges from 75° to 85° ; a 
tepid bath, from 85° to 95° ; a warm bath, from 95° to 98° ; a hot 
bath from 98° to 105°. A warm bath is of the same temperature 
with the surface of the body. Of course it produces no shock. To 
those who are past the meridian of life, and have dry skins, and begin 
to be emaciated, the warm bath, for half an hour, twice a week, is 
eminently serviceable in retarding the advances of age. 

It is a mistake to suppose the warm bath is enfeebling. It has a 
soothing and tranquillizing effect. It renders the pulse a little 
slower, and the breathing more even. If the bath be above 98°, it 
becomes a hot one, and the pulse is quickened. 

The temperature of the warm bath, as of the cold, should be made 
to range up and down according to the vigor of the frame, and the 
circulation of the individual. The aged and the infirm, whose hands 
and feet are habitually cold, require it to be well up towards the 
point of blood heat. The pulse should not be made to beat faster by 
it, nor should sensations of heat or fullness be induced about the 
temples and face. 

The Vapor Bath. — This differs from the warm bath in being ap- 
plied to the interior as well as to the exterior of the body. The 
warmth is inhaled into the air-tubes at the same time that it envelops 
the external person. The first sensation of the vapor bath is oppres- 
sion, and causes some difficulty of breathing ; but this passes off as 
soon as the perspiration begins to flow. From' the steam-chamber, 
the bather should step into a tepid bath, and after remaining a short 
time in this, wipe himself thoroughly with dry towels. 

Cold Affusion immediately after either the warm or the vapor bath, 
is excellent. In Russia it is common, after the vapor bath, to pour 






HYGIENE. Ill 

upon the head of the bather a bucket of warm water, then one of 
tepid, and lastly one of cold ; and to finish with giving him a good 
towelling. It is even said that the natives leave the steam and the 
hot bath, and roll themselves in the snow. 

No danger need be feared from cold affusion when the skin is red 
and excited by the warm bath, provided the nervous frame is not in 
a depressed condition. If the body is chilled, and the nerves pros- 
trated by disease or fatigue, the application of cold water to the skin 
may do great mischief, and should in no case be hazarded. Cold 
water applied to a hot skin cannot do harm ; to a cold skin, it can do 
nothing but harm. Hence, the cold bath may be used with advan- 
tage on rising in the morning, while the body is warm. Another good 
time is at ten or eleven o'clock in the forenoon, when the nervous 
power is advancing towards its height for the day. 

Reaction Necessary. — As a means for promoting cleanliness, the 
importance of the bath can hardly be overstated. For the support 
and improvement of health, it is equally important. But for the pro- 
motion of the latter, one prerequisite is essential, — the reaction of 
the skin. 

Various means are resorted to, to secure this. The Hindoos secure 
it by a kind of shampooing, thus described by a writer : " One of the 
attendants on the bath extends you upon a bench, sprinkles you with 
warm water, and presses the whole body in an admirable manner.- 
He cracks the joints of the ringers, and of all the extremities. He 
then places you upon the stomach, pinches you over the kidneys, 
seizes you by the shoulders, and cracks the spine by agitating all the 
vertebras, strikes some powerful blows over the fleshy and muscular 
parts, then rubs the body with a hair-glove until he perspires," etc. 
" This process," says the writer, " continues for three-quarters of an 
hour, after which a man scarcely knows himself ; he feels like a new 
being." Sir John Sinclair speaks thus of the luxury of the process : 
" If life be nothing but a brief succession of our ideas, the rapidity 
with which they now pass over the mind would induce one to believe 
that in the few short minutes he has spent in the bath, he has lived a 
number of years." 

The Coarse Towel, the horsehair glove, and the flesh-brush are the 
appliances commonly used for stimulating the skin, and causing re- 
action. For tender skins, the towel is sufficiently rough. With this 
the bather should rub himself, unless he is weak and the exertion 
produces palpitation. The muscular exertion necessary for this will 
help the reaction. 

Restoration of the Bath desirable. — It is greatly to be wished 
that the bath might be restored to something like the importance it 
held among ancient nations. It is a luxury, a means of health, and 
a source of purity both of body and of mind ; for the morals of any 
people will rise where the use of the bath is regular and habitual. 



112 HYGIENE. 

The attempt to cure all diseases by what is called the " water-cure," 
has a bit of fanaticism about it, which will cure itself in time. But 
that water, used judiciously in the form of baths, is a potent moral 
and physical renovator of the race, is not to be doubted ; and this 
should commend it to all sensible people, even though it should some- 
times be abused by excess, as all good things are. 

A people with clean hands, and clean bodies, and clean health, will 
very naturally come to like clean streets and clean cities, and finally, 
clean consciences. A fondness for cleanliness in one form, almost ne- 
cessarily runs into a like fondness for it in other forms, until the pu- 
rifying desire pervades the whole nature, moral as well as physical. 

Air and Ventilation. 

Water and air are fluids. Water covers two-thirds the surface of 
the globe, having a depth, in some places, of five miles or more. Air 
covers not merely the remaining third of the earth, but the water as 
well. It embraces the entire globe, pressing alike upon land and 
water, and having a depth of about forty-jive miles. This is a sea of 
such magnitude, that the Atlantic or Pacific shrinks to a very small 
lake in the comparison. 

Man has his residence, and walks about at the bottom of this ocean. 
He has no means of navigating it, and, therefore, never rises to its 
surface ; but, with his natural eyes, and with telescopes, he discovers 
objects which lie millions and billions of miles beyond it, and even 
acquires much exact and useful information respecting them. 

This vast ocean of air we call an atmosphere, from two Greek words 
signifying vapor, and a sphere, — it being an immense fluid-sphere, or 
globe. 

Pressure of the Atmosphere. — This atmosphere presses upon man 
and upon every object on the surface of the earth, with a force equal 
to fifteen pounds to every square inch ; and as a man of average size 
has a surface of about 2500 square inches, the air in which he lives, 
presses upon him with a weight of eighteen tons. This would of 
course crush every bone in his body, but for the fluids within him 
which establish an equilibrium, and leave him unoppressed. 

The Philosophy of Breathing cannot be fully explained in the 
brief space allotted to this subject; it is enough to say, that, upon 
the attempt being made to draw in the breath, the muscles of the 
breast draw up the ribs, the diaphragm or midriff at the same time 
contracting, — the whole movement being such as to create a vacuum 
in the lungs. The air, pressing upon every part of the surface, as 
mentioned above, rushes in and fills the vacuum. The lungs being 
filled, the contraction of the muscles of the belly causes the dia- 
phragm, which has sunk down towards a plane, to rise up into the 
form of an umbrella, and squeeze the air out of the lungs. 



HYGIENE. 113 

This is about all that need to be said of the method of getting the 
air into and out of the lungs. The whole process is under the con- 
trol of that part of the nervous system called the medulla oblongata, 
or the top of the spinal cord. 

Objects of Breathing. — There are at least three objects to be ac- 
complished by breathing ; the renewal of the blood and the taking of 
impurities out of it ; the warming of the body ; and the finishing up 
of the process of digestion, and the change of chyle into nutritive 
blood. 

There is no good reason for attempting here to explain the last of 
these objects. To give any idea of the first two, it is necessary to 
furnish a very brief explanation of the circulation of the blood. 

The heart is double. There are in fact two hearts, a right and a 
left, joined together. The right heart receives the blood from the 
veins, and forces it up into the lungs, whence it is brought back to 
the left heart, and by this is driven through the arteries into every 
part of the body. When received into the lungs, the blood is of a 
dark purple color, and is loaded with carbonic acid and some other 
impurities. It has also been deprived, during its circulation through 
the body, of most of its oxygen. The small, delicate vessels which 
convey this dark and impure blood through the lungs, pass directly 
over the air-cells ; and at this moment the carbonic acid and water 
pass through the blood-vessels and air-cells, and are borne from the 
body on the outgoing breath ; while the oxy- 
gen enters the blood through the walls of the 
same vessels ; and this exchange, which takes 
place with every breath, alters the blood from 
a dark purple to a scarlet red. Fig. 71 
shows at 1, a bronchial tube divided into three 
branches ; 2, 2, 2, are air-cells ; 3, branches of 
Fie*. 71. the pulmonary artery winding around the air- 

cells with the dark blood to be reddened. 

That carbonic acid and water are borne out of the lungs with every 
breath, may be easily proved. If we breathe into lime-water, it will 
become white. This is owing to the carbonic acid in the breath unit- 
ing with the lime, and producing carbonate of lime. Then, if we 
breathe upon a piece of glass, it becomes wet, showing that there is 
watery vapor in the breath. That the blood receives oxygen from 
the air we breathe is proved by the fact that the ingoing breath has 
one-fourth more oxygen in it than the outgoing. 

The lungs, then, take out of all the air we breathe, one-fourth of 
its oxygen. If we breathe it over a second, a third, and a fourth 
time, it not only has less oxygen each time, and is less useful for the 
purposes of respiration, but it becomes positively hurtful by rea- 
son of the poisonous carbonic acid which, at every outgoing breath, 
it carries with it from the lungs. 

Effect of Sleeping in a Small Room. — Now, consider the effect of 




114 HYGIENE. 

sleeping in a small room, seven feet by nine, not furnished with the 
means of ventilation. A pair of lungs, of ordinary size, take in, at 
each breath, about a pint of air. Out of this air one-fourth of its 
oxygen is extracted ; and when it is returned from the lungs, there 
comes along with it about eight or nine per cent of carbonic acid. 
As it is not safe to breathe air containing more than three or four 
per cent of this gas, the pint which the lungs take in and throw out 
at each breath is not only spoiled, but it spoils something more than 
another pint with which it mingles ; and as the breath is drawn in 
and thrown out about eighteen times per minute, not less than four 
cubic feet of air is spoiled in that time by one pair of lungs. This is 
two hundred and forty feet an hour ; and in eight hours, the usual 
time spent in the sleeping room, it amounts to one thousand nine 
hundred and twenty cubic feet. During the hours of sleep, therefore, 
one pair of lungs so spoil one thousand nine hundred and twenty 
cubic feet of air that it is positively dangerous to breathe it. 

In a room seven feet by ten, and eight feet high, there are five 
hundred and sixty cubic feet of air, a little more than one-quarter 
the amount spoiled by one pair of lungs during sleeping hours. In 
a room of this size, there is not air enough to last one person three 
hours ; and yet two persons often remain in such rooms eight or nine 
hours. 

Why then do they not perish ? Simply because no room is entirely 
air-tight. Fortunately, all our rooms are so made that some foul air 
will get out, and a little that is pure will find its way in. Were it 
not so, no man who closed the door behind him, for the night, in a small 
bed-room, would ever see a return of day. 

Suppose fifty children are confined in an unventilated school-room, 
twenty feet by thirty, and ten feet high. These children will spoil 
about one hundred and fifty feet of air in one minute, or nine thou- 
sand feet per hour, or twenty-seven thousand feet in three hours, — a 
usual half-day's session. But the room holds only six thousand cubic 
feet of air, — the whole of ivhich these children would spoil in forty 
minutes. 

These simple facts show the absolute necessity of ventilation. Yet 
how poorly it is provided for in our sleeping rooms, our sitting rooms, 
our school houses, our churches, our court houses, our halls of legis- 
lation, and even in our anatomical and medical lecture-rooms ! 

In sick=rooms, ventilation should receive special attention. — 

Every disease is aggravated by the breathing of bad air. Yet it is 
common to close all the doors and windows of rooms where sick per- 
sons are confined, lest the patients should take cold. This is a bad 
practice. The sick should have plenty of fresh air. Their comfort 
is promoted by it, and their recovery hastened. 

It is strange that human beings should be afraid of pure air. It 
is their friend and not their enemy. Impure air only should be 
shunned. 



HYGIENE. 115 

The supply of good air ample. — There is no necessity for breath- 
ing air which has lost a part of its oxygen, and acquired a portion of 
carbonic acid. The supply of good air is ample. An ocean of it 
forty-five miles deep, covering the whole globe, seems a pretty plain 
intimation that it is not to be sparingly used. When men retire 
within their dwellings, and attempt to shut out this great sea of air, 
they show about as much wisdom as would be exhibited by fishes 
which should build water-tight huts around themselves at the bottom 
of the ocean, and swim about continually in the unchanged water 
within. Fishes can only live in glass globes when the water is 
changed every day ; and if the water be changed half a dozen times 
a day, they cannot be as healthy as when swimming in the great 
ocean. 

Cultivating Trees. — In most of our cities there is almost a crimi- 
nal neglect of the cultivation of trees ; yet they add greatly to the 
health, and prolong the lives of the citizens. 

The leaves of a tree are the lungs with which it breathes ; but in- 
stead of extracting oxygen from the air, and giving back carbonic 
acid, like man, it takes only the poisonous carbonic acid, and gives 
back oxygen. 

Were there no animals on the globe, the vegetables would con- 
sume all the carbonic acid, and die for want of breathing material ; 
on the other hand, were there no trees or other vegetables, the ani- 
mals would in time so far exhaust the oxygen as to perish for lack 
of it. The two together keep the air healthy for each. 

The relation of plants and animals, in all that relates to their 
peculiar actions and effects, is a complete antagonism. Their move- 
ments are in contrary directions, and by hostile forces. Their oppos- 
ing actions may be illustrated thus : — 

The animal consumes the non-ni- 
trogenized substances, sugar, starch, 
and gum. 

The animal produces carbonic acid, 
water, and ammoniacal salts. 

The animal absorbs oxygen. 

The animal pboduces heat and 
electricity. 

The animal is an oxidizer. 

The animal is locomotive. 



The vegetable pboduces the non- 
nitrogenized substances, sugar, starch, 
and gum. 

The vegetable decomposes carbonic 
acid, water, and ammoniacal salts. 

The vegetable disengages oxygen. 

The vegetable absobbs heat and 
electricity. 

The vegetable is a de-oxtdizer. 

The vegetable is stationary. 



We learn from the facts of Geology that the time was in the his- 
tory of our globe, when lunged animals could not breathe its atmos- 
phere ; it was too much loaded with carbonic acid. The trees then 
grew with a rapidity almost inconceivable, decomposing the poison- 
ous gas, taking to themselves the carbon and setting the oxygen 
free, and lifting up their brawny arms to heaven in acts of thankful- 
ness for the great feast. 

At length the noxious gas was exhausted ; and then, pale and 
sickly, they feebly held up their hands for help ; and God sent num- 
berless tribes of warm-blooded animals, full of life and energy, that 



116 HYGIENE. 

sported in the exhilarating air, and destroyed vast forests, thereby 
reproducing carbonic acid. 

These simple facts should teach man the sanitary importance of 
trees and bushes ; and wherever he has a rod, I had almost said a 
foot of ground to spare, a tree should be planted and carefully 
nursed. This is particularly necessary in large cities. Every narrow 
street in a city should be lined with trees. For their absence, thou- 
sands of men, women, and children have died sooner than they 
otherwise would. We want them stretching up their arms to all 
our windows to give us oxygen, and to take to themselves the car- 
bonic acid we exhale. 

Tight Dresses. — The health may be injured by not breathing air 
enough, as well as by inhaling that which is impure. It is therefore 
improper to compress the lungs by wearing tight dresses. If the 
ribs are held down by the dress, but little air can get into the lungs, 
and only a small amount of carbonic acid can be carried out. In 
this event, the health is injured in two ways : the blood is not vital- 
ized by oxygen received, and it is poisoned by carbonic acid retained. 

Tight lacing has in a measure gone out of fashion ; yet too much 
of it for the best development of female health is yet retained. As 
a knowledge of physiology and the laws of life, and a better judg- 
ment of the true symmetry of the female form prevail, this barbar- 
ous custom will pass out of use, and the substantial health and 
real beauty of the American woman will together rise to a higher 
standard. 

Fill the Lungs well. — Persons who take but little exercise are 
apt to acquire the habit of drawing the air very little into the lower 
part of the lungs. This should be counteracted by taking long and 
full inspirations for a short time, every day, while in the open air. 
This practice would get the lungs in the habit of opening to the air 
quite down to their base, and would make the breathing much more 
natural as well as effectual at all times. In the case of young per- 
sons, it would enlarge the capacity of the chest, and add to the brief 
years of life. Parents should see to it that their children spend 
from ten to twenty-five minutes every morning inflating their lungs 
with pure air. 

Travell ing. 

It is true that many persons who dwell in one spot, and hardly 
move from it all their lives, live to old age. Yet change of location 
for a short time, or permanently, does promote health, and protract 
life. The mind tires of contemplating one set of objects for a great 
length of time ; and in the absence of all stimulation, it sinks into 
apathy, and imparts no energy to the body. The physical frame, 
partaking of the ennui of the mind, droops. This is doubly true 
when one is suffering from illness. 



HYGIENE. 117 

Travelling is eminently fitted to draw the thoughts of the nervous 
and feeble from themselves, and to turn them with interest to out- 
ward objects. This is of great importance. It is better than stimu- 
lants and tonics. 

The nervous system has great power over the health; and the 
pleasurable sensations, excited by visiting new places and scenes, 
and conveyed to the mind through the nerves, often awaken in the 
constitution energies which are essential to recovery. 

Travelling places a man in entirely new circumstances. It sur- 
rounds him with novelties, every one of which makes a demand upon 
his attention. It breaks up his old trains of thought, which have 
been monotonous so long that they have grown oppressive. It 
causes the world to touch him at a thousand new points, and sur- 
prises him every day, perhaps every hour, with a view of the false 
relations he has sustained to it. It opens to him new depths in his 
own nature, and causes him to wonder that they never attracted his 
attention before. It opens to him one door after another, leading 
him into new apartments of knowledge ; and as the world grows, he 
finds himself growing with it, until his whole nature dilates and 
beats with new life. 

Means of Travelling Increased. — The last twenty-five years 
have greatly increased the facilities for travelling. Many of the 
sick may now seek health in distant lands, who, had their circum- 
stances been similar twenty years ago, would have been compelled 
to pine at home. The railroads give an easy journey to thousands 
with the comforts of the parlor cars. 

One thing more wanted. — But one thing is wanted to bring the 
means of travelling, for the sick, very nearly to perfection ; it is a 
method of propelling carriages upon common roads, by some cheap 
power, which can never be exhausted, and which shall be easily man- 
aged by the traveller or his companion. This is a prominent want 
of the present hour; a giant discovery, which, at a single stride, 
would carry the world forward a hundred years, and which, we may 
hope, is in the womb of the near future. The power, it is believed, 
will be electro-magnetism. The mode of applying it, when discovered, 
will be simple, yet wonderful ; and the results to the sick, beneficent 
beyond expression. The human mind cannot conceive the advan- 
tages which invalids would derive from such a mode of conveyance. 
Journeys might be long or short ; might be made with any rate of 
speed which the strength permitted. The morning or afternoon 
stages might be discontinued when fatigue demanded, and resumed 
at pleasure. Over uninviting regions the traveller might glfde 
swiftly, and linger where Nature spreads her feasts for the mind. 

The best Seasons for Travelling are spring and autumn. Win- 
ter is too cold. A pleasurable excursion may sometimes be made in 
summer, but in general the season is too hot for comfort. In ehang- 



118 HYGIENE. 

ing climate, food, water, etc., in the sultry season, there is danger of 
contracting very troublesome bowel complaints. 

Means of Travelling for the Poor. — There is one painful thought 
connected with travelling as a means of health, — it cannot be en- 
joyed by the poor. When sick they generally have the careful 
attention of humane physicians ; they receive from kind neighbors 
little delicacies of food and drink ; they are watched with by night, 
and visited by day ; but though suffering from the hard routine of 
a laborious life, and needing diversion and recreation more than all 
else, they cannot travel. They have not the means, and nobody 
thinks of supplying them for such a purpose. 

This is a channel into which charity ought to pour some of its 
benevolent streams. In large cities there is a class of poor females 
who sit in their small rooms and ply the needle diligently through 
the whole year, and who run down every summer very near to con- 
finement in bed. Two or three weeks, in the hot season, spent in 
travelling in the mountains and elsewhere, would bring back the 
color to the pale cheeks of such persons, and save them many years 
both from the grave and from the almshouse. No millionaire could 
make a better use of property than to set it apart, at his death, for 
the specific purpose of enabling the poor to travel. And if this 
suggestion should induce one rich man to consecrate his wealth to 
the Godlike work of bestowing health, happiness, and intelligence 
upon the poor, the great labor of preparing this book will not have 
been endured in vain. 

Amusements. 

That which engages the mind, and at the same time impresses it 
with pleasurable sensations, is a sufficiently accurate definition of 
amusement. Whatever occupies the thoughts and senses in an 
agreeable way, and employs them with some degree of intensity, 
comes under the same head. 

This broad and general definition allows us to disregard our daily 
employments as amusements when they engage our deep attention 
and at the same time give us pleasure. 

The term "amusements," however, in the more popular sense, is 
restricted to those sports, games, plays, exhibitions, entertainments, 
etc., which involve a suspension of our daily labors, and are properly 
called diversions. 

When nature is tired and worn with those severe and exhausting 
toils by which we earn our bread, amusements turn us aside, divert 
us, engage other powers, and allow our tired faculties to rest. They 
are, therefore, of very great importance. Even the most trifling 
amusements may have the highest value. Their very nature and 
object imply that they will be valuable just in proportion as they 
divert and rest us. And just in proportion as they do these things, 
they give us health. 



HYGIENE. 119 

One other thing amusements do for us, which must not be forgot- 
ten ; they preserve in us, in middle life, and even in old age, the 
warm simplicity of childhood. They keep us young in our disposi- 
tions and feelings. They keep us in harmony with nature, and con- 
sequently artless and truthful. They prevent the formalities of con- 
ventional life from stiffening us into cold and repulsive hypocrites. 

Selection of Amusements. — Of course the same amusements are 
not adapted to all persons. The farmer who has worked his muscles 
all day, would not be benefited by a game of ball in the evening ; 
yet there are few games more suitable for the student who has bent 
for many hours over his books. Care should always be taken, there- 
fore, that amusements or sports do not bear upon those limbs or 
faculties which are wearied by work. 

Amusements improve various faculties. — To one who has a 

taste for art, who is fond of works of genius and poetry, theatrical 
entertainments will always be agreeable, and a source of gratification 
and health. I know these exhibitions are objected to by many as 
immoral and hurtful, but more, I think, from habit and fashion, than 
upon any solid grounds of reason or religion. They certainly appeal 
to a high order of faculties in the human mind ; and to those who 
are fitted to receive them, teach lessons of great moment. Even the 
lower exhibitions of comedy, though not particularly improving to 
the mind, are yet, from their power to provoke laughter, among the 
most powerful up-builders of health. 

The Games of Whist, Euchre, etc., engage the minds of the play- 
ers in a sort of mental contest, which is exciting, agreeable, and 
health-imparting. These games make us skilful in calculating 
chances, and judging how men ought to act under certain contin- 
gencies. They make us sharp to detect and turn aside the unseen 
forces, which tend to oppose and destroy our success in life. 

I hardly need to say that money or rather property should never 
be staked upon a game of cards, or upon any other game. Gambling 
is one of the meanest as well as most destructive things in which men 
can engage. It raises the healthful excitement of these innocent 
amusements, — innocent when properly pursued, — into raging pas- 
sions, which, when defeat comes, as come it will, sink into remorse 
and bitterness as terrible as the mind can conceive. I warn young 
men, as they would escape the pangs of a hell on earth, and the loss 
of character, happiness, and probably health for life, to avoid any 
such abuse of cards. 

Chess, Chequers, etc., appeal likewise to the fondness of competi- 
tion, which is common to all men. But they cultivate in us a little 
more of the mathematical element. As they require very close appli- 
cation of the mind, they are not suitable for persons of sedentary em- 
ployments, or whose daily avocations require a constant use of the 



120 HYGIENl. 

mind. Such persons should choose lighter and more active amuse- 
ments. 

Lighter Amusements. — Beside these higher amusements, there 
are a great number of lighter and more childish ones, which should 
not be overlooked. 

Some of these are merely physical, involving a trial of strength, 
fleetness, action, etc., as the games of ball, cricket, etc. Others are 
domestic in their nature, involving mirth, and various other of the 
lighter excitements, as blind-man's buff, puss in the corner, hole in the 
wall, fox and geese, hunt the slipper, hurly-burly, roll the platter, etc. 

In fashionable American households, these simple domestic plays 
have in a great measure gone out of use, — being deemed vulgar, and 
below the dignity of ladies and gentlemen. I am sorry to say this ; 
for the vulgarity, in my judgment, is in those who reject them, and 
not in the play. 

The officer of our navy, whose visit to the mansion of Lord Hard- 
wick I have spoken of on page 93, reports that on the evening of one 
of his visits, the play of blind-man's buff was engaged in by the whole 
party ; and that his Lordship in attempting to make a short, turn dur- 
ing the play fell upon his back, when one of his daughters, who was 
blinded, caught him by the heels, and being assisted by others, drew 
him feet-foremost half the length of the hall, amid the shouts of the 
whole party. This would have been deemed very vulgar by fashion- 
able people in this country. But to me, who am no believer in any 
nobility which Lord Hardwick can receive from kings or queens, this 
simple narrative raised him at once to a peerage in nature's realm. 
Without doubt, he is one of nature's noblemen. A man in his sta- 
tion, and with his wealth and temptations to snobbery, who can pre- 
serve such simplicity of character, must have a warm as well as a 
noble heart in his breast. 

Value of Domestic Amusements. — I remark here that, in all our 
amusements, we should, as far as possible, seek those of a domestic 
character. They are more simple and childlike in their nature, and 
preserve in us, even to old age, the freshness of feeling, and truthful 
simplicity, which spread so beautiful a greenness over the autumn of 
life. 

Simple domestic amusements, too, are always gotten up on a cheap 
scale; they do not encourage costly extravagance, and can be in- 
dulged in by the poor as well as the rich. 

But more, and better than all, they keep young men and old men, 
and young women and old women, at home, by making the domestic 
circle the centre of attraction. They draw the seekers of pleasure 
around the hearth-stone, instead of outward in the world. They in- 
cline young and old to look to the family circle as the centre of the 
most pure, because the most simple and natural, enjoyments. They 
teach us to look to home as the centre of life, and to all outside as 
only its appendages. 



HYGIENE. 121 

M 

It has been said that homes are found only in England ; that in 
other countries, life wanders, houseless and shelterless, abroad, seek- 
ing happiness, it knows not where, while in England it nestles warmly 
in the bosom of home. To whatever extent this is true, — and I be- 
lieve there is truth in it, — it is owing to the simple household amuse- 
ments of England. 

An American Want. — One of the great wants of this country is a 
more liberal provision for amusements. We attach here too much 
value to wealth ; and we pursue it with an intensity altogether in- 
compatible with health. We cannot take time for recreation because 
we are in so great a hurry to be rich. 

If we would save ourselves from a total wreck of health, we must 
take broader and better views of life. We must value it for its solid 
comforts, rather than for its glitter and show. 

Contrary to the general belief, insanity is very prevalent among 
seamen and farmers. The former lead a life of dreary solitude upon 
the ocean ; the latter, one, if not of equal, certainly of very objection- 
able solitude upon the land. The sailor who does business upon the 
great sea should provide himself with great numbers of games to 
amuse him in his wanderings. The farmers of our land should cul- 
tivate more of the sociabilities of life. Let them meet together in 
the fine summer evenings, like the peasants of France, and dance 
upon the green lawns before their cottages. They will till their lands 
more cheerfully for it ; enjoy better spirits and health ; and live to 
greater age. 

Completeness of Life. — Amusements are necessary in order to 
give a completeness to life. The faculties of the human mind are 
numerous. It is only when they are all exercised, in their due pro- 
portion, that there is a harmonious beauty in our lives. The cus- 
toms of society twist us all out of shape, — perverting us mentally, 
morally, and physically, and robbing us of every manly and health- 
ful quality. Getting out of the ruts of fashionable life, we must 
come back to the simple paths of nature. 

I would strongly impress upon parents, teachers, and guardians, 
the importance of studying well the various temperaments, physical 
and mental peculiarities of their children, in order to judge wisely 
of the kind and amount of recreation required by them. 

Instance : a pale, delicate child of ten to twelve or fourteen years, 
with clear complexion, flaxen hair, blue eyes, slender frame, and" a 
nervous, sensitive organization, with strong mental cast, requires 
much more recreation and out-door exercise than a full-blooded, 
robust child of that age ; a fact not at present duly considered, as a 
general thing. 



TEMPERAMENTS, CONSTITUTION, AND 
SYMPTOMS. 



Man has thinking ', warming, nourishing, and moving powers. For 
the performance of each of these great functions, he has organs of 
the best possible construction. 

For Thinking, he has a brain. If this be large in proportion to his 
other organs, it gives a character, a cast, a peculiarity to his whole 
organization. Everything about him is subordinate to his brain. 
We recognize him, at once, as a thinking and feeling being. He 
has an intellectual look. There is a delicacy, a refinement, a sensi- 
tiveness, a studious habit, an air of thoughtfulness about him, which 
determine his traits, his tone, his temper, his whole character. Hence 
it is proper to say he has a cephalic or thinking temperament. 

The Lungs and Heart, devoted to renewing and circulating the 
blood, are placed in the chest or thorax. If these be large in man in 
proportion to other organs, he is characterized by great activity of cir- 
culation, by a large supply of red blood, and by the general indica- 
tions of a full, warm, and bounding life. This activity gives him 
his tone and temper, and shows that his is the thoracic or calorific 
temperament. 

In the Great Cavity of the Abdomen is done the work of receiv- 
ing, digesting, and disposing of the materials which nourish the body. 
If the organs which do this work be large in proportion to others, the 
body is fed to repletion, and the whole organization speaks of the 
table. The habit, the look, the temper, are all sluggish. This is the 
abdominal or alimentary temperament. 

The Bones and Muscles are instruments by which the movements 
of the body are performed. If these be the largest, in proportion, of 
any in the body, then the locomotive powers are in higher perfection 
than any others. There is largeness of person, energy of movement, 
and greatness of endurance. The whole cast of the person partakes 
of the strength and coarseness of bone and muscle. This is the 
muscular or locomotive temperament. 

This gives us four temperaments, as follows : — 

I. The Cephalic Temperament, denoted by large brain, activity of 
mind, and general delicacy of organization. 

122 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 123 

II. The Thoracic Temperament, indicated by a large chest, force 
of circulation, redness of skin, great activity, warmth of temper, 
and fulness of life. 

III. The Abdominal Temperament, denoted by a large develop- 
ment of the stomach, liver, bowels, and lymphatics ; by a fulness of 
belly, fondness of high living, and a disposition to float sluggishly 
upon the current of the world, rather than to struggle against it. 

IV. The Muscular Temperament, indicated by largeness of frame 
and limbs, coarseness of structure, and great power of locomotion 
and endurance. 

There are some reasons for reckoning but three temperaments in- 
stead of four, by reducing the thoracic and abdominal to one, after 
the manner of the phrenological Fowlers, — especially as the organs 
in the chest, and their appendages, take an important part in the 
process of nutrition. But as the heart and lungs are placed in one 
cavity, and the stomach, liver, etc., in another, and as one set of 
these organs may be largely developed, and the other defectively, I 
have thought it most convenient, on the whole, and quite as philo- 
sophical, to retain the four temperaments. 

These temperaments seldom or never appear single and pure. 
They mix and cross with each other in all possible ways. 



Medication and Temperaments. 

The object of speaking of temperaments in this work is to make 
the reader acquainted with the principles upon which remedies are 
to be adapted to their development. The philosophical-minded phy- 
sician will, in prescribing, always keep the temperament in view. 

Persons of a Cephalic Temperament cannot bear powerful medi- 
cines, — particularly drastic purges. Their fine, delicate and sensi- 
tive organizations would be torn all to pieces by doses which would 
hardly be sufficient in a fully-developed muscular temperament. 
This should always be borne in mind in prescribing for persons of a 
large brain and delicate organization. 

In this temperament, too, fevers, instead of running a high and 
fiery course, take the low typhoid type, the patient becoming pale, 
and showing a constant tendency to sink. Such patients would be 
killed by purging, leeching, cupping, sweating, and starving, They 
want tonics, stimulants, and every kind of support which the case 
will possibly permit. 

Persons of a Thoracic Temperament, having a rapid circulation, 
and a fulness of blood, are most liable to inflammatory diseases. 
When fever attacks them, they have what is called a « high fever." 
If rheumatism comes, it is acute rheumatism. Disease takes hold of 
them smartly. As they do everything with emphasis and energy 



124 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 

when well, so, when ill, they make a business of it, and are sick with 
all their might. 

Stimulants and tonics generally make such persons worse. They 
want sedatives, and diaphoretics, and sweats, and purgatives, and 
leeches, and cups, and low diet, and cold bathing, and whatever else 
will slacken the ferocious swiftness of their circulation. 

Those of the Abdominal Temperament are not particularly sub- 
ject either to very high fevers, or to those typhoid forms which 
produce sinking. As in the two temperaments noticed above, their 
complaints chiefly attack the organs most largely developed. Their 
diseases affect the stomach, the liver, the spleen, and the bowels. 
These are the largest organs in their bodies, and are most used ; and, 
being overworked, they fall into disease. 

As these persons are slothful in all their habits, so their diseases 
run a sluggish course. They are not so liable to sudden death as 
persons of either of the preceding temperaments. They have all 
sorts of chronic diseases which linger a great while, and are cured 
with much difficulty. 

These persons will bear larger doses of medicine than either of 
the preceding. Neither do their constitutions respond as readily to 
medicine. A physician will be disappointed if he expects to see 
them recovering as fast under its use. 

Those of a Muscular Temperament, having little fondness for 
anything but a hardy, active life, are much exposed to the elements. 
Though strong and long-enduring, the hardship of their lives often 
breaks them down, and when felled by disease, they are oftentimes 
shockingly racked and torn by it. 

These persons bear large doses of medicine, and when sick, need 
to be treated with an energy proportioned to the strength of their 
constitution. Rheumatism, which affects the joints, the ligaments, 
and the tendons, is an affection from which they suffer severely. 

The Constitution. 

In prescribing for disease, it is of very great importance to take 
notice of the constitution. This is a different matter from the tem- 
peraments. Persons of the same temperament are often quite unlike 
in the strength of their constitution. And those having good natural 
constitutions, frequently abuse them by improper habits and indul- 
gences, and at length come to have broken and very feeble consti- 
tutions. 

Some persons' muscles and other tissues are put together as if 
they were never intended to come apart. Like some of the woods 
of the forest, — the lignum vitse for example, — they are fine-grained 
and tough. A real smart boy will wear out an iron rocking-horse 
sooner than one of these persons can exhaust their constitution by 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 125 

hard work. Others, to outward appearance equally well made, have 
very little endurance, break down easily under hard work, and lose 
their flesh from trifling causes. 

The state of the constitution, therefore, should always be learned 
before much medicine is given ; for what a person of a strong con- 
stitution will need, may greatly injure a feeble person, even of the 
same temperament. 

Habits. — These must likewise be attended to. Persons using 
stimulants require larger doses of medicine to affect them than other 
persons. 

Climate. — Medicines act differently on the same persons in sum- 
mer and winter. Narcotics act more powerfully in hot weather and 
climates than in cold, and must be given in smaller doses. 

Idiosyncrasy. — Medicines of only ordinary activity,- act very pow- 
erfully, and even violently on some persons. This is owing to a pecu- 
liarity of stomach, or constitution, called idiosyncrasy. It makes the 
person, in this particular, an exception to the general rule. And no 
physician can know beforehand in what particulars this exceptional 
disposition will show itself. Persons, however, learn their own idio- 
syncrasies, and should make them known to those who prescribe for 
them for the first time. 

The Sex. — The peculiarities of each sex should never be forgotten 
in prescribing for the sick. 

Males are not so sensitive as females. They will bear more medi- 
cine, and their nervous system is not so readily excited by it. 

Influence of Age. — Human life is divided into infancy, childhood, 
youth, manhood, and old age. Each of these periods has peculiarities 
which modify disease. 

. The First Period, extending from birth to the age of seven years, 
is marked by tenderness and excitability, and is alive to every irrita- 
tion. Teething and other disturbances occur at this period, and need 
careful management. 

The Second Period extends from seven to fourteen, and is quite 
subject to disease, including the second dentition. During these two 
periods there is no great difference between the sexes ; both are ten- 
der, and need careful watching. 

During the Third Period, the changes occur which mark and sepa- 
rate the sexes. This is a developing period, when the functions be- 
come established, and the frame acquires form, proportion, and 
strength. 

At this time, hereditary tendencies to disease, latent till now, begin 
to show themselves, and call for every possible endeavor to break 
them up, and fortify the constitution. 



126 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 

The Fourth Period embraces the vigorous maturity of life, when 
the powers of body and mind, in both sexes, are at the summit of 
their excellence. The functions are now well established. It is dur- 
ing this period that the female is subject to most of the harassing 
ailments peculiar to her sex. So numerous are these complaints, and 
so large and valued the class of persons affected by them, that he who 
treats them with the greatest skill, and with the delicacy which their 
nature demands, may be said to be at the head of his profession. 

The Fifth Period is that of old age, when the functions are declin- 
ing, and the frame is bending under the weight of years. Old age 
begins earlier with females than with males. Many ailments are com- 
mon to this period, which require peculiar management, both medi- 
cinal and hygienic. 

Proper Frequency of Dose. — Each succeeding dose should be 
given before the effect of the preceding is gone. If this rule is not 
attended to, the cure does not advance. What is gained by each 
dose is lost by the rallying of the disease in the interval. Care must 
be taken, however, not to apply this rule too strictly with very active 

medicines. 

• 

How to Examine a Patient. 

When a patient is presented for examination, having observed the 
temperament, constitution, sex, and age, 

1. Learn the causes of the disease, whether local, specific, or gen- 
eral, and also its history. 

2. Search out its nature and character, whether febrile or other- 
wise. 

3. Take notice of the whole train of symptoms, -^-embracing the 
pulse, the condition of the mouth, tongue, and digestive organs, the 
breathing, the urine, the fecal discharges, the condition of the brain 
and nervous system, the state of the skin, etc. 

Brief Table Explanatory of Symptoms. 

GENERAL APPEARANCE OF PATIENT. 

1. Tonic spasm ol the trunk indicates Locked jaws. 

2. Distorted features, altered position, " Paralysis of one side. % 

and impaired motion of limbs 

.'). Irregular and perpetual motion " St. Vitus's dance. 

4. Entire and absolute immobility " Catalepsy. 

.">. Great and unnatural boldness " Insanity or delirium. 

6. Great and unusual languor " The beginning of an acute disease, or 

the progress of a chronic one. 

7. Ability to lie only upon the back " Apoplexy. Organic disease of the brain 

or spinal marrow. Acute inflamma- 
tion of the lining of the abdomen. 
Rheumatism of the joints. 

8. Lying upon the face " Several kinds of colics. 

9. Lying upon one side " Pleurisy, or inflammation of the lungs. 

When one lung only is affected in 
consumption, the patient generally 
lies on the diseased side. 



TEMPEKAMENTS, CONSTITUTION, AND SYMPTOMS. 



127 



10. Maintaining the sitting posture indicates 

only 

11. The head thrown back " 

12. Eestlessness and tossings 

13. General enlargement of the body " 



Disease of the heart or lungs, which 
interferes with breathing. 

Severe diseases of the larynx and wind- 
pipe. 

The beginning of acute inflammation. 
Fevers. Delirium, and acute mania. 

Cell-dropsy. Emphysema from a 
wound of the chest. 



Head, Face, and Neck, 



1. Head bent to one side 



2. Head increased in size 

3. Swollen scalp 

4. Dull expression of face 

5. Full, red face, with blood-vessels 

of eyes injected 

6. Pinched, contracted countenance 

7. Pinched nose, sunken eyes, hollow 

temples, skin of forehead tense 
and dry, complexion livid 

8. Wrinkles across the forehead 

9. Wrinkles from forehead, vertically 

to root of nose 

10. A white line from inner angle of 

the eye to just below the cheek- 
bone 

11. White line from the upper border 

of the wing of the nose (alanasi), 
curved to the outer margin of the 
orb of the eye 



12. The white line in children from 

angle of mouth to lower part of 
face 

13. A white line external to the last 

two, in a semicircular direction 
towards the chin 

14. Swelling of the face and eyelids 

15. Transient redness or flushing of 

face 

16. Hectic flush 

17. Paleness of face 



18. Dingy, white, or greenish face 

19. Yellow tint 

20. A citron tint 

21. A bluish tint 

22. Perpetual motion of eyelids 

23. Forcible closure of eyelids 

24. Eyelids remaining open 

25. Palsy of the upper lid 

26. Flowing of tears over the cheek 

27. Nostrils dilating forcibly and rap- 

idly 

28. Itching of nostrils in children 



indicates Convulsions. Paralysis of one-half the 

body. Dislocation of bones of neck. 

Swelling of glands of neck. 
Chronic hydropholus. Enlarged brain. 
Erysipelas. Small-pox. 
Typhoid fever. 
Swelling of heart. Congestion of 

brain. 
Acute inflammation of peritoneum. 

Exposure to severe cold. 
Chronic disease just before death. 



Excessive pain arising externally. 

Distress, anxiety, and severe internal 
pain. 

In children, a brain or nervous affec- 
tion ; in adults, abuse of the genera- 
tive organs. 

In consumption and wasting of flesh. 
The lower part of the line indicates 
disease of stomach ; the upper part, 
some affection of upper part of bowel. 
When united with the white line 
named above, and with a drawing in 
of the cheek, fixed eyes, and a wan 
complexion, it implies worms. 

An affection of the chest, with diffi- 
culty of breathing. 



Chronic and obstinate 
chest or belly. 



disease in the 



Albumen in the urine. 

Suffering from the monthly irregular- 
ity. 

Consumption. Chronic affections. 

Cold stage of fever. Acute inflamma- 
tion. Chronic diseases, especially 
Bright's disease, during recovery. 

A low and deficient state of blood. 

Jaundice. 

Cancerous disease. 

Poor circulation in the veins. Cholera. 
Typhus fever. Blue disease. 

Mania and idiocy. 

Intolerance or dread of light. 

Orbicularis palpebrarum. Paralysis of 
the muscle which closes the eye. 

Injury of the third pair of nerves. 

Obstruction of the lachrymal duct. 

Difficulty of breathing. 

Worms in the bowels. 



The Tongue. 



Surface of tongue covered with a indicates 
layer of whitish, soft, mucous 
substance, which may partially 
be taken off with a scraper, — 
also, clammy mouth 



Derangement of stomach 
both. 



or bowels, or 



128 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



2. State of tongue as above, with 

clammy mouth, bitter taste, and 
fetid breath. 

3. Great load on tongue as above, 

which peels off, leaving the 
tongue smooth, red and tender 

4. Tougue slightly white from small 

white points, and sometimes cov- 
ered with fur, like the fibres of 
coarse velvet 

5. Tongue pale, tumid, clean and very 

smooth 

6. Tongue furred and dry 

7. Tongue white and loaded, with 

much thirst 

8. As above at first, — afterwards 

clean, red, and dry 

9. Tongue white and loaded, with dry- 

ness 

10. Tongue dry., parched, tender, and 

dark brown or black. Pushed out 
with great difficulty and tremb- 
ling 

11. Tongue loaded with white, through 

which numerous elongated, very 
red papillae protrude their points 



indicates Acute dyspepsia. Asthma. 
11 Severe cases of acute dyspepsia. 



Chronic dyspepsia. Some affection of 
the liver, if the fur be yellow. 



Chlorosis or green sickness. 

Violent local inflammation. Irritation 

in bowels. 
Inflammatory fever. 

Protracted inflammatory fever. 

Mild typhus fever. 

Severer forms of typhus fever. 



Scarlet fever. 



The Throat, 



1. Throat enlarged 

2. Violent pulsation of carotid arteries 



3. Pulsation of the nameless artery 

(arteria innominata) above the 
breast bone, and to the right of 
the windpipe. 

4. Circumscribed swelling about throat 



indicates The approach of puberty in females. 
" Acute mania. Inflammation of brain. 

Enlargement of heart, and dilation 
of right ventricle. Anemia. 
" Regurgitation from aorta. 



Enlargement of glands. 



1. General enlargement of one side of 

chest 

2. Bulging at the base of a lung 

3. Bulging at front upper part of chest 

4. Bulging right hypochondrium (See 

Fig. 95) 

5. Bulging in region of heart 

6. Tumor where the third rib joins the 

breast-bone 

7. Tumor between the base of the 

shoulder blade and the spine 

8. Depression or retraction of one side 

of chest 

9. Breathing increased in rapidity. 

Generally, in health, about 
twenty breaths are taken in a 
minute 
10. Breathing diminished in rapidity 



11. Jerking respiration 

12. Breathing with muscles of ribs only 



The Chest. 

indicates Large effusion of water from pleurisy. 



Water from pleurisy settling to the 

bottom. 
Emphysema. 
Enlargement of liver. 

Water in heart-case. Enlargement of 

heart. 
Aneurism of the ascending aorta. 

Aneurism of the descending aorta. 

Consumption. Absorption of fluid, 

effused by pleurisy. 
Spasmodic asthma. 



Pleurisy. Paralysis of respiratory mus- 
cles. Inflammation of lungs. Emphy- 
sema. Pneumothorax. Consumption. 

Spasmodic asthma. Obstruction in 
larynx and windpipe. 

Abdominal inflammation. Inflamma- 
tion of diaphragm. 



1. Decreased size of belly 



The Belly. 

indicates Dropsy. Wind in bowels. Inflam- 
mation of peritoneum. Obstruction 
in bowels. Hysteria. 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



129 



2. Enlargement in epigastrium (Fig. 93) indicates Hysteria. Cancer of stomach. 

3. Enlargement in hypogastrium (Fig. 95) " Distension of bladder. Ovarian tu- 

mors. Accumulation of feces in 
bowels. 

4. Belly diminished in size " Chronic dysentery. Lead colic. Also 

in most chronic diseases. 



1. Enlarged penis in children 

2. Drawing up of testicles 

3. Enlargement of scrotum 



Private Organs. 

indicates Stone in bladder. Masturbation. 
Stone in kidneys. 
Hydrocele. Hematocele. Saroeele. 



1. The limbs immovable 

2. Limbs contracted and rigid 

3. General swelling of limbs 

4. Swelling of joints 

5. Limbs diminished in size 



The Limbs. 

indicates Paralysis. 

" Softening of the brain. 

Defective circulation of blood. 
" Rheumatism. Water in the joints. 

White swelling. 
" Paralysis. 



The Nervous System, 



1. Morbidly increased sensation 

2. Tensive pain 

3. Dull, heavy pain 



4. Smarting pain 

5. Shooting, tearing pains 

6. Boring pains 

7. Contusive pains. 

8. Itching. Sensation as of ants creep- 

ing over the skin 

9. Exaltation of vision 

10. Black flecks floating before the 

eyes 

11. Painfully acute hearing 

12. Dull hearing 

13. Increase of strength 

14. Debility 

15. Trembling 



16. Rigidity of upper extremities 

17. Cramp 

18. Temporary spasm 

19. Pain at extremity of penis 

20. Pain in right shoulder 

21. Pain in left shoulder 

22. Exaltation of affections 

23. Loss of moral sensibility 

24. Exaltation of intellect 



indicates Acute inflammation of brain and 
spinal marrow. Fevers. Hysteria. 
Phlegmonous inflammation. 
" Enlarged internal organs. Internal 

tumor. Effusion of water into cavi- 
ties lined with serous membranes. 
Felt in the loins previous to dis- 
charge from menstruation, and from 
piles. 
Scarf-skin removed. 
Neuralgia. Cancer. 
Constitutional syphilis. Rheumatism. 
Gout. Inflammation of periosteum. 
" Bruises. Acute diseases. 

" Several diseases of the skin. 



Ophthalmia. Inflammation of brain. 
Some nervous diseases. 

Affections of the brain and optic 
nerve. Dyspepsia. 

Inflammation of brain. Hysteria. 

Typhus fever. 

Delirium. Inflammation of brain. 
Mania. 

Most diseases. 

Cold stage of fever. Nervous affec- 
tions. Old age. Action on the sys- 
tem of lead, mercury, strong coffee, 
alcoholic drink, tobacco, opium. 

Softening of the brain. Infiltration 
of blood into the brain. Hysteria. 

Pregnancy. Hysteria. Painters' colic. 

In convulsions of children. Some 
affections of the brain. 

Stone in bladder. 

Congestion of liver. 

Disordered stomach. 

Hypochondriasis. 

Mania. Typhus fever. Masturbation. 

Melancholy. Sometimes indicates 
close of life. 



1. Stiffness of chest 

2. Pressure upon parts 



The Breathing. 



indicates Cartilages turned to bone. Pleura 
hardened. Distortion from rickets. 
" Tumors. Dropsy of belly. 



130 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



3. Obstruction of air-tubes 



4. Compression of lungs 



5. Pain in parts moved in breathing 

6. Paralysis of muscles of chest 

7. Spasm of muscles of chest 

8. Deficiency of red blood 



indicates Spasm of glottis. Spasm near the 
small ends of bronchial tubes. 
Mucus, etc., thrown out upon the 
inner surface. 

" Effusions in pleurisy. Water in 

chest. Air in substance of lungs. 
Aneurism and other tumors. 

" Pleurisy. Inflammation of perito- 

neum. 

" Injury of spinal marrow. 

" Locked jaw. Spasmodic asthma. 

" Anaemia. Chlorosis or green sickness. 



1 . Hollow and barking cough 

2. Sharp, ringing cough 

3. Hoarse cough 



4. Wheezing cough 

5. Belching cough 

(i. Cough in paroxysms 

7. Cough sounding harsh and concen- 

trated when listening with the 
stethoscope. 

8. Cough sounding hollow, when lis- 

tening with the stethpscope, as 
though it came from a cavern. 

9. Cough having a metallic or ringing 

sound when listening with the 
stethoscope. 



The Cough. 



indicates Last stage of consumption. Clironic 
bronchitis. Some nervous affections. 
' ' Croup. 

Beginning of cold. Chronic laryn- 
gitis. 
" Asthma. 

" Some diseases of larynx. 

Hooping cough. Hysteria. 
" Consumption. Inflammation of the 

lungs. Pleurisy. Enlargement of 
bronchial tubes. 
" Tuberculous cavity. Enlarged bron- 

chial tubes. 



Large tuberculous cavity. 



The Expectoration. 



1 . Scanty expectoration 

2. Copious expectoration 

3. Watery expectoration 

4. Mucous expectoration 

5. Expectoration of pus 

6. Expectorated matter shaped like 

coin (nummular) 

7. Muco-purulent, floculent expecto- 

ration 

8. Tubular expectoration 

<». Whitish or greenish expectoration, 
that clings to the vessel 

10. Yellow expectoration 

11. Rusty expectoration 

12. Putrid smell of expectoration 

13. Faint and sweetish smell of expec- 

toration. 

14. Expectoration smelling like garlic 



indicates First stage of acute diseases of the 
lungs. 

" Decline of acute diseases of air-passages 

and lungs. 

" Beginning of bronchitis. Congestion 

of lungs. Vesicular emphysema. 

" Bronchitis. Inflammation of lungs. 

" Consumption. Third stage of inflam- 

mation of lungs. 

" Tubercular consumption. Bronchitis 

of measles. 

" Consumption far advanced. 

Plastic bronchitis. Pneumonia. 
" Acute affections of lungs, particularly 

bronchitis 
" Chronic bronchitis. Other chronic af- 

fections of the lungs and throat. 
" Inflammation of the lungs. 

" Gangrene of the lungs. 

" Bronchitis. First stage of consumption. 

" Broncho-pleural fistula. 



Pain. 



1. Dull, heavy, aching pain at the indicates Acute bronchitis. 

base of the chest 

2. Soreness about the breast bone, and " Acute bronchitis. 

between the shoulders 

3. Sharp, sudden, tearing pain below " Pleurisy. 

the nipple 

4. Pain darting from front part of " Consumption. 

chest to between shoulder blades 

5. Constant pain between the shoulders " 



Consumption. Green sickness. 
chronic diseases. 



Other 



TEMPERAMENTS. CONSTITUTION, AND SYMPTOMS. 



131 



The Pulse. 



1. Strong pulse, resisting compression indicates 

by the finger 

2. Weak pulse, easily pressed down " 



3. Full pulse, as if the artery were in- 

creased in size 

4. Small pulse, opposite of full 



5. Hard, sharp, contracted pulse, — vi- 

brating like a cord under the finger 

6. Soft pulse, yielding readily to pres- 

sure 

7. Frequent pulse 

8. Slow pulse 



Inflammatory affections, especially of 
the substance of large organs, as the 
liver, etc. 

Prostration from disease. Nervous and 
chronic affections. Fear. Diseases 
of women and children, and old per- 
sons. 

Congestion of brain. Apoplexy. Dis- 
ease of heart. 

Inflammation of stomach, bowels, 
bladder, etc. Hysteria, and other 
nervous affections. 

Inflammation of membranes. Active 
bleedings. Lead colic, etc. 

Affections characterized by debility. 

Inflammatory diseases. Hemorrhages. 
Apoplexy. Sometimes in disease of 
heart. 



Relating to Digestion. 



1. Tongue trembling and dry, and di- 

minished in size 

2. Voracious appetite 

3. Diminished appetite 

4. Increased thirst 

5. Thirst gone 

6. Vomiting 



7. Pain increased by pressure 

8. Pain relieved by pressure 

9. Urgent desire to go to stool 

10. "Watery stools 

11. Mucous stools, like white of egg 

12. Hard and lumpy stools 

13. Clay-colored stools 

14. Yellow or dark-brown stools 

15. Dark-green stools 

16. Stools red, and streaked with blood 

17. Pitchy black stools 

18. Stools pure blood, with no colic 

19. Stools like rice-water 

20. Black stools 

21. Shreds of false membrane in stools 

22. Fat with stools 

23. Fetid stools 



indicates Typhoid and other low fevers. 

Pregnancy. Hysteria. Insanity. Some- 
times in dyspepsia. 
" In most acute diseases. 

' ' Acute affections of stomach and bowels . 

" Cerebral disease, with coma. 

" Early pregnancy. Colic. Disease of 

brain. Inflammation of stomach. 
Hernia. 
Inflammation of internal organs. 
" Over-distension of bowels. Neuralgia. 

Colic. 
Dysentery. Sometimes in diarrhoea. 
Diarrhoea. Cholera. 
" Chronic inflammation of colon. 

" Constipation. Colic. Cancer of stom- 

ach. 
Deficiency of bile. 
" Too much bile. 

4i Bile from children after taking cal- 

omel. 
" Dysentery. 

" Melaena. 

" Bleeding piles. 

- Asiatic cholera. 
Iron taken in medicine. 
" Dysentery. Diarrhoea. Worms. 

" Diabetes. Consumption. 

" Diseases attended by debility. 



The Urine. 



1. Diminished secretion of urine 

2. Retention of urine in the bladder 

3. Urine increased in amount 

4. Red or yellow sand deposits in urine 

(uric acid) 

5. "White sediment in urine (earthy 

phosphates) 

6. Oxalate of lime deposits in urine 

7. Blood in urine 

8. Albumen in urine 

9. Mucus in urine 

10. Sugar in urine 



indicates Dropsy. Inflammatory and febrile 
diseases. 

" Paralysis. Typhoid fever. Hysteria. 

" Diabetes. Cold stage of fevers. Hy- 

steria. Various passions of the mind. 

" Fevers. Acute Rheumatism. Con- 

sumption. Dyspepsia. Great indul- 
gence in animal food. 

" Depressed state of the nervous system, 

of serious import. 

" Derangement of digestion. 

" Bleeding of kidneys, etc. 

" Bright's disease. 

" Inflamed mucous membrane of ure- 

" thra, bladder, etc. 

" Diabetes. 



132 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



1 • Profuse perspiration 
2. Diminished perspiration 



Night sweats 
Sour-smelling sweat 
Fetid smelling sweat 
Sweat with mouldy odor 
Smelling like ammonia 
Sweat having the odor of mice 
Sweat smelling like rottenstone 



The Perspiration. 



indicates Acute rheumatism. Decline of acute 
" inflammations and fevers, being 

sometimes critical. 
" Early stage of acute disease. Dropsy. 

Diabetes. 
" Consumption. 

" Rheumatism. Gout. 

Some debilitating fevers. 
" Measles. Scarlet fever. 

" Typhoid fever sometimes. 

" Insanity. 

" Miliary. 



The Temperature, 



1. General heat of surface 

2. External local heat 

3. Hot forehead 

4. Hot scalp 

f 5. Skin of chest hot 
I 6. Hands and feet hot. 

7. Acrid heat, burning the hand when 

applied 

8. Chills 

9. Low temperature 
10. Cold hands and feet 



indicates Fevers. 

" Inflammation. 

" Headache. 

" Disease of brain. 

" Inflammation in chest. 

" Consumption. 

" Typhus fever. 

" Beginning of fever. 

" Poor circulation. 

" Nervous diseases. Dyspepsia, 
state of the blood. 



Impure 



The Temperature of the Body. 

The use of the thermometer is an important addition to the means 
of making physical examination, and is one of the improvements in 
modern medicine. 

It is intended to measure the heat of the body. 

The best kind now in use is the self-registering. 

The bulb of the instrument is to be placed in the warmest part of 
the body, and should be allowed to remain there for eight to ten 
minutes. 

Some place it under the tongue ; some in the axilla. 

Sometimes it is necessary to introduce it into the rectum or vagina. 
In these parts the temperature is a degree higher than in other parts. 

The normal temperature of the body is from 98° to 99° Fahrenheit, 
in the great majority of persons. 

Exceptionally it may be half or a whole degree either above or be- 
low this range. 

The normal fluctuations are inconsiderable in comparison with the 
variations of disease. 

The natural variations in health are as follows : The temperature 
is at its minimum at five o'clock a. m. ; the maximum is reached in 
the latter part of the afternoon, and then decreases till five o'clock 

A. M. 

By means of the thermometer we are able to determine all differ- 
ences with precision. 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 133 

The increase of heat in different febrile diseases rarely exceeds 
110° Fahrenheit, and as a rule the amount of increase is a criterion 
of its severity. 

An increase to 100° Fahrenheit or 101° is evidence of mildness of 
the disease. 

If the thermometer indicates steadily 105° Fahrenheit, it is certain 
that the disease is severe. 

A persisting temperature above 105° Fahrenheit denotes that there 
is great danger, and an increase to 108° to 110° Fahrenheit is usually 
a fatal sign. 

The abnormal changes of temperature consist of more or less in- 
crease. 

Diminution below the normal standard is comparatively rare ; yet 
it sometimes occurs and is of some importance. 

In the course of typhoid fever, a sudden decrease may indicate in- 
testinal hemorrhage. Sometimes the temperature falls without im- 
provement in the other symptoms. This is an unfavorable symptom. 

The value of thermometric changes depends in no small measure 
upon the symptoms with which they are associated. 



SKIN DISEASES. 



The skin is the soft and pliant membrane which covers the entire 
surface of the body. The interior, like the exterior is likewise covered 
by a skin, which, from its always being moist, is called a mucous 
membrane. At the various openings of the body, the outer and the 
inner skins are united, — forming one continuous skin, — like the 
same piece of silk turned over the border, and covering both the out- 
side and inside of a bonnet. 

From this continuity or oneness of the skin and mucous membrane 
springs an important medical law, namely, that a disease of the skin 
may spread to the mucous membrane, and a disease of the mucous 
membrane may spread to the skin. We see this illustrated by the 
breaking out around the lips which follow colds, and the itching of 
the nose of children when the mucous membrane of the bowel is irri- 
tated by worms. 

The Skin is Composed of Two Layers. — These are separated from 
each other by the action of a blister. The thin portion which is raised 
up by the fluid of a blister is called the scarf skin, the cuticle, or the 
epidermis ; that which remains in connection with the body is the 
sensitive skin, the cutis, the derma, or the true shin. The two skins 
have very different offices to perform. The scarf-skin is horny and 
insensible, and serves as a sheath to protect the more sensitive skin 
under it. Were the scarf-skin taken off, we could not bear to have 
anything touch us. 

The derma, or true shin, and its glands, etc., are the seat of all the 
cutaneous diseases. These maybe separated into four great divisions, 
— namely, diseases of the true shin, diseases of the sweat glands and 
tubes, diseases of the oil glands and tubes, and diseases of the hairs 
and hair glands. 

Then the diseases of the true skin are divided into 

Inflammation of the true shin ; 

Enlargement of the papilla* of the true shin ; 

Disorders of the vessels of the true shin; 

Disorders of the sensibility of the true shin ; 

Disorders of the color-producing function of the true shin. 

The inflammation of the true skin is conveniently divided into two 
groups, — namely, 

Such as are marked by inflammation of the derma and mucous 
membranes, with constitutional symptoms of a specific hind, and 

134 



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SKIN DISEASES. 135 

Such as are distinguished by inflammation of the derma, without 
constitutional symptoms of a specific kind. 

Congestive Inflammation of the True Skin. 

The First of these Groups, — those characterized by inflammation 
of the cutis, ivith constitutional symptoms of a specific kind, — embraces 
measles, scarlet fever, varioloid, and coiv-pox. 

Measles. — Rubeola. 

Measles is an acute inflammation of the entire skin, both external 
and internal, associated with an infectious and contagious fever. 

Symptoms. — The disease sets in with chills, succeeded by burning 
heat, listlessness, languor, drowsiness ; pains in the head, back, and 
limbs ; frequent pulse ; soreness of the throat ; thirst, nausea, vomit- 
ing, frequent dry cough and high-colored urine. These symptoms 
increase in violence for four days. On the third day the eyes become 
inflamed, cannot bear the light, and pour fourth a profusion of tears. 
This last symptom is called coryza. The nose likewise discharges a 
large quantity of watery secretion, and sneezing is frequent. The 
larynx, windpipe, and bronchial tubes become inflamed, and hoarse- 
ness, soreness of the breast, etc., are the result. 

The redness of the skin and breaking out appear about the fourth 
day, and produce heat and itching. This breaking out is character- 
ized by a patchy redness, which, on close inspection, is found to con- 
sist of numberless minute red points and pimples, collected into 
patches in the shape of a half or quarter moon. They appear first on 
the forehead and front of the neck, then upon the cheeks and around 
the nose and mouth. On the fifth day they reach their height in this 
region, and then appear upon the body and arms, and on the sixth 
day, upon the legs. The color of the skin, when the inflammation is 
at its height, is of a bright raspberry red. The decline of the rash 
takes place in the same order in which it comes out. The redness 
fades on the sixth day upon the face ; on the seventh, upon the body 
and limbs ; on the eighth, upon the back of the hands. The coryza, 
the hoarseness, and the cough, decline about the seventh day, while 
a diarrhoea comes on about the eighth or tenth, — showing that the in- 
flammation of the mucous membrane is subsiding. When the inflam- 
mation disappears, the whole scarf-skin peels off in the form of a 
scaly scurf. The artist has given a good picture of the disease in the 
beautifully colored lithograph, Plate I, Fig. 1. 

Treatment. — When the disease is mild and regular in its course, 
scarcely anything will be required, except mild diet, slightly acid 
drinks, with flax-seed tea, slippery elm, or some equivalent, to quiet 
the cough. Sponging with tepid water, if done with frequency, mod- 
erates the fever, and adds to the comfort of the patient. If the fever 



136 ' SKIN DISEASES. 

runs high, take half an ounce of rochelle salt, and use recipe 125. 
Should the eruption "strike in," apply leeches or cups over the in- 
ternal organ affected, if any, and recall the rash by sweating. 

Those who have been exposed to the contagion, and are liable to 
have the disease, should avoid all unnecessary exposure to wet or 
co ld, — keeping the feet warm and dry, and the whole body well clad. 
With these precautions, and a mild, unstimulating diet, much of the 
force of the disease may be broken. 

During the first stages of the disease, bathing the feet once or twice 
a day with hot water, and freely using warm, sweating drinks, as 
saffron, summer-savory, pennyroyal, balm, and mullein tea, and put- 
ting mustard drafts to the feet, will hasten the coming out of the 
eruption. 

Should the breaking out be delayed by excessive fever, give full 
doses of tincture of veratrum viride, or nauseating doses of ipecac, 
antimony, lobelia, or hive-syrup, and teaspoonful doses of compound 
tincture of Virginia snake-root. 

Besides the milder forms of the disease, cases occur, chiefly in 
broken-down constitutions, in which the rash delays its coming out 
till the seventh day, and is then mingled with dark and livid spots, 
which remain, often, for ten or twelve days. The fever is of a low, 
typhoid kind, and the patient is extremely weak and languid. 

In this condition of things, the -patient must be supported by tonics 
(77 and 59), and whisky, and expectoration promoted by some appro- 
priate remedy, if required. 

If at any stage of the disease there should be fixed pain in any 
part of the chest, which is made worse by coughing, or by taking a 
full breath, we may conclude there is some inflammation of the 
chest ; and it must be treated as directed for pneumonia. 

Scarlet Fever. — Scarlatina. 

This is likewise an acute inflammation of the entire covering of 
the body, both external and internal, connected with fever which is 
infectious and contagious. 

Symptoms. — The fever comes on somewhere between the second 
and tenth day after exposure. On the second day of the fever, the 
eruption comes out in the form of very small points and pimples, 
which appear either in patches, or constitute a general redness, of a 
bright scarlet color. In Plate I, Fig. 2, the artist has given a fine 
picture of the disease. 

The disease begins with languor, pains in the head, back, and limbs, 
with drowsiness, nausea, and chills ; and these are followed by heat, 
thirst, etc. When the redness appears, the pulse is quick, and the 
patient is anxious, restless, and sometimes delirious. The eyes are 
red, the face swollen, the tongue covered in the middle with white 
mucus, and is studded with elevated points of extreme redness. The 






SKIN DISEASES. 137 

tonsils are swelled, and the throat red. The greatest degree of red- 
ness is reached on the evening of the third or fourth day from its be- 
ginning, when a gentle moisture appears, the disease begins to decline, 
with itching, and the scarf-skin falls off in branny scales. 

A swelling or puffiness of the flesh, which spreads out the fingers 
in a singular manner, seems to be peculiar to scarlet fever. 

In the first stage of the complaint, the tongue, as stated above, is 
covered with a fur ; but as it advances, the tongue often becomes 
suddenly clean, and presents a glossy, fiery-red surface, which is 
sometimes, with the whole lining of the mouth, raw and tender. 

It is peculiar in this complaint, that the inflammation of the 
throat always runs into a state of ulceration. As far as can be 
seen, on pressing down the tongue, the throat is swollen and of a 
deep, florid red; and on the tonsils may be seen white or gray 
ulcers. This makes swallowing very difficult, and aggravates the 
sufferings of the patient. The great amount of mucus in these 
parts causes also a continual rattling in the throat. 

The eustachian tube, which extends up to the ear, is apt to get 
involved in the inflammation, and cause swelling and pain in that 

region. The glands under the ear and jaw 
sometimes inflame, and after a time they oc- 
casionally break. Abscesses formed in the 
ear frequently produce some deafness which 
is not easily cured. 

In the cell-dropsy, which sometimes appears 
after scarlet fever, the crystals of urate of 
ammonia may often be found in the urine 
with the microscope (Fig. 72). 

This disease resembes measles, but may 

fig. 72. be distinguished from it by the absence of 

cough ; by the eruption being finer, and of a more scarlet color (see 

plate) ; by the rash coining out on the second day instead of the 

fourth ; and by the ulceration in the throat. 

Treatment. — In ordinary cases, the treatment should be very 
simple. The apartment should be kept cool, and the bed-covering 
light. The whole body should be sponged with cool water as often as 
it is hot and dry, and the patient be permitted to take cooling drinks. 
Besides this, in many cases, very little is needed, except to give a 
few drops of the tincture of belladonna, night and morning. 

In some cases where there is a good deal of fever and soreness of 
throat, give tincture of veratrum (125) often enough to keep down 
the pulse. Give every half hour (an adult) till pulse reaches sixty. 
Aconite in drop doses to children every fifteen minutes. In addi- 
tion to this, the feet and hands should be soaked in hot water, with 
a little ground mustard, or pulverized cayenne, stirred in. This 
bath should be continued twenty minutes, twice a day, for two or 
three days. 




138 SKIN DISEASES. 

The cold stage having passed, and the fever set in, warm water 
may be used without the mustard, etc. If the head be affected, put 
mustard drafts upon the feet. Should the bowels be costive, they 
may be gently opened by some very mild physic. 

No solid food should be allowed ; but after the first shock of the 
disease is passed, drinks, in reasonable quantities, Avill be advisable, — 
such as cold water, lemonade, barberry and tamarind water, rice 
water, balm or flax-seed tea, and some thin water-gruel. 

To promote the action of the skin, the spirits of nitre, with other 
articles (125), adapting the dose to a child, will be found useful. 
The nitrate of potash is useful, given in one to three-grain doses, 
dissolved in water, every three or four hours. 

Muriatic acid, forty-five drops in a tumbler filled with water, and 
sweetened, and given to a child in teaspoonful doses, is a good remedy. 

In very violent attacks, the system sometimes inclines to sink im- 
mediately ; typhoid symptoms show themselves ; there is great pros- 
tration ; the eruption strikes in ; the skin changes to a puiple or 
mahogany color ; the tongue is of a deep red, or has a dark-brown 
fur upon it, and the ulcers in the throat become putrid. This is 
called scarlatina maligna ; but it is only a severer form of the same 
disease. 

The treatment of this form must be different from that recom- 
mended above. It must be tonic. Quinia (§5^) must be freely given. 
Wine whey, mixed with toast-water, will be useful. Tincture of 
cayenne, in sweetened water, may be given often in small doses. 
Ammonia (135) may likewise be given as a stimulus. Gargles (245) 
(244) (243) are also required. 

A dropsical affection is one of the most frequent results of scarlet 
fever. It is believed that this seldom occurs, if the warm bath is 
daily used, as soon as the skin begins to peel off. After the dropsy 
has set in, give the warm bath twice a week, and encourage perspi- 
ration by the compound tincture of Virginia snake-root, and similar 
articles. The child should have a generous diet, at the same time, 
to bring up its strength. 

Anointing the skin with vaseline at night and washing off in the 
morning with suds removes the poisonous scales, and lessens the 
danger of contagion, as well as improves the activity of the skin. 
Nasal and aural catarrhal diseases are commonly observed to follow 
scarlet fever and need attention of a physician. Rheumatism like- 
wise is a frequent sequela, while nephritis or inflammation of the 
kidneys is often a sad reminder of the disease. These two compli- 
cations are to be treated as directed elsewhere. 

TABLE EXHIBITING THE DIFFEKENCE BETWEEN SMALL-POX, VARIO- 
LOID, SCARLET FEVER AND MEASLES. 

SMALL-POX. VARIOLOID. 

First. Period between exposure and when dis- First. Period of incubation more irregular 

ease first shows itself is from five to twenty days — than Small-Pox — from five to twenty days — av- 
usually shows itself in ten or twelve days. erages twelve days. 



SHALL POX 



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Progress of h 

Small Pox. W 









7?^. 2™£%. ^rffaay. 5^<%. #ft%. ffAfey. Mbday. 



Progress of 
Varioloid. 





lftdouj. Z^day. 3^day. 4$d*y. 8$douj. W^day. 



Progress of 
Vaccination . 



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SKIN DISEASES. 



139 



Second. The fever and temperature is high, but 
is less after rash appears. 

Third. The rash appears on third or fourth day 
and is seen on the forehead or some part of face. 

Fourth. The eruption first consists of pimples, 
then watery blisters which become white and sink 
in the center. 

Fifth. The tongue is coated and swollen. 

Sixth. The eyes do not run, and bronchitis does 
not appear. 

Seventh. Sore throat is often present but not to 
as great an extent as in Scarlet Fever. Delirium 
and convulsions may occur. 

Eighth. Secondary fever appears after several 
days. 

Ninth. There are apt to be pocks and the eye- 
sight be weakened, but by modern treatment it 
can usually be avoided. 



SCARLET FEVER. 

First. Period between contagion and when dis- 
ease first shows itself is usually from three to six 
days, but may be much longer. 

Second. Fever greatly increased and continues 
without abatement after eruption appears. 

Third. Eruption makes its appearance on sec- 
ond day on the chest and neck and spreads over 
the body during the next twelve hours. 

Fourth. The eruption extends over the entire 
skin. 

Fifth, Eruption lasts from six to seven days 
when it begins to come off in large scales. 

Sixth. Tongue is covered with little red points. 

Seventh. There is little trouble with bronchitis 
or running of eyes. 

Eighth. Sore throat. 

Ninth. The mind is apt to be affected and there 
may be delirium. 

Tenth. Usually no secondary fever. 

Eleventh. In Scarlet Fever there is great dan- 
ger of the patient being left with kidney trouble, 
or the eyes, ears, or throat may be affected. 



Second. Fever high till rash is well developed 
and then a greater improvement than in Small- 
Pox. 

Third. Eruption appears on third or fourth 
day. 

Fourth. Rash consists of pimples, may go on 
to pustules and blisters, but usually subside be- 
fore advancing so far. 

Fifth. Tongue coated and swollen. 

Sixth. No nose or eye symptoms as a rule. 

Seventh. Sore throat mild. Delirium and sev- 
erity of disease often marked at beginning but 
quickly subside. 

Eighth. Secondary fever less marked than in 
Small-Pox. 

Ninth. Instead of rapidly convalescing, the 
patient often shows an amount of weakness and 
anasmia all out of proportion to preceding symp- 
toms. 

MEASLES. 

First. Period between exposure and when dis- 
ease first shows itself is from seven to fifteen 
days. 

Second. There is a moderate fever. It does 
not decrease but increases after eruption. 

Third. Eruption appears on fourth day on 
face and spreads over rest of body in about two 
days. 

Fourth. Eruption is crescent-Shaped, rest of 
skin healthy. 

Fifth. Eruption lasts about five days, then 
peels off in scales. 

Sixth. Tongue has red edges and is coated. 

Seventh. The nose and eyes run and bronchitis 
is usually apparent. 

Eighth. Usually throat is not sore. 

Ninth. The mind is not affected. 

Tenth. The fever subsides after the third day 
and there is no secondary fever. 

Eleventh. The patient's eyes may be inflamed 
and consumption or bronchitis follow. 



Small-Pox. — Variola. 

This is another disease characterized by acute inflammation of 
the entire skin, both external and internal, connected with infectious 
and contagious fever. The eruption has the form of red points, 
which soon become pimples, then vesicles, then flattened and scooped- 
out vesicles, then pustules, and finally hard brown scabs. These last 
fall off from the eleventh to the twenty-fifth day, and leave behind 
them small pits and scars. The fever is remittent, and precedes the 
eruption some three or four days, — ceasing when the eruption is 
developed, and returning when it has reached its height. The 
period between exposure and the attack of the disease, called incu- 
bation, is from five or six to twenty days, — being short in the severe 
cases, and longer in the milder ones. 

Symptoms. — The disease begins with languor and lassitude, with 
shivering, and pains in the head and loins ; with hot skin, and quick- 
ened pulse and breathing ; with thirst, loss of appetite, and furred 
tongue ; with nausea, vomiting, constipation, restlessness, and uni- 
versal prostration. To these symptoms sometimes succeed difficult 
breathing, cough, drowsiness, and even insensibility. The tongue. 
white at first, soon becomes red at the point, and over the whole 



140 SKIN DISEASES. 

surface. The fever is highest during the night. The constitutional 
symptoms are more violent just before the eruption, but immediately 
subside, and soon disappear, when the breaking out is established. 
The eruption is at first in the shape of small red points, which are 
hard to the touch, and shaped like a cone, and are proportionate in 
number to the subsequent pustules. In Plate II the artist has 
well exhibited the developed disease, as well as the progress of the 
eruption from day to day. 

Treatment. — Like the two preceding diseases, the ordinary, un- 
complicated form of this requires only the most simple treatment. 
Not much is wanted, except confinement in bed, cooling drinks, cool 
and even temperature, frequent change of linen, and sponging the 
body with cool water. But when what is called the fever of inva- 
sion is past, and the eruption is fully developed, and has brought 
along with it the secondary fever, then some recipe, as (131), (355), 
(125) will be in place, and some gentle laxative to keep the bowels 
open (8), — also gentle injections (249), and opiates to relieve 
sleeplessness and nervous symptoms; (356) (357) may be used if 
very sleepless. 

Should the system, at this period, appear to be sinking, a more 
generous diet, and a little wine may be allowed. If the brain 
suffers, apply cold ice-cloths to head, or an ice-bag behind the ears, 
and put the feet in a mustard bath (242). If the breaking out 
appears with difficulty, put the patient into a warm bath, and give 
extract of jaborandi (358). Gargles will frequently be needed for 
the inflammation, and dryness of the mouth and throat (243). 
Cold sponging may be considered as highly beneficial, in both the 
primary and secondary fever. The belladonna likewise is a useful 
remedy, used in the same way as in scarlet fever. The plaster (288), 
applied to the face, will, it is said, arrest the formation of matter, 
and prevent the unsightly scars which so often cover the face of 
persons who have suffered from small-pox. Paint the face once or 
twice a day with glycerine, which will effectually prevent pitting. 
The use of collodion is still better. 

To avoid Pitting, and the occurrence of unsightly scars of the 
face, several methods of dressing have been used. The simplest 
consists in covering in the vesicle with iodoform-collodion, say, 
twenty grains of the former to one ounce of the latter. Having 
pricked the vesicle with an absolutely clean needle, one, for instance, 
that has been boiled in soda-water for five minutes, a layer of this 
collodion should be applied and allowed to dry on at once. Should 
pus form under this coating it must be released by washing off the 
collodion with alcohol. The wound is then to be thoroughly disin- 
fected with carbolic acid water (one teaspoonful to pint of water) 
and the collodion again applied. 

This process will avoid most of the pitting. 



SKIN DISEASES. 141 

Varioloid. — Varicella. 

Varioloid, or modified small-pox, begins with symptoms similar 
to those of small-pox, but much milder in degree. These symptoms 
are feverishness, nausea, vomiting, pains in the loins and head, and 
a quickened pulse. The eruption comes out on the third or fourth 
day, and looks like that of small-pox. It reaches its height the 
fourth or fifth day, and then declines without any secondary fever. 
The pustules dry up and form brown scabs which fall off in a few 
days, and leave slight pits, and a few red or purple spots. 

Varicella appears under a variety of forms, called " hives," " swine- 
pox," " chicken-pox," " horn-pox," etc. But they all have a family 
likeness, and need not be described. The treatment of all these 
forms must be conducted on the same principles with small-pox. 
Sponging the skin in all these inflammatory conditions has the hap- 
piest effect, and should seldom be omitted. 

Cow- Pox. — Vaccina. 

This disease exists to some extent among lower animals, and is 
identical with small-pox in man. The immortal Jenner taught the 
world that the pus taken from the cow having this disease, and in- 
troduced under the skin of man, would produce an eruption similar 
to that of small-pox, and that this would protect the system from 
the latter disease. This was an immensely important discovery, and 
will render the name of Jenner famous through all time. 

It is a question of great importance how far vaccination, or inocu- 
lation with the matter of cow-pox, does, in fact, protect the system 
from small-pox. That it is a protection, to a certain extent, is 
doubted by none. That in some instances it protects through life, 
is likewise generally admitted. Is it a protection in all cases, and 
through the whole life ? Perhaps not, though this is a disputed 
point. Probably the mild form of the vaccine disease does not im- 
press the system powerfully enough to last more than a certain num- 
ber of years. Most thinking physicians now believe it is wise to 
revaccinate occasionally, to make sure of the protection. It is done 
with little trouble, and may save a terrible infliction. Plate II, 
Fig. 4, gives a good idea of the appearance and progress of the 
eruption. 

The Second Group of diseases, characterized by inflammation of 
the true skin, without constitutional symptoms of a specific kind, are 
Erysipelas, Nettle-Rash, False-Measles, and Inflammatory Blush. 

Erysipelas. — St. Anthony's Fire. 

Erysipelas is a diffused inflammation of the skin, affecting only 
a part of the surface of the body, and is accompanied by a fever, 
which is generally thought to be infectious and contagious. The 



142 SKIN DISEASES. 

local inflammation is disposed to spread ; it extends deep, and is 
attended by swelling, a tingling, burning, and pungent heat, and by 
a redness, which disappears when the skin is pressed by the finger, 
and returns on remitting the pressure. 

Symptoms. — The constitutional symptoms are chilliness and 
shaking, succeeded by heat ; lowness of spirits, lassitude, pains in 
the back and limbs, pains in the head, quick and hard pulse, thirst, 
loss of appetite, white . and coated tongue, bitterness of mouth, 
nausea, vomiting, pain in stomach, and costiveness. 

These symptoms go before the local inflammation several days ; 
they increase with the redness of the skin, and disappear upon its 
decline. The nervous system is sometimes severely affected, and 
indicated by low, muttering delirium. At the close of the inflam- 
mation there is generally a relaxation of the bowels, and the scarf- 
skin peels off. Sometimes matter forms under the skin, and occa- 
sionally mortification occurs. The face is the most frequent seat of 
the disease. It commonly begins on one side of the nose, and soon 
spreads over one side of the face, closing up the eye, and changing 
the features in a shocking manner. See Plate III, Fig. 1. 

Somewhere about the third, fourth, or fifth day, very minute blis- 
ters appear on the inflamed parts, filled with water, which increases 
until the blisters break and let it out. The disease comes to a head 
on the eighth or ninth day, when the blistered parts dry, and the 
skin begins to peel off. 

Treatment. — In the treatment two things are to be done, — to 
subdue the fever, and the local inflammation. The fever is assuaged 
by rest, mild diet, gentle laxatives (26), (21), (125) ; and by the 
use of tincture of veratrum. For the local inflammation, various 
things have been advised, but nitrate of silver, on the whole, has the 
preference. First wash the inflamed part with soap and water to 
remove any oily substance, and wipe the skin dry. Then moisten 
the inflamed and surrounding skin, and pass over it a stick of nitrate 
of silver, touching not only the inflamed part, but going even an 
inch be}^ond it on all sides. Or, a solution of nitrate of silver and 
nitric acid (214) will in many cases, according to Dr. Higginbottom, 
do even better. A solution of copperas (215) is a good application. 
So is (303). 

In mild cases, flour may be dusted on the inflamed part from the 
dredging-box. Warm fomentations are also useful, and cloths wet 
with water, and laid on. A solution of perchloride of iron, applied 
to the inflamed skin, is much used now, or water as hot as can be 
borne. 

In erysipelas the powers of the system are generally reduced, and 
tonics, such as quinine, wine, etc., are generally required. Dr. 
Robert Williams, — high authority in these matters, — says he puts 
his patients upon milk diet, gently opens the bowels, and gives them, 
daily, from four to six ounces of port wine, together with sago, and 
that he seldom has to change this course, whatever the symptoms. 



ERYSIPELAS 




PL 3. 



W^B/mst^**^ 



Fig.l 




INrLAHMATORY BLUSH 



>fih 



I cV Fi 9 



-- 



/') O 



Cj 



■ i . ... ■ 



m o 




$B "" s ' 



SKIN DISEASES. 143 

For the inflamed skin, a tea made of buckwheat meal is a good 
wash. Alcohol and water, or new rum, may be used for the same 
purpose. 

Nettle=Rash. — Urticaria. 

Nettle-bash begins with fever, which lasts two or three days, 
when wheals of various shapes, round, oval, and oblong, appear in 
the midst of red, slightly elevated patches, attended by great itching 
and tingling, as if the common nettle had been applied to the skin. 
The wheals go off during the day, and come again at night. The 
eruption is often a symptom of other diseases, or of mental anxiety. 
Sometimes it is the effect of articles of diet. Children have it occa- 
sionally while cutting teeth. A lighter form of the disease exists, in 
which the wheals appear and disappear at short intervals, according 
to the heat of the weather, the exercise, diet, etc. 

Treatment. — The treatment varies according to the cause of the 
disease. If this be anything offending the stomach, especially if it be 
putrid fish, an emetic (2), (4) will be required, followed by brisk 
physic (359). After which take a few doses of quinine (75). For 
external application, the lotion (216) or common vinegar and water 
(215) will be useful. Dr. Wilson recommends corrosive sublimate, 
etc. (217), as the best lotion to apply outwardly. Soda bath better. 

The diet should be simple and cooling, all stimulating food and 
condiments being avoided. Fruit, candies, and berries often the 
cause. 

Rose=Rash. — Roseola. — False Measles. 

Symptoms. — The summer rose-rash appears first on the arms, face, 
and neck, thence it spreads over the whole body, producing tingling 
and itching. It is usually preceded by the symptoms of fever-chills, 
succeeded by flushes of heat, languor, pains in the head, back, and 
limbs, restlessness, quick pulse, and thirst. The rash appears in 
small irregular patches, paler than those of measles, and of a more 
roseate hue. There is some hoarseness from inflammation of the 
throat. The rash never continues more than five days, unless it be 
merely partial, in which case it sometimes comes and goes at inter- 
vals for weeks. If it " strike in," it generally produces disturbance 
of the stomach, headache, and faintness, which are relieved by its re- 
appearance. 

The autumnal rose rash is in more distinct patches than the former, 
of a circular figure, slightly elevated, and of a dark damask-rose hue. 
Seldom any fever, or itching and tingling. 

Treatment. — For the first-described form of the disease, light diet, 
acid drinks, and gentle laxatives; for the second, recipe 59 or 51, ac- 
cording to convenience. 



144 SKIN DISEASES. 

Inflammatory Blush. — Erythema. 

WHAT is called marginated inflammatory blush, is a mottled, red, 
smooth fullness of the skin, occurring on the extremities and loins, in 
irregular patches, bounded on one side by a hard, elevated, red border. 
This species of disease attacks old people, and indicates some inter- 
nal disorder, which is dangerous. 

Another form of the complaint appears on the arms, neck, and 
breast, in extensive, bright-red, irregular patches, slightly elevated. 
The redness, at its height, is very vivid, and continues about a fort- 
night, when it assumes a purplish hue in the centre. 

Treatment. — Light diet, gentle purgatives (21), soda bath to al- 
lay the tingling and secure sleep, and the mineral acids (63), with 
bitter tonics, comprise all that is required, except sponging with 
water, and friction. 

Watery Pimples. 

We now come to a class of diseases character.zed by watery pim- 
ples. Wilson says they are distinguished by " effusive inflammation of 
the derma," which means that there is inflammation of the true skin, 
which causes water to be poured out on top of the derma, and under- 
neath the scarf-skin, causing the latter to be lifted up in the form of 
small or large blisters, or vesicles. At first the fluid in these pimples 
is transparent, but in a short time becomes milky. Sometimes this 
fluid absorbs ; at other times, it dries up, and with the cuticle scales 
off as scurf. 

Eczema and Salt Rheum. 

Eczema is an inflammatory, acute or chronic, non-contagious skin 
disease characterized at first by redness, little pimples, vesicles or 
pustules and is attended by more or less burning itching. This pro- 
cess terminates either in the formation of crusts as the result of dried 
sticky serum, or else in the formation of fine scales. 

No skin disease has such a variety of aspects nor such grades of 
inflammation. There is generally more or less oozing of the blood- 
serum, which dries and thickens, forming crusts. There is usually 
more or less thickening of the skin, making it like leather ; there is 
generally some considerable scaling. 

Eczema may subside in a few weeks never to return, or, what is 
more probable, may lapse into a chronic state and continue for months 
and years, with bothersome symptoms, which are extremely annoying. 

Salt Rheum is a chronic eczema of this last variety. 

Treatment. — In the acute stage of eczema, soothing lotions, pow- 
ders, or ointments should be used, such as 372, 373, 374. Some are 



SKIN DISEASES. 145 

better treated with powders, some by lotions ; the itching and heat 
are best relieved by 373. 

In the more chronic variety some stimulating ointments are needed, 
like 375. Carbolic acid, 10 or 15 grains to the ounce of oleate of 
zinc ointment, is an admirable remedy for the itching and burning. 
Salicylic acid, 10 grains to the ounce of benzoated zinc ointment 
is likewise very serviceable, while tarry preparations generally are 
the most satisfactory in this chronic stage. 

No skin disease, however, is often so stubborn to treatment as the 
different forms of eczema. The cure often will be slow and medi- 
cines frequently changed. The local varieties of eczema require spe- 
cial treatment. 

Eczema of Head in Children. — After oiling freely the crusts over 
night and washing off with suds in the morning, apply Salicylic acid, 
1 part, tincture benzoin, 2 parts, vaseline, 50 parts. The very chronic, 
thick, and indurated skins require 360, and in many cases 219, espe- 
cially the chronic hand-cracks. The diet must be free from irritating 
articles of food, the bowels regulated and the hygiene of the skin at- 
tended to, while tonics and general systemic measures are often called 
for. 

Tetter — Shingles. — Herpes. 

After a slight feverish attack, lasting two or three days, clusters 
of small, transparent pimples, filled sometimes with a colorless, some- 
times with a brownish lymph, appear on the cheeks or forehead, or 
on the extremities, — and at times on the body. The pimples are a 
little larger than in eczema, — about the size of a pea. After a few 
days the vesicles break, pour out their fluid, and form brown or yel- 
low crusts, which fall off about the tenth day, leaving the surface red 
and irritable. The eruption is attended with heat, itching, tingling, 
fever and restlessness, especially at night. Ringworm is a curious 
form of herpes, in which the inflamed patches assume the form of a 
ring. Shingles usually attack the aged about the ribs of one side, 
and are evidences of impaired health and nutrition. They are very 
prostrating and require tonics from the start. 

Treatment. — Light diet, gentle laxatives. If the patient be ad- 
vanced in life, and feeble, a tonic (75) will be desirable. For exter- 
nal application, belladonna (173), or an ointment of sulphuret of lime, 
(174), or elder-flower ointment, etc. (175). Equal parts of chloral 
and camphor applied several times a day, especially later in the disease 
(361), give most relief. 

Itch. — Scabies. 

To this disease all classes are liable, though it is much less com- 
mon than in former years. It is found frequently among the poor, 



146 



SKIN DISEASES. 



whose condition in life does not give them the means to guard at all 
points against it ; but it is most common among such as neglect per- 
sonal cleanliness. 

Symptoms. — An eruption of distinct, cone-like, watery pimples, 
which are transparent at the summits, and are accompanied by an ex- 
cessive itching, which is made worse by high-seasoned food, by drink- 
ing liquor, and by the heat of the bed. When these pimples are 
scratched and torn, a sticky, watery fluid is poured out, which forms 
small scabs ; and, in time, if the disease is not cured, these scabs be- 
ing torn off, extensive sores are made. 

Cause. — It will excite the wonder of many readers to state that 
animals of so small a size as scarcely to be seen with the naked eye 
exist in the skin of man. Yet such is the fact; and it is the presence 
of these minute creatures, or the effect of their presence, which con- 
stitutes the disease called itch. The little creature (acarus scabiei, 
by name), a species of mite, is one seventy-seventh part of an inch in 
length ; and when closely inspected under the microscope, is really a 
beautiful, I may say an elegant, animal. Here are a front, a side, and 
a back view of him, well done by the artist. 






Fig. 73. 



Fig. 74. 



FIG. 75. 



His Method of Attack. — When placed upon the skin, the little 
fellow, like the squirrel and other ground-animals, sets himself to 
make a hole through the scarf-skin with his head and fore feet. Into 
this he pushes his whole body. He then begins to burrow himself in 
the derma or true skin — making a channel many times his own 
length, at the end excavating a chamber where he sleeps, and whence 
he goes out to do his day's work at mining, or boring for food. When 
tired of this sleeping apartment, he digs onward and scoops out an- 
other. 

This travelling, and boring, and turning about in an organ as sen- 
sitive as the true skin, must, of course, occasion a tickling and itch- 
ing ; and from this circumstance the disease took its name of itch. 
But this itching is not painful. James the First is said to have re- 
marked that the itch was fitted only for kings — so exquisite is the 



SKIN DISEASES. 147 

enjoyment of scratching. Probably it is a royal luxury. Be that as 
it may, most persons would consent to have it all done by royal fin- 
gers. They have been used for meaner purposes. 

Treatment. — Whatever will kill the little animal described above, 
will cure the itch. Various agents have been employed for this pur- 
pose, but none have been found equal to sulphur. The compound 
sulphur ointment is a sovereign remedy for the disease. Four ounces 
of this should be well rubbed into the skin, before the fire, morning 
and evening, for three or four days. This will put an end to the 
whole colony of these sovereign squatters upon forbidden soil. 

Two ounces of sulphuret of potash, and the same amount of soft- 
soap, dissolved in a pint of water, and applied well to the skin, is 
used in many cases with good effect. 

Caustic potash, one part to twelve parts of water, applied in a sim- 
ilar way, is said to be a pretty sure remedy. 

A solution of the chloride of lime, used as a wash, will often effect 
a cure. 

The ointment of the American hellebore sometimes does well. 

Before applying any of these preparations, let the skin be washed 
with warm water and soap, and well dried. Be sure the parasite is 
killed before ceasing treatment. Best to continue, few days longer 
than what is apparently needed. 

Rupia. 

This is from a Greek word which means dirt, from the dirt-colored 
crusts which are formed after the breaking of the large watery pim- 
ples. The vesicles are like those of eczema and herpes, except that 
they are larger. This is distinguished from all other skin diseases by 
the formation of unhealthy, foul, and burrowing sores, which pour 
out a reddish matter in such quantities that it collects and dries upon 
the sore, and forms a crust of great thickness, — sometimes of the 
size of an oyster-shell. Rupia has its origin in a weakly and debili- 
tated constitution, and cannot be cured without renovating the whole 
system. It is a manifestation either of syphilis or lupus. 

Treatment, — Warm baths once or twice a week, with generous 
and nutritious diet. Tonic medicines (63) (51) (67) (61) (§&} will 
be required. For external treatment, dust the surface of the ulcers 
with cream of tartar, or apply nitrate of silver (214) (219) (220), 
white vitrol, etc. See syphilis. 

Pemphigus. — Pompholix. 

The first of these terms is from the Greek, and means a bubble : 
the second, pompholix, is from the same language, and means a water- 
bubble. This is still more applicable to the disease in hand, which 
consists, in fact, in the raising up of the scarf-skin in the shape of 



148 SKIN DISEASES. 

bubbles, containing a watery fluid. These bubbles are just like com- 
mon blisters. They vary from the size of a split pea to that of a 
hen's egg. They rise up very rapidly, and break in two or three 
days, leaving a raw surface which soon becomes covered by a thin 
crust. 

Treatment. — Similar to that for Rupia, with the addition of iodide 
of potassium (140), and applying the stick nitrate of silver to the 
whole surface of the ulcer, and a short distance beyond it on all sides, 
or the ointment (176). See treatment for syphilis. 

Mattery Pimples. 

Another natural group of skin diseases are distinguished by an 
eruption of pimples, filled, not with water, like those just described, 
but with matter. The pimples of this class are not transparent, or 
whitish, but opaque and yellow from the first. The matter is poured 
out upon the true skin, and raises up the scarf-skin, in the same way 
as the watery pimples. As in the preceding diseases, too, the drying 
up of the matter forms crusts. But these pimples are never so small 
as those of eczema, nor so large as those of pemphigus. 

Crusted Tetter. — Impetigo. 

This eruption consists at first of slightly-elevated pustules or pim- 
ples, closely congregated, with an inflamed border. These break, and 
the surface becomes red, excoriated, shining and full of pores, through 
which a thin, unhealthy fluid is poured out, which gradually hardens 
into dark, yellowish-green scabs. These scabs sometimes look like a 
dab of honey dried upon the skin. This has given impetigo the name 
of "honey disease," or honey scab. This honeyed look is well repre- 
sented in the crusts which form on the lips and ears of children. 
Sometimes these scabs cover nearly the whole face, and are called the 
milk crust. This is putting the agreeable words milk and honey to 
rather questionable uses ! When this crusted tetter invades the head 
or scalp, it causes the hair to fall, and becomes what is called a scall. 
Impetigo may be simple, or contagious, or syphilitic. 

Treatment. — The vapor bath, and water dressing. The following 
ointments are useful : oxide of zinc, white precipitate, or diluted ni- 
trate of mercury (178). Hydrocyanic acid (221), applied externally, 
has a fine effect. The crusts should first be removed by a weak lye 
made from hard-wood ashes, or potash ; then, after applying one of 
the ointments above, or the lotion, cover the part with oil-skin. If 
the crusts are on the head, the hair should be cropped off before the 
remedies are applied. When of syphilitic origin, treat as for that 
disease. 



SKIN DISEASES. 149 

Papulous Stall. — Ecthyma. 

The mattery pimple called ecthyma is developed on a highly in- 
flamed skin. The bladders are about the size of a split pea, and are 
surrounded by a broad ring of redness. They are generally separate, 
not clustered like impetigo. They are scattered over various parts of 
the body, and are followed either by a hard black crust, or by a sore. 
The disease is either acute or chronic. The latter attacks weakly 
children, and persons reduced by sickness or low living. 

Treatment. — For the acute form, give a generous diet, with oint- 
ment (176), and the cold sponge-bath on the sound parts. Use 
(176) (175) (214) (211) for external application. Hygienic treat- 
ment, tonics, and stimulants are called for ; iron, quinine, arsenic, and 
nux vomica. 

Scaly Eruptions. 

The scaiy eruption is called a dry tetter. It is an inflammation of 
the true skin, and is distinguished from the rashes and pimples by 
the alteration of the scarf-skin. The diseases forming this group are 
three in number, — lepra, psoriasis, and pityriasis. 

Leprosy. — Lepra. 

In this disease, the eruption makes its appearance as a small, sal- 
mon-red spot, raised a little above the surrounding skin, and consti- 
tuting, in fact, a flat pimple, almost as large at the top as at the bot- 
tom. On top of this pimple the scarf-skin becomes rough, and after 
a little while a thin scale is produced. New layers are added to its 
under surface, and it accordingly grows thicker. It has a bright, 
silvery lustre. These scaly spots multiply, and become the form of 
leprosy called lepra guttata, from the Latin gutta, a drop, the scales 
looking like drops of water on the skin. 

But the eruption more frequently spreads out into circular patches, 
of the size of a fifty-cent piece. These generally appear below the 
elbows and knees, and on the breast and shoulders, and back of the 
hands. Sometimes the entire hand is covered with scales of a pecu- 
liar silvery whiteness. These patches heal from the centre. 

Psoriasis. 

This differs from lepra in the eruption being more irregular. The 
spots sometimes come out in thick clusters, and blend in various 
ways. Instead of appearing in distinct circular forms, as in leprosy, 
the patches are irregular, and of every size. Instead of one well- 
formed and thick scale, there are many small and thin ones. And 
instead of a depressed centre with rising edges, the surface is level. 
While leprosy is a circular dry tetter, this is an irregular dry tetter. 



150 SKIN DISEASES. 

Treatment. — Pyrogallic acid in ointment, 10 to 40 gr. to oz. Ap- 
ply daily ; it discolors the skin for a while. Chrysophanic acid in 
same strength is the best remedy known. It also discolors the skin 
and inflames the neighboring skin for a while. Recently the thyroid 
gland of the sheep has been nsed in five-grain tablets three times 
daily as an internal medicine with much success. 

Pityriasis. 

This is much like the two preceding, except that it gives rise to 
a copious production of very small bran-like scales. Indeed, its name 
is from the Greek, and means chaff or bran. It is a branny tetter. 
It may occur on any part of the body. 

Treatment. — When the skin is highly inflamed and stiff with heat, 
pain, and itching, the diet should be light, and the drinks of a cooling 
and unexciting kind. The warm bath and gentle friction of the skin 
are useful. Laxatives or tonics may be employed, according to the 
indications, — frequently laxatives first, and tonics afterwards. The 
specific remedies for curing the disease are unknown ; iodide of potas- 
sium (140), arseniate of iron (68), Fowler's solution, in two-drop 
doses, three times a day ; or Donovan's solution, in five-drop doses, 
three times a day. For external application, use a naphthaline oint- 
ment' (17 7), zinc ointment, white precipitate ointment, diluted nitrate 
of mercury ointment, or solution of corrosive sublimate (212). 

Dry Pimples. 

These are distinguished by the high degree of irritation of the 
skin winch they create. They are exceedingly troublesome, not only 
from the distress and itching they occasion, but because they are 
likely, in consequence of this, to be torn into painful and obstinate 
sores. 

When appearing in children, they are called red gum, and tooth- 
rash. In grown persons, one form is named lichen, and another, dis- 
tinguished by excessive itching, prurigo. 

In this form of pimples, the fluid is not poured out upon the sur- 
face of the true skin, — as in several of the preceding diseases, — but 
is collected within the tissue of this organ, and the pimples feel hard 
under the finger. 

The tooth-rash of infants is always accompanied with some fever- 
ishness, caused generally by irritation of the gums from growing teeth, 
occasionally by flannel worn next the skin. 

Lichen has a variety of forms. In one case the pimples are of a 
bright red, in another, bluish or livid. In one case they appear in 
circular groups, in another they produce great disorganization of the 
skin, and occasion terrible suffering. 



SKIN DISEASES. 



151 



Prurigo is a still more cruel disease than lichen. The pimples are 
not very manifest, but the skin is thickened or swollen, and con- 
densed. The suffering from it is terrible. It gives one no sleep, 
night or day. That form of it called ant-bite prurigo gives the sen- 
sation of millions of ants eating the flesh, or as many red-hot needles 
piercing it. This renders the existence of many elderly persons a 
terrible burden. 

Treatment. — Careful diet, and gentle aperients and tonics, accord- 
ing to the condition of the system. Externally, the cold salt-water 
sponge-bath, and glycerine, vinegar and water, applied with a soft 
sponge. Tar and sulphur are among the more successful remedies in 
fighting this rebellious disease (362). Iron, quinine, cod-liver oil. 
For relieving the terrible itching of the private parts, which females 
sometimes suffer, I have found morphine (223), for external use, 
very effectual. 



Lupus. 

This makes its appearance in the form of one or more circular 
elevations, of a dull red or salmon-color, and partially transparent. 
When pressed under the finger, these elevations are found to be soft, 
and when the finger is removed, they are flat and whitened. They 
generally appear on the face, and particularly the nose. 

In another and worse form of the disease, the tubercles are harder; 
and after a time, they become covered with thin brown scabs, which 
are scratched off, and followed by others, 
and these by others, until ulcers appear, 
which are sometimes slow and sometimes 
rapid in their progress. The whole nose 
has been destroyed by them in a month. 
(See Fig. 76.) This is one of the dis- 
eases which Erasmus Wilson thinks, and, 
in my judgment, correctly, to be, like 
scrofula, the result of the syphilitic poi- 
son, filtered through the blood of several 
generations. It is a disease which is the 
most destructive in the shortest time of 
all diseases. 

Treatment. — The internal remedies 
are iodide of arsenic (141), and iodide 
of potassium (140) ; the external, vine- 
gar of Spanish flies ; and to promote the 
healing of the ulcers, a weak solution of nitrate of silver (211) (214) 
is adapted. 

Hardly any disease has been treated by so many different remedies. 
At present the prospect of a cure is good, as certain anti-tubercular 




Fig. 76. 



152 SKIN DISEASES. 

lymph injections have been found effective ; but no time should be 
lost in immediately consulting a surgeon, as its growth can be ar- 
rested, and the disease may be exterminated by early treatment. 

Warts and Corns, — Verruca — Tylosis — Clovus. 

In the derma or true-skin there are a great many small arteries, 
veins, and nerves, united together, and formed into loops (see Fig. 
43), resembling, in shape, the peaks of miniature mountains. These 
are called papillce. These loops, frequently, without any apparent 
cause, take on a disposition to grow, and by extending themselves 
upward, they carry the scarf-skin along with them, which is thickened; 
and together they form what is called warts. Corns are formed by a 
somewhat similar growth of the papillae, brought about by the pres- 
sure and friction of tight boots and shoes. 

Treatment. — For warts, take a piece of diachylon plaster, cut a 
hole in the centre the size of the wart, and stick it on, the wart pro- 
jecting through. Then touch it daily with aqua fortis. Nitrate of 
silver sometimes answers well for touching it. They may be taken 
off very neatly, sometimes, by tying a string tight around them. 
Corns should be shaved down close, after being soaked in warm 
water and soap, and then covered with a piece of wash-leather, or 
buckskin, on which lead plaster is spread, a hole being cut in the 
leather the size of the corn. They may be softened, so as to be easily 
scooped out, by rubbing glycerine on them. Manganic acid destroys 
warts and corns rapidly. Bunions, which affect the joint of the great 
toe, must be treated with fomentations, and sugar of lead water 
(224), when there is considerable inflammation, with rest in a hor- 
izontal position. But the best cure for corns and bunions is to put 
away tight shoes. Wear a bunion-plaster for some time to take the 
pressure off of the corn or bunion. 

Mother's Marks. — Naevus. 

The small vessels of the skin, called capillaries, suffer certain al- 
terations of structure which pass under the name of mother's marks. 
These marks are simply a great dilatation of these minute blood-ves- 
sels. They vary in size from a mere point to a patch of several 
inches square. 

The smallest of all is the spider mark. It is a small red point, 
from which several little straggling vessels spread out on all sides. 
Sometimes this is of the size and appearance of a red currant ; at 
other times, of a strawberry or raspberry ; and occasionally it is even 
much larger, and is compared to a lobster. 

When the circulation is active through them, or the individual is 
excited by exercise, or by moral causes, these marks are of a bright 
red color. Some are naturally livid and dark-colored, and look like 



SKIN DISEASES. 153 

blackberries, and black currants. The blueness of these is owing to 
the vessels being still more stretched and dilated, and to the conse- 
quent slower passage of the blood through them, which gives more 
time for its change from the arterial red to the venous blue. 

Treatment. — If the mark is not making progress, it had better be 
let alone, or only subjected to gentle pressure by putting a piece of 
soap-plaster over it. When its course is threatening mischief, it is 
sometimes cured by pencilling a small portion of its surface, from 
time to time, with nitric acid. They may be operated on with safety 
by electrolysis and other methods. 

Disordered State of the Nerves of the Skin. 

Itching. — Pruritus. This is supposed to be dependent on an al- 
tered condition of the nerves of the skin, and consists in a painful 
sensation of itching. There is no perceptible alteration in the ap- 
pearance or structure of the skin. This itching is thought, generally, 
to be a result of sympathy, through the nerves, with some diseased 
and excited condition of a distant part. The itching, is brought on 
by the most trifling causes, and for hours may deprive the sufferer of 
every particle of repose. It more frequently affects the fundament, 
or the private parts, particularly the scrotum. 

Treatment. — As this disease is only a symptom of several others, 
the constitutional treatment belongs under the heads of these other 
diseases. The local applications for relieving the itching are, a solu- 
tion of sugar of lead (224), hydrocyanic acid (363), of corrosive sub- 
limate (212), diluted nitrate of mercury ointment, and poppy fomen- 
tations. Also (223). Tonics are often of first importance. Weak 
solutions of carbolic acid or soda water at tim£s suffice. 

Disorders Affecting the Color of the Skin. 

Colored Patches. — Maculce. The depth of color in the skin de- 
pends on the amount of a certain coloring matter, called pigment, in- 
corporated with the deeper and softer portion of the scarf-skin. In 
the scarf-skin of the inhabitants of northern latitudes, there is but 
little of this pigment ; in that of the dwellers of Africa, there is a 
great deal ; among the inhabitants of Southern Europe, the quantity 
is intermediate between the two. 

The depth of color in the skin depends on the energy of its action. 
In the tropics, where light and heat are in excess, the skin is stimu- 
lated to great action, just as vegetation is, and the color is increased 
and intensified. This is illustrated every year before our eyes. In 
summer, under the heat of the sun and the flood of light, the pigment- 
forming power is increased, and the fairest skin is browned ; while 
the withdrawal of these forces leaves the winter's scarf without pig- 
ment, and blanched. 



154 SKIN DISEASES. 

What the sun and light do, under natural circumstances, diseased 
action may effect. Hence we occasionally meet with alterations of 
color in the skin, from a disordered state of the system. We witness 
the formation of patches of dark color and irregular shape on various 
parts of the body. Sometimes they are raised above the level of the 
skin, and are called moles. At other times, they have no elevation, 
and spread over the whole body. 

Occasionally, from some peculiarity of constitution, the pigment is 
diminished, and white patches appear all over the body. At other 
times, a black person will become completely white. Such are called 
albinos. 

In many cases the coloring of the skin has varieties of tint, as when 
persons of light complexion, are, in the summer season, covered with 
yellow spots, like stains. These spots are known by the name of 
freckles, or, in learned language, lentigo. 

Treatment. — It is generally best not to meddle with a mole. If it 
be very unsightly, let it be removed by two incisions, taking out an 
elliptical portion of skin, and ft closing the wound with sticking plaster. 
In the case of bleached places, apply the shower bath, tonics, and a 
stimulating liniment (163) to the faded spots. For the change of 
color called sunburn, a liniment (191) of lime-water, etc., is the best 
preparation. For freckles, use recipe 360, or, perhaps, still better, 
364. 

Disorders # of the Sweat=Glands. 

The perspiration is sometimes greatly increased above nature's de- 
sign. This is, technically, idrosis. In other instances there is too 
little sweating. This is called anidrosis. Sometimes the perspiration 
is so altered in its physical qualities as to have some peculiar smell. 
This is osmidrosis. In some rare instances, according to old writers, 
the sweat was changed in color. This was chromidrosis. And now 
and then a case occurs of bloody perspiration, of which the most 
memorable case on record is that of the Redeemer of men, who, in 
the garden, sweat great drops of blood. Several cases of this are re- 
corded in medical books. It is called hamiidrosis. 

The proper action of the skin being so vitally important to health, 
these changes often involve very serious consequences. 

Treatment. — Either too much or too little sweating can generally 
be corrected by the cold or warm bath, friction, tonics, and proper 
clothing. Small doses of jaborandi, also ergot and strychnine, are 
among the best internal medicines (365). 

Disorders of the Oil=Glands and Tubes. 

That the skin may be limber, healthy, and fit for use, it is neces- 
sary to have it oiled every day. For this object, the Creator has 



SKIN DISEASES. 155 

wisely provided, by placing in the true skin a large number of very 
small glands and tubes, whose office it is to prepare and pour out 
upon the surface the proper amount of oil. The gland, regular little 
oil-pot, is in the true skin ; and from it a pfece of hose or tube runs 
up through the scarf-skin, through which the oily fluid is poured out. 
Some of these tubes are spiral, others are straight. On some parts 
these vessels do not exist ; on others they are quite abundant, — as on 
the face, nose, ears, head, eyelids, etc. They produce the wax of the 
ears ; and on the head, they open into the sheath of the hair, and fur- 
nish it with a hair-oil or pomatum better than the chemist can make. 
These little vessels are always at work, when the skin is healthy ; 
and no persons need be afraid to wash all over every day, lest, as the 
Boston Medical Journal taught, the skin will be injured by having 
the oil removed from it. You might as well be afraid to eat a 
meal of victuals, lest the saliva should all be swallowed with it, and 
none be left for future use. There is oil enough where that upon 
the skin comes from, and the vessels which produce it are not injured 
by work, any more than the muscles of the legs are by walking. 

Grubs or Worms. — But, unfortunately, the skin is not well taken 
care of in all cases, as in cities and towns where sedentary habits pre- 
vail. Here, the actions of the skin, instead of being regular and com- 
plete, are often sluggish and imperfect ; and the contents of the oil- 
cells and tubes, instead of flowing easily, become hard and impacted, 
and the vessels are not emptied. When this matter becomes station- 
ary, dry, and hard, it distends the tube, and fills it to the surface; and 
then coming in contact with the dust 
and smoke of the atmosphere, the ends 
become black, and look like the heads 
of worms. These spots are common 
on the nose and face of persons who 
have a sluggish skin. They may be 
squeezed out by pressing the nails on 
each side of them. These are called 
grubs and worms, or, technically, come- 
dones. When this matter produces in- 
flammation of the tube, there is then a 
black spot in the middle of a red pimple, 
and the disease is called spotted acne. 

Now and then the oily matter becomes very hard, producing spine- 
like growths, and even horns (Fig. 77) ; and again, it collects and 
forms soft tumors, as wens, etc. These are technically called encysted 
tumors. Sometimes the action of the glands is too great, and oil is 
poured out so profusely that the face shines with it. At other times 
there is so little that the skin is dry and harsh. In the hardened 
oily matter, which constitutes grubs, are found small animals, which 
Dr. Wilson calls the " animal of the oily product of the skin." On 
page 156 are three views of him. 




156 



SKIN DISEASES. 



Treatment. — For roughness and harshness 01 skin, wash with soap 
and water every night, and rub well into the skin after the bath, and 
in the morning, the ointment (362), and take a dose of sulphur, etc. 
(23), twice a »week. Or', rub the skin every morning with a damp 



Fig. 78. 



Fig. 



Fig. 



sponge dipped in fine oatmeal, and after drying the surface, the lini- 
ment (164) may be applied. The spinous variety, or porcupine dis- 
ease, requires washing with a quart of warm water, having a large 
teaspoonful of saleratus dissolved in it, and the use of the ointment 
(181) twice a day. For grubs, stimulate the skin by washing it 
with strong soapsuds, twice a day, and rubbing briskly with a coarse 
towel; and by using the corrosive sublimate (225) as a lotion. 

A spare diet will do much towards improving the skin in many 
cases; use tonics in others. Usually, destroy the old skin first (360) 
and apply after (352) to heal. 

Barbers' Itch. — Jackson's Itch. — Sycosis. 

This, is very much like acne, — only differing from it in its loca- 
tion. It appears chiefly on the hairy parts of the face, — the chin, 
the upper lip, the region of the whiskers, the eyebrows, and the nape 
of the neck. It consists in little conical elevations, which maturate 
at the top, and have the shaft of a hair passing through them. These 
pimples are of a pale yellowish color. In a few days they burst, and 
the matter running out, forms into hard, brownish crusts. These 
crusts fall off in one or two weeks, leaving purplish, sluggish pimples 
behind, which disappear very slowly. 

The eruption is preceded by a painful sensation of heat, and tight- 
ness of the skin. 

The disease is supposed to be brought on frequently by using a 
dull razor in shaving. It is very obstinate, — often lasting for man}' 
months, and even for years. 



SKIN DISEASES. 157 

Treatment. — The most important part of the treatment is the re- 
moval of the cause. The beard must not be pulled with a dull razor; 
the shaving had better be discontinued altogether, and the beard be 
merely cropped off with scissors instead. All intemperance in eating 
and drinking, and exposure of the face to heat, must be avoided. A 
light, cool diet will do much towards curing the disease. 

The nitrate of mercury ointment, and a solution of oxalic acid, are 
the best applications. If one does not succeed, try the other. Black 
wash is to be used when the face is much inflamed. 

Disorders of the Hair and Hair=Tubes. 

The hair is an appendage of the scarf-skin, and is intended to be 
both useful and ornamental. 

It is subject to several disorders. It may grow too long, or too 
thick, or it may appear in an improper place. This last happens in 
the case of those little spots and patches which disfigure the face, 
and are called moles. The hair may be defective in its growth, or 
may fall off prematurely from various causes, or in the natural course 
of things from old age. This last is called calvities. It may change 
its color, too, under a great variety of circumstances, and at nearly 
every age. It is not very uncommon to find a single lock varying in 
color from that which surrounds it. Old age, the winter of life, nat- 
urally brings the frosted locks ; but they frequently appear also upon 
the heads of younger persons. Strong mental emotions, such as fear, 
grief, or sorrow, may bring a bleaching of the hair in a brief period, 
or even suddenly. Byron, in his " Prisoner of Chillon," beautifully 
refers to this fact : — 

" My hair is gray, but not with years, 
Nor grew it white 
In a single night, 
As men's have grown from sudden fears." 

PoTTigo. — There is a troublesome disease of the hair and hair-tubes 
called porrigo. It begins with the formation of a thin layer of scurf 
either around single hairs, or in patches which enclose several. These 
patches frequently have a circular form, which give to the affection 
the character of a ringworm. The hair-tubes are generally a little 
elevated, in the shape of papillae, which gives to the diseased scalp 
the appearance of " goose-flesh." These hairs, losing their proper 
nourishment and healthiness, break off at unequal distances from the 
skin, leaving their rough ends twisted and bent, and matted into 
thick grayish and yellow crusts. Upon the surface of these crusts 
may generally be seen the ends of a few hairs, looking like the fibres 
of hemp or tow. The scratching causes inflammation of the skin after 
a time, and matter is poured out, which still further mats the hair, 
and thickens the crusts. There are several varieties of this disease, 
differing slightly from each other ; but this general description will 
answer all practical purposes for this work. 



158 SKIN DISEASES. 

The reader will often notice a disease of the hair-glands, character- 
ized by a yellowish and dirty-looking powder, covering the scalp and 
hairs. This matter is collected at the mouths of the follicles, and 
considerable of it is strung upon the hairs like beads. Pull out a 
hair, and the root will be found thin, dry, and starved in its appear- 
ance. In this disease, it is difficult to keep the hair cleansed, or to 
prevent its falling off. 

Favus. — Still another disease, called favus, is known by the collec- 
tion of a yellow substance, at first, around the cylinder of the hair. 
This substance, after a time, spreads out upon the scarf skin, and 
dries into yellow crusts, in the form of a cup, around the base of each 
hair. A number of these cups, collected together, look like the cells 
of a honey-comb. This disease is contagious, and is communicable 
by contact to any part of the skin. 

Treatment. — For removing the hair from particular parts of the 
scalp, it is common to resort to depilatories. Of these, the recipes 
260, 261, 262, are frequently used, and are as good as those adver- 
tised ; indeed, they are the same. Forceps are the best means. 

To prevent loss of hair, and to restore it when lost, the circulation 
should be stimulated in the small vessels of the scalp. With this 
view, washing the head every morning with cold water, drying it by 
friction with a rough towel, and brushing it to redness with a stiff 
hair-brush, are excellent. To these should be added some stimulating 
ointment (183), or liniment (257), (258), (259). These last are about 
the best known preparations for causing the growth of the hair. 

Ringworm of the scalp requires attention to the diet, and such 
remedies as will improve the general health, with stimulating appli- 
cations externally (257), (258), (259). 366 is the newest and best 
mode. 

To color the hair, several preparations are used. Of these, 163 is 
about the best. It produces a beautiful black. A preparation of sul- 
phur and sugar of lead (264) is the famous compound recommended 
by General Twiggs, and extensively used. Preparations of nitrate of 
silver (265), (266), (311) are much in use in some quarters. They 
perhaps give a finer black to the hair, but they render it dry and crisp, 
and they will stain, the skin, if care is not used in applying them. 

Use care in the use of these remedies. 

In Favus, the two great objects to be gained are, to remove all lo- 
cal causes of irritation, and to excite the diseased hair-glands to 
healthy action. The first object is affected by cutting off the hair 
with the scissors, and removing the crusts by washing the scalp with 
castile soap and water. It may be well first to wet the crusts through 
witli corrosive sublimate (212), in weak solution. The washing with 
soap and water should be repeated every day, and be, followed by 
rubbing into the scalp a stimulating ointment (183). A very weak 
solution of the nitrate of mercury (226), applied every other day, 
with a earners hair brush, sometimes produces excellent effects. 



SKIN DISEASES. 



159 



Lice. 



Pediculosis or Lice is a contagious, animal, parasitic affection, 
characterized by the presence of pediculi in the skin and scratch- 
marks of the sufferer ensuing from the annoying itching. There are 
a number of varieties classified according to the peculiar parasite and 
its location. They all cause great discomfort and itching. 

The Pediculosis Capitis, or head-louse, is found in the scalp, and 
is a long, oval body with six legs furnished with nails ; it has an oval 
head with two prominent eyes and two horns. The ova or nits are 
small whitish bodies closely glued to the hair 
and look like small pieces of dandruff. One or 
two are deposited on a hair. 

They occur for the most part in poorly nour- 
ished children brought up under bad hygienic 
surroundings, and thence communicated to 
others. They cause extreme itching and scratch- 
ing, so that often the irritation is unbearable and 
the sticky serum of the blood mats together the 
hair, forming crusts. Sleep is often interfered 
with and ill health results. (See Fig. 81.) 




Fig. 81. 
head-louse. 



Pediculosis Corporis, or body-louse, is gen- 
erally the property of the clothing ; it is some- 
what larger than the head-louse and deposits its 

eggs in the seams of the clothing, remaining on the body only long 

enough to gain sustenance. The young are hatched in five or six 

days. The louse reproduces again in 

eighteen days. As the parasite crawls 

about it produces extreme itching and 

the scratching follows, resulting in long 

lines of excoriation. The chief locations 

for this parasite are the back, chest, abdo- 
men and thighs. The middle-aged and 

elderly are more apt to be attacked than 

the young. Here uncleanliness again is a 

prime factor in their occurrence. (Fig. 82.) 

Pediculosis Pubis, or crab-louse, is a 
smaller, shorter, stouter parasite than the 
two preceding, and attacks the pubes par- 
ticularly, but is also found in the axillae 
and over the eyelashes and beard of the 
male. They may be seen clinging closely to 
the skin with remarkable tenacity. They 
occur on adults and produce the same lesions as the other varieties. 
They are generally the result of promiscuous sexual intercourse. 
(Fig. 83.) 




Fig. 82. 
body-louse. 




160 SKIN DISEASES. 

Treatment. — The main object in the treat- 
ment of these filthy diseases is the destruction 
of the parasite. The lesions they produce 
disappear with the disappearance of the ani- 
mal. It need hardly be said that strict clean- 
liness of person is a sine qua non. The rem- 
edies usually employed in their extermination 
are the mercurials, sulphur, carbolic acid, to- 
bacco, etc. 

crabTlouse. I n case °f tne head-louse the most effica- 

cious method of treatment consists in saturating the head over night 
with petroleum and washing off with soap in the morning. In young 
children the hair may be cut to get rid the more easily of the nits, 
but this is not necessary. The applications of petroleum may have 
to be repeated several times and the hair frequently washed with soft 
soap, soda washes, vinegar, etc., to get rid of the nits. If the louse 
be of the body variety the treatment must be directed to the clothing, 
which is to be changed often and either boiled or baked. This pro- 
cess is to be repeated until no more parasites are found. The itching 
of the body is best allayed by carbolic acid lotions (one teaspoonful 
to pint of water). 

The crab-louse is best treated by the well-known mercurial oint- 
ment, or blue ointment, and is to be washed off with soap and water 
each morning. It must be persisted in till no more crabs are found 
and no further itching is noticed. 

Bed-Bugs. 

The best preventives against these annoying bugs is corrosive sub- 
limate and pyrethrum powder. Purchase a small bottle of the corro- 
sive sublimate tablets, usually sold at the druggists for surgical pur- 
poses, and dissolve one in a quart of water. This solution is to be 
freely used about the cracks of the bed, after it has been taken apart, 
and also about any wooden furniture of the room as well as the wood- 
work of the room. The powder is then to be used freely. This pro- 
cess is to be repeated several times. 

The bites themselves are best relieved by carbolic lotions, vinegar 
and water, ammonia and water, etc. 

Freckles. 

This is a disease of the pigment layer of the skin and consists in 
a deposit of the coloring matter of the skin in irregular shapes, 
of the size of a pin-head or pea, and are yellowish, brown or even 
blackish, occurring for the most part on the face and back of the 
hands. They may be few and scattered or exceedingly abundant 
and cover a large area. All ages are subject to them except in very 
young children. The light-complexioned are more subject to them, 



SKIN DISEASES. 161 

while the red-haired seldom escape them. Sunlight develops them so 
that many have them conspicuously only in summer. The possession 
of freckles is a matter greatly of idiosyncrasy, as many people never 
have them, no matter how much they may be subjected to the sun. 

Treatment. — One's aim in treatment should be toward destroying 
the pigment layer by some corrosive agent, like corrosive sublimate, 
which perhaps is the best remedy. 

Two grains to the ounce in water will in most cases prove suffi- 
ciently strong. The susceptibility of the skin to this remedy and the 
extent of the area involved have much to do with the strength of the 
remedy employed. This remedy is poisonous and is to be used with 
care. Do not get it near the lips, but to effect a cure it must be per- 
sisted in for quite a while. 

"Washing the face in buttermilk several times a day is excellent. 

Corns. 

Or all the minor ailments of the human body, few are more dis- 
tressing than the inflamed corn. They consist of a thickening of the 
outside or horny layer of the skin. As a secondary change, conse- 
quent on long irritation, the nerve and blood supply increase and an 
extreme tenderness is produced, amounting often to incapacity to 
walk or work. They are caused mechanically by the undue pressure 
of the boot against the joint or by one toe pressing against another. 
Too short a boot, which causes pushing out of the big toe joint, too 
narrow a boot, causing crowding of the large joints, are the more fre- 
quent causes of the corn. 

Bunion. 

The bunion is produced by wearing too short a boot, as a rule, and 
consists in the gradual displacement of the big-toe joint, so that fi- 
nally there is an actual deformity. The corn usually is added to this 
deformity. 

Treatment. — The outer layers of the corn should be softened and 
scraped off by a sharp, thin knife. The softening process may be ef- 
fected by soaking in a soda solution, or better still, by the following 
mixture : — 

Salicylic acid one-half ounce 

Extract cannabis indica ten grains 

Collodion one scruple 

This is to be applied each night. Care is to be exercised in not 
paring the corn too closely lest bleeding occur and poisoning ensue 
from the unclean knife that may be used. Pressure of the boot must 
be avoided by the substitution of another form of boot and also per- 
haps by wearing a plaster with a hole in the center, thus distributing 
the pressure over a greater area. When trimmed the corn is to be 



162 SKIN DISEASES. 

likewise covered by a corn-plaster bound on the foot by strips of 
adhesive plaster. Painting with iodine often takes out the sore- 
ness and hardens the skin so that it may be more readily cut. In- 
flamed corns should be poulticed and treated like any pus wound. 
Spirits of turpentine will often take the soreness out of a corn. Ab- 
sorbent cotton, or better, wool, worn between the toes, will prevent 
or cure a corn between the toes. 

Dandruff. 

This is a disease of. the sebaceous glands of the scalp, characterized 
by a large secretion of the sebaceous matter and forming crusts or 
scales. The secretion may be so thick and oily as to mat together 
the hair, or so dry as to fall off the head in a shower when the head 
is combed. It is the most frequent cause of baldness. The crown 
of the head is the most frequent location of this disease. 

Treatment. — Inasmuch as those subject to this disease are often 
below par in health, such constitutional remedies as cod-liver oil and 
iron are valuable adjuncts in bringing about a cure. Should the 
amount of scales be considerable, especially if there are crusts, as in 
the case of little children, the best procedure consists in oiling the 
scalp over night with some bland oil, wearing a flannel cap, and wash- 
ing off the oil in the morning with soft-soap and water. The follow- 
ing blood tonic is an admirable one for adults : — 

Tincture of iron one ounce 

Dilute phosphoric acid . . . . . . . one ounce 

Syrup of lemon two ounces 

Take one-half teaspoonful in a wineglass of water three times daily. 
Use a glass tube to avoid staining the teeth. The scalp needs a 
shampoo once or twice a week ; the following will be found to be a 
suitable one:- — 

Green soap eight ounces 

Alcohol four ounces 

Put a little here and there over the scalp and then rub up with 
warm water. The scalp may then be stimulated night and morning 
with a little of the following lotion :[ — 

Tincture of cantharides three drachms 

Tincture of capsicum three drachms 

Castor oil two drachms 

Alcohol two ounces 

Spirits rosemary two ounces 

Another good remedy for daily use : — 

Hydrate of chloral two drachms 

Water four ounces 



SKIN DISEASES. 



163 



The yolk of two eggs well rubbed into the scalp and afterwards 
washed off with hot water is also a good cleansing agent and sham- 
poo. 

For very stubborn cases the following lotion applied night and 
morning will be found efficacious : — 

Corrosive sublimate . . . 12 grains 

Glycerine 4 drachms 

Alcohol 5 ounces 

Spirits rosemary 4 drachms 

Whatever method is pursued, the application must be persevered 
in and applied from twice daily to once every few days according to 
progress made and severity of case. 



Baldness. 

This disease is generally the outcome either of some constitutional 
weakness and requires general tonic treatment like iron and cod-oil, 
or is the result of some local lesion of the scalp proper. When due 
to syphilis, the hair falls out suddenly and quite extensively ; the 
eyebrows also suffer the same way. Its treatment is to be conducted 
on the same plans as directed under treatment of the syphilitic dis- 
ease. Eczema, scrofulous blood, etc., may also be the exciting cause 
of baldness. Baldness may ensue in areas only, and oftentimes is as 
complete as though no hair had ever grown there. This form is apt to 
be very stubborn and requires very irritating treatment, like blisters 
or the rubbing in of strong carbolic acid once a day for a number of 
days before ceasing treatment. 

The baldness of old age is of course irremediable, but may be ar- 
rested by attention to the general health and the employment of rem- 
edies mentioned under the consideration of dandruff. 

As has been mentioned, dandruff is the most fertile source of bald- 
ness. When once the scalp is clean and the dandruff is cured the 
following lotion will be found to be of great value in those cases of 
baldness characterized by the hair falling out in small patches : — 

Carbolic acid one drachm 

Alcohol one and a half ounces 

Castor oil . two drachms 

Oil bitter almonds ten drops 

Strong carbolic acid itself may be rubbed in the inveterate cases. 
The following lotion also contains desirable ingredients : — 

Tincture cantharides . . . one and a half ounces 
Tincture capsicum .... one and a half ounces 

Castor oil . two drachms 

Cologne one ounce 



DISEASES OF THE BRAIN AND NERVES. 



The brain and spinal column are the great centres of the nervous 
system. 

The brain produces sensation, thought, and voluntary motion. When 
this organ is diseased, therefore, we may expect one of these functions 
to be either disturbed or destroyed. 

Of Sensation there are various disturbances, perversions, and sus- 
pensions, caused by disease of the brain and nerves ; such as nausea, 
giddiness, specks floating before the eyes, ringing in the ears, decep- 
tive tastes and smells, intolerable itching, neuralgic pains, boisterously 
high spirits, depression without apparent cause, anxiety, and dread. 

Thought, in like manner, is disturbed and perverted in many ways. 
There is high delirium, dullness and confusion, loss of memory, weak- 
ened judgment, and every degree of stupor, down to entire loss of 
consciousness. 

Voluntary Motion is perverted and destroyed in muscular twitch- 
ings, trembling of the limbs, spasmodic stiffness, involuntary jerk- 
ings, convulsions, muscular debility, and palsy. 

The brain is composed of three parts, — the cerebrum, the cerebel- 
lum, and the medulla oblongata. These are all contained within the 
skull bones, and are immediately covered by three membranes, called 
the dura mater, the arachnoid, and the pia mater. The dura mater is 
a strong, fibrous membrane lying next to the skull-bones. The arach- 
noid is a serous membrane, lying next below, and the pia mater, which 
means pious mother, is a vascular membrane, lying next to the brain, 
dipping into it in places, and containing the vessels which bring to it 
all its nutrient materials. Hence its name. 

These membranes are all liable to be inflamed, — and so is the 
brain. 

Inflammation of the Dura Mater. 

The inflammation of this membrane does not often occur sponta- 
neously ; but it happens frequently from external injuries, as blows 
upon the head. 

After a blow upon the head which stuns him, a man may recover 
himself, and for some days remain in perfect health. Then he has 

164 



DISEASES OF THE BRAIN AND NERVES. 165 

pain iii the head, is restless, cannot sleep, has a flushed face, red eyes, 
hot skin, hard pulse, rigor, nausea, vomiting, — ending with convul- 
sions and delirium. 

This disease is often caused by what is called otitis, or inflamma- 
tion of the internal ear. In such cases, inflammation will arise within 
the tympanum, causing intense earache ; matter comes at length from 
the external ear, but the pain does not stop ; the patient shivers, be- 
comes drowsy, perhaps delirious, and finally sinks into stupor. The 
dura mater is inflamed. 

Treatment. — When the disease arises from inflammation in the 
ear, leeches are to be applied behind the ear, and blisters and other 
irritants afterwards. Other modes of treatment will be mentioned 
after the next two forms of disease. 

Inflammation of the Arachnoid and Pia Mater. 

Arachnitis. 

These two membranes are generally inflamed together. They 
are so intimately connected that each involves the other in its own 
troubles. 

Generally this is divided into three stages : — 

The Irritative, characterized by wakefulness, irritable temper, re- 
pugnance to strong light, and contraction of the pupils. 

The Inflammatory Stage, known by transient pains in the head, 
alternating with similar ones in the bowels, increased restlessness and 
irritability, a quick and tense pulse, an expression of discontent on 
the face, the eye-brows knit and frowning, the eye-lids half closed, 
retching and vomiting, deep sighing, and torpid bowels. 

The Depressing Stage, in which the delirium is more continuous, 
the countenance has a look of surprise and stupor, the pupils are con- 
tracted or dilated, the white of the eyes injected and red, the pupils 
rolled up during sleep, constant sleepiness, inattention to surrounding 
objects, torpidity of mind, gradually increasing until complete coma 
closes all the senses. 

The disease does not always exhibit all these symptoms, or come on 
in the regular way described. Sometimes the first thing noticed is a 
long-continued paroxysm of general convulsions. Again these con- 
vulsions will come on after violent pains in the head, and are attended 
with screaming. 

Inflammation of the Brain. Brain Fever. 

Encephalitis. — Phrenitis. 

Acute and general inflammation of the brain and its membranes 
has two stages. 

The Stage of Excitement, in which there is intense and deep-seated 
pain in the head, extending over a large part of it, a feeling of tight- 



166 DISEASES OF THE BRAIN AND NERVES. 

ness across the forehead, throbbing of the temporal arteries, a Hushed 
face, injected eyes, looking wild and brilliant, contraction of the pupils, 
great shrinking from light and violent sound, delirium, want of sleep, 
general convulsions, a parched and dry skin, a quick and hard pulse, 
a white tongue, thirst, nausea and vomiting, and constipation of the 
bowels. 

The Stage of Collapse, in which there are indistinct mutterings, 
dull and perverted hearing and vision, double vision, the pupil from 
being contracted expands largely and becomes motionless, Uvitchings 
of the muscles, tremors and palsy of some of the limbs, a ghastly and 
cadaverous countenance, cold sweats, profound coma, and death. 

The disease will not show all these symptoms in any one case. It 
runs a rapid course, causing death, sometimes, in twelve or twenty- 
four hours ; or it may run two or three weeks. 

Treatment. — This should be energetic, and administered early. 
The measures usually employed are hot foot-baths, and the ap]?lication 
of cold to the head, with occasional mustard poultice to legs. 

General Bloodletting. — This is much approved by many ; for 
myself, I do not like it. Wet cups and leeching are about the extent 
to which I would ever carry the abstraction of blood in these diseases. 
These may sometimes be applied with advantage to the neck, and be- 
hind the ears. 

Cold Applications. — These, applied to the head, are of great im- 
portance. First, shave the head, and put on cloths wetted in water 
as cold as it can be made, changing them often ; or, put powdered 
ice in a flexible bladder, and lay it upon the head, — taking care not 
to make it too heavy. Heat in a few cases is better borne. 

Cathartics. — These, while the inflammation is in the active stage, 
should be thorough and energetic. To effect it, many use calomel 
and other forms of mercury. They are not needed. Croton oil is one 
of the best articles (31), or colocynth, gamboge, etc. (32), without 
the oil, or the compound powder of jalap. 

In the stage of collapse, if there is pallor of the countenance, a 
feeble and flying pulse, great debility and tremors, coldness of the 
extremities, etc., give wine and other stimulants. 

See that the bladder is emptied every day. 

The feet, in the early stage of the complaint, should be bathed in 
warm water, or mustard and water (242). Mustard draughts must 
also be put upon the feet. 

The tincture of veratrum, given in full doses, to bring down the 
pulse, and produce sweating, must not be omitted. Give (351). 

Softening of the Brain. — Ramollissement. 

Inflammation of the brain, when it has run its course, sometimes 
leaves this organ, or portions of it, in a softened condition. The 



DISEASES OF THE BEAIN AND NERVES. 167 

same mischief may happen to the brain from the blood-vessels which 
run to it being diseased, so as not to be able to carry blood for its 
proper nourishment. 

Symptoms. — The most remarkable symptom of this disease is the 
rigid contraction of the muscles which draw up the limbs ; the hand 
may be clenched and pressed against the shoulder, or the heel carried 
up to the hip. 

The other symptoms are various, — tingling and numbness in the 
ends of the fingers ; perverted vision, and sometimes blindness ; par- 
alysis of one limb, or half the body; difficulty of answering ques- 
tions ; forgetf ulness, making it difficult, at times, for the patient to 
remember his own name. General treatment is indicated. 

Suppuration and Abscess of the Brain. 

When a diseased brain is examined after death, sometimes matter 
is found mixed in with the softened portion. This shows that suppu- 
ration took place. At other times, the matter is found in a cavity, 
which shows that an abscess had formed during life. 

The symptoms of these mischiefs are convulsions in the earlier 
stages, and palsy in the latter. Surgical methods now often save 
life, and cause a cure in these cases. 

Induration of the Brain. 

Instead of softening the brain, inflammation sometimes does the 
very opposite, — it hardens it, — producing a change something like 
that which happens to white of egg when dipped in hot water. 

Convulsions appear as the result of this change, as in suppuration 
and abscess ; palsy much more seldom. 

Tumors of the Brain. 

Tumors infect the brain occasionally, — growing around it, on all 
sides, pressing themselves into its substance, and causing many dis- 
turbances. Cancers and hydatids are found there. The signs which 
these irritating bodies produce are like those of other diseases of the 
brain, and therefore cannot be distinguished during life. Syphilis is 
often the cause of them, and, when due to this, may be cured. 

Delirium Tremens. — Drunkard's Delirium. 

Mania a Potu. 

This is often mistaken for brain-fever ; but it is quite a different 
disease. It is not the result of inflammation of the brain, but of irri- 
tation. It is important to distinguish it from inflammation, because 
the remedies which are employed for that would be injurious if used 
for this. 



168 DISEASES OF THE BRAIN AND NERVES. 

The Symptoms are incessant talking, fidgeting with the hands, 
trembling of the limbs, a rapid pulse, profuse sweating, utter sleep- 
lessness, and a mingling of the real with the imaginary in the busy 
talk. The patient is apt to think some one is about to do him a 
great injury, yet is unwilling to be alone. His face is pale and sal- 
low (sometimes red and flushed), his eye is rolling, quick and ex- 
pressive, his speech stuttering and inarticulate, — bodily and mentally, 
he is busy day and night, and can with difficulty be confined to his 
bed or room. As the disease advances, and he has been long without 
sleep, he imagines vermin to be crawling upon his scalp and body ; 
troops of rats run across his bed, or look at him out of the wall ; 
giant boxers confront him, and he squares off for a round at fisti- 
cuffs ; animals, figures of all shapes, and horrible monsters frighten 
his imagination; devils laugh at him, and dance before him. In long 
and sleepless hours, he talks and chatters with these spectral phan- 
toms, — now beckoning them, now shrinking from them, till he wears 
out and sinks from exhaustion. This is a disease of drunkards and 
opium eaters. The attack generally occurs in consequence of the 
withdrawal for three or four days of the accustomed stimulus. 

Treatment. — Opium and its preparations are the sovereign rem- 
edy. Give one-third of a grain of morphia ; if this does not quiet the 
patient, give thirty drops of laudanum every two hours, till sleep is 
produced. Sleep will cure him, and nothing else will. A draught 
or two of his accustomed drink, brandy, gin, or whatever it may be, 
will also generally dispose him to sleep, if he be not already in drink. 

Recently, a very effectual remedy has been found in the use of 
tepid baths, prolonged from four to ten hours, in connection with 
cold applications to the head. In connection with this, small doses 
of opium are required ; but the treatment may yet prove to be very 
valuable by enabling us to dispense with excessive doses of opium. 
Twenty grains of chloral may be given every hour till patient sleeps. 

Inebriety. 

In the beginning of the present century insanity was regarded as a 
visitation of God's displeasure and not as a disease subject to scientific 
investigation and amenable to treatment. Inebriety is regarded now 
as insanity was some hundred years ago, the disease being consid- 
ered irremediable. Alcohol is a poison, and like other poisons is cap- 
able of destroying life. In large doses it becomes a powerful irritant 
or a narcotic producing coma and death. It being constantly intro- 
duced into the system produces a general disease in the system. We 
believe inebriety can be cured like any other disease, but is subject to 
relapses like other diseases. 

The " alcohol habit," under the title Inebriety, oftentimes has the 
symptom or outward manifestation of diseased conditions, which an- 
tedate the alcoholic craving, and are its predisposing and exciting 
causes which retard, and sometimes even prevent a cure. 



DISEASES OF THE BRAIN AND NERVES. 



169 



In the popular, and too often in the professional mind, alcohol is 
regarded as the cause and root of the whole evil of inebriety. We 
desire to assert that inebriety is frequently dependent upon causes 
with which alcohol has nothing to do. There is a neurotic craving 
— it may be congenital, it may be developed as the result of disease 
or accident. This craving demands the various forms of narcotic 
stimulants, those that first excite, then produce narcosis more or less 
complete. Alcohol fulfills this condition, is easily accessible, reason- 
ably inexpensive, and is the one drug that meets a morbid craving 
that seems to be almost universal. 

We do not fail to recognize the deteriorating effects of alcohol 
manifested principally, at least, more pronouncedly upon the nervous 
system as seen in the various forms of insanity. We also note the 
degenerating effects of alcohol on lung, liver, kidney or other organs 
and tissues of the body ; or as a special poison in the same sense that 
lead, arsenic and tobacco produce their effects. 

We believe that the great majority of inebriates become so from he- 
redity, environment and disease, that produces physical degeneracy 
and pushes them over and plunges them into inebriety. 

The patient with fever craves and may drink water freely, exces- 
sively and injuriously. The diabetic is an aqua-maniac in a certain 
sense, but in neither case do we recognize the aqua-mania or water 
craving as the disease, but rather as proceeding from certain abnor- 
mal conditions which we readily recognize. So the liquor thirst is 
the result of morbid conditions that produce an abnormal desire, 
which alcohol seems, temporarily at least, to satisfy. 

The excessive use of alcohol, while it is oftentimes the cause of 
various diseases of the nervous system, and also a frequent cause of 
insanity, is also the precursor or initiatory symptom of certain diseases 
of the nervous system and also of insanity. 

The paretic will crave and use alcohol in the earlier stages of his 
malady. The victim of nervous syphilis is addicted to it, more es- 
pecially in the later stages, when the nervous system becomes in- 
volved. 

Any depressing, exhausting, or painful disease may produce the 
alcoholic craving, alcohol being sought for its stimulating properties. 

Alcohol, moreover, is second only to opium, ether, or chloroform 
as an anaesthetic ; indeed, has been used as a substitute for the latter. 
Hence, persons find experimentally that alcohol relieves pain, and 
its use is carried to a harmful extent, its deleterious effects produced, 
and inebriety established. 

It is possible that a healthy individual, with good personal and 
family history, may use alcohol sociably or as a matter of custom, un- 
til the habit becomes firmly established. 

The alcohol breaks down the constitution, invades and degenerates 
the nervous system, and thus develops inebriety, because the alcoho- 
lic degenerations, or even functional disturbances of the nervous sys- 



170 DISEASES OF THE BRAIN AND NERVES. 

tern, are the very conditions under which inebriety is established. 
We say this is possible, but we assert again that behind the large 
majority of inebriates will be found a defective family or personal 
history, not only complicating but causing the inebriety ; retarding, 
oftentimes preventing a cure. 

It can be thus seen that inebriety is but a symptom — a flag of 
distress hung out by the nervous system. As some one has aptly 
said, " neuralgia is the cry of a diseased nerve," so the " drink-craze " 
is the cry of the neurasthenic for a stimulant, of the pain-tortured 
nerve for an anaesthetic, of the victim of insomnia for a hypnotic. 

Not any patient that applies for relief to the physician needs a 
more careful examination than does the inebriate. You may rest as- 
sured that there is some underlying cause, probably several that must 
be removed if we would restore the inebriate to his former habits of 
sobriety. If he is found suffering from the later manifestations of 
syphilis he will need special treatment for this condition, especially 
if the nervous system is involved ; a painful stricture of the urethra 
may require division. 

Chronic malarial poisoning with its complicating disorder of stom- 
ach, liver and spleen, will demand special treatment. In a case on 
record the irritation of a tape-worm produced a tendency to the ex- 
cessive use of alcohol, which tendency passed away when the worm 
was expelled. 

la a word, a large majority of inebriates are diseased persons, and 
that primarily and antecedent to their inebriety, which is appended 
to and aggravates their diseased condition. 

Special diseases, therefore, require special treatment, irrespective 
of the inebriety, if we would cure the inebriate. In this connection 
we may ask, are there an}^ drugs that we can substitute for alcohol 
that will take its place, and satisfy the inebriate, as a substitute for 
alcohol ? 

Opium and the salts of morphia will do so in a marked degree, al- 
though cocaine, chloral and the bromides have been so used. 

The use of opium or morphia is not uncommon among inebriates 
who desire to " leave off alcohol." The inebriate, as a rule, is a con- 
genital neurotic. From birth almost, he reaches out for some drug 
that will gratify or meet his neurotic craving. The alcohol and the 
opium habit to the inebriate are convertible habits, and the inebriate, 
like a pendulum, will swing from alcohol to opium ; not infrequently 
the two habits are combined, as in the form of tinct. opii, constitut- 
ing a mixed habit, in which the effects of both alcohol and opium 
have to be considered. Occasionally a case is presented in which 
morphia is used hypodermically, and the alcohol used in the usual 
manner. In cases where opium addiction is associated with the habi- 
tual use of alcohol, the opium habit is of paramount importance and 
the alcohol assumes a secondary place. 

The fact that opium can substitute alcohol is the keynote to many 
vaunted secret cures, in the so-called " narcotic treatment " for alco- 



DISEASES OF THE BRAIN AND NERVES. 



171 



hoi. It simply substitutes one habit for another, and as long as the 
victim is taking the so-called remedy he is reasonably comfortable. 
But I admit if the " narcotic treatment " was carefully practiced, in 
judicious hands it might, in conjunction with such other remedial 
measures as would best eradicate the primal causes of the inebriety, 
prove useful, if not curative, in cases of inebriety. 

Are there any drugs that are specifically beneficial for the treatment 
of inebriety as such ? We would state that drugs that act directly as 
a stimulant to the nervous system are of value. Strychnia is a type 
of this class of drugs, and one of the best of it class. 

Luton, of Rheims, Belgium, was the first to point out its value in 
alcoholism. Then the Russians used it largely and it was known as 
the " Russian treatment," and finally, the Americans adopted its use 
in such cases. 

Strychnia has proved serviceable as both abortive and curative in 
acute alcoholic delirium, as well as useful in the more chronic forms 
of alcoholism. It seems to be tolerated in such cases — in cases of 
alcoholic poisoning under normal conditions, we have no record of 
the value of strychnia as an antidote ; interesting experiments might 
be made on the lower animals with the view of determining this 
point. Strychnia is an excellent cardiac tonic, and one of the best 
respiratory stimulants, and might be used in general medicine in 
cases in which alcohol is oftentimes prescribed. 

Oxide of zinc, during the past twenty years, has been used with 
advantage in cases of chronic alcoholic intoxication. 

Quinine has been used more particularly in the later or convales- 
cent period of the treatment of alcoholism. 

The so-called "Red Cinchona Cure" for a time interested the pub- 
lic. Rational medicine does not recognize any special drug or speci- 
fic remedy as a universal cure for inebriety, nor does clinical experi- 
ence form any basis for such a claim. From the very nature of the 
case, such a remedy would be impossible. The aetiology of inebriety 
is dependent on such a variety of causes and its environments and 
complications so numerous that any one remedy could not fulfill all, 
or even meet the more important of these conditions. However val- 
uable drugs may be to meet certain indications in the various condi- 
tions incident to inebriety, we believe that so far as the curative 
treatment of inebriety is concerned, drugs must assume a secondary 
place, valuable as they may be in their respective spheres. 

In the treatment of the alcohol habit we place first: Restraint and 
seclusion in a special asylum for a definite period, and total* abstinence 
during this period. 

In a few words, concisely expressed, this statement includes the 
plan now adopted by the leading asylums of this country and of 
Europe for the recovery of the inebriate. It involves restraint, 
(legal, if need be), seclusion, a special institution, in which all the 
latest and best methods of dealing with the inebriate are procurable, 
a sufficient period in which to apply these measures, and we need 



172 DISEASES OF THE BRAIN AND NERVES. 

hardly add, a long period of total abstinence from all alcoholic liquors. 
We need hardly add that diet, rest, recreation, hygienic surroundings, 
and the exhibition of appropriate drugs are all included in the above 
plan. 

The causes of degeneration being removed, the factors of regenera- 
tion being brought into action, new formation of nerve, muscle and 
tissue must supplant degenerated tissue, if haply organic disease has 
not resulted in irreparable injury. 

We have hinted at an hysterical element in the history of inebriety. 
The inebriate, whatever may be his condition, is largely influenced 
by his surroundings. 

In the light of such an hysterical element in the clinical history of 
inebriety, we can readily account for the apparent success of the so- 
called temperance movements that sweep over communities periodi- 
cally and effect many apparent cures, or rather, in the language of 
the day, reformations. Such an element will also explain why, after 
such a tidal wave of excitement, relapses take place oftentimes in 
large numbers, and the period of excitement is followed by a period 
of reaction. 

The occurrence of relapses is readily accounted for by the fact that 
the stimulus of the period of excitement buoys up the inebriate for 
the time being, during which strong mental emotion is a powerful 
factor. He is keyed up, as it were, for the time, and sustained by a 
moral stimulus. When this is withdrawn, reaction, followed by cor- 
responding depression, sets in, and the old method of stimulation is 
again imperatively demanded and yielded to. 

Why some inebriates go through such a period of excitement and 
do not relapse, and why others do, can be accounted for by the fact 
that the former are in a reasonable degree of physical health, and are 
not burdened, dragged down and handicapped, either by disease that 
is non-alcoholic, or that is the result of alcoholic degeneration. The 
inebriates so affected are not influenced, or if at all, only temporarily, 
by the so-called "temperance revivals" that appear and disappear 
with almost stated regularity in large and small communities, and we 
must add do good, but only in the channel indicated. 

It is also operating through this hysterical feature of inebriety 
that charlatanism may effect a temporary, possibly a permanent suc- 
cess in a certain class of cases. 

In cases where the hysterical element largely preponderates, we be- 
lieve psycho-therapeutical agencies, or even those that appeal to 
purely mental conditions, will be of service, but they will not cure a 
cirrhosed liver, lung, or kidney, or remove the physical causes upon 
which the inebriety may depend. In addition to those measures that 
appeal to the higher moral nature, there ought also to be combined 
such as meet certain intelligent wants. To this end all reasonable 
amusements, entertainments, and especially such occupations as will 
interest the person and keep him busy, should be encouraged, if not 
made compulsory. 



DISEASES OF THE BRAIN AND NERVES. 173 

Incidentally I may mention hypnotism as having been used espe- 
cially by French physicians, with some benefit in cases of chronic al- 
coholism. I have no data to give, and have not had any personal 
experience with it. 

The Bi-Chloride of Gold cure, known as the Keeley cure, is in 
many cases successful, but not in all. Would advise its use as a last 
resort ; though we think its use sometimes leads to insanity and 
suicide. It cures at all events for the time being. 

If the temperance advocates would supply light, warm, cheerful 
places of resort with hot and temperance drinks, supplied with pool 
and billiard tables where the poor could spend their evenings and 
meet each other and amuse themselves at a reasonable expense, and 
establish cooking schools for the wives where they could learn how 
to cook nourishing and palatable food which would supply the body 
with the nourishment which it must have, and requires, we believe 
it would do more towards temperance than all the laws that could 
be passed. 

Enlargement of the Brain. — Hypertrophy. 

This is chiefly a disease of childhood. It consists in an unnatural 
growth of the brain. Sometimes the skull grows with it, and there 
may not be any, or only slight, symptoms of disease. 

The complaint is sometimes congenital, — the child being born 
with a head far above the natural standard of size. Sometimes a 
child's head, from this disease, will reach the size of an adult's by 
the time it is five or six years old. This is not necessarily a disease, 
though children that suffer from it are very apt to die finally of some 
affection of the brain. 

Symptoms, — Dullness of intellect, indifference to external objects 
great irritability of temper, inordinate appetite, giddiness, and an ha- 
bitual headache, which at times is very severe. In addition to these, 
there are, at times, convulsions, epileptic fits, and idiocy. There is a 
peculiar projection of the parietal bones, which serves well to distin- 
guish this disease from acute hydrocephalus. 

Treatment. — As far as possible, suspend and repress all exercise 
of the mind. Take the child from school as soon as the disease is 
discovered, and put it to the most active muscular exercise in the 
open air. The moment there is any excitement of the brain, or heat 
on the top of the head, apply cold water, ice, or cold evaporating 
lotions. If, as the child grows up, the signs of mischief increase, the 
diet must be simple, and carefully regulated. Bread and milk only 
is sometimes advisable. 

Shrinking of the Brain. — Atrophy. 

This is a disease in which the volume of the brain is diminished. 
There are' two forms of it; one is congenital, the brain not being 



174 DISEASES OF THE BRAIN AND NERVES. 

properly developed at birth ; the other occurs in consequence of dis- 
ease either in the membranes or the arteries. The symptoms are not 
distinguishable during life from those of other brain affections, and 
therefore it can only be treated according to general principles. 

Water in the Head. — Acute Hydrocephalus. 

This, like enlargement of the brain, is likewise a disease of child- 
hood, and often attacks scrofulous children. 

Being an inflammatory disease, it is important to have early notice 
of its existence, and, if possible, to be aware of its approach ; which 
we may be, frequently, by observing the following premonitory 

Symptoms ; namely, a disturbance of the digestive functions, indi- 
cated by a capricious appetite, — the food at one time being disliked, 
at another devoured greedily; a foul tongue, offensive breath, enlarged 
and sometimes tender belly, torpid bowels, stools light-colored from 
having no bile, or dark from vitiated bile, fetid, sour-smelling, slimy 
and lumpy. The child loses its healthy look, and grows paler and 
thinner. Its customary spirit and activity are gone ; it is heavy, lan- 
guid, dejected ; it is fretful, irritable, uneasy ; and sometimes is a lit- 
tle tottering in its gait. 

After these warning symptoms, the disease may begin in one of 
three ways : — 

The pains in the head become more severe and frequent, and are 
sharp and shooting, causing the little patient to wake and shriek out. 
As the drowsy state advances, the shrieking gives place to moaning. 
Beside these symptoms, there are stiffness in the back of the neck, 
pain in the limbs, great tenderness of the scalp, vomiting, sighing, 
intolerance of light, knitting of the brows, increased disturbance of 
stomach and bowels. This stage may last ten to fourteen days, the 
child growing more weak and peevish. 

Another form of attack is marked by acute pain in the head and 
high fever, convulsions, flushed face, brilliant eyes, intolerance of light 
and sound, pain and tenderness in the belly, stupor, great irritability 
of stomach, causing retching and vomiting upon every attempt to sit 
up in bed. 

The third mode of attack is very insidious, — the early symptoms 
being mild and hardly noticeable, or not even occurring at all. In 
such case, the convulsions or palsy come suddenly, without notice, 
bringing swift and unexpected destruction. This has sometimes been 
called water-stroke. 

The First Stage is the period of increased sensibility and excite- 
ment, caused by inflammation, in which the pulse is quick and irreg- 
ular. 

* 

The Second Stage is one of diminished sensibility, or lethargy, dur- 
ing which water is effused upon the brain, and the pulse is slow. 



DISEASES OF THE BRAIN AND NERVES. 175 

The Third Period is one of palsy and convulsions, with squinting 
of the eyes, rolling of the head, stupor, and a rapid, thread-like pulse. 

Treatment. — The first or inflammatory stage of the fever is very 
important, and must be controlled for five or six days. Scammony and 
croton oil (33) may be chosen for this purpose, Apply cold water, 
ice, etc., to the head. Use tinct. veratrum viride or (355). 

In the second stage, put blisters upon the back of the neck, and one 
upon the bowels if they are very tender. 

In the third stage, effusion having taken place, use the warm bath, 
or the vapor bath, — also digitalis, squills, and iodide of potassium, 
(144), (128), (302), (130). The effusion, if permanent, may be 
drawn off. 

Confine the child to a darkened room, of moderate temperature, — 
excluding all noise and causes of excitement, and let him lie upon a 
hair mattress, with his head somewhat elevated. 

Diet. — Gruel only during the stage of excitement, — during that 
of collapse, it should be nourishing, but mild and easy of digestion, 
as beef tea, plain chicken or mutton broth, and animal jellies. At 
the same time, support the patient by the cautious use of the aromatic 
spirit of ammonia, ten drops every four hours, valerian, wine whey, 
and infusion of gentian, columbo, or quassia, (64), (66). 

Dropsy of the Brain. — Chronic Hydrocephalus. 

Acute hydrocephalus is an inflammation; chronic hydrocephalus, 
now to be considered, is a dropsy. It often begins before birth. It 
consists in the accumulation of enormous quantities of water within 
the brain, sometimes within its ventricles, at other times upon its 
surface. When it occurs soon after birth, it advances slowly and 
imperceptibly, — the enlargement of the head being the first thing 
noticed. 

The skull being tender in infancy, it separates at the fontanelles, 
as the fluid accumulates, and the head, at times, attains an enormous 
size, — so great that the child cannot carry it upright, but lets it droop 
laterally upon the shoulder, or forward upon the breast. 

As the disease advances, the senses become blunted, the child is 
deaf or blind, the intellect is weakened, perhaps idiocy appears, the 
flesh and strength pass away, convulsions and paralysis come in their 
turn, and a stupor is apt to occur which ends in death. 

Treatment. — The remedies may be external, or internal, or both. 

Internal Remedies. — These should be purgatives (33), (31), or 
diuretics and alteratives (302), (145), (144). 

External Remedies. — Apply an ointment of the iodide of potas- 
sium to the scalp every night (185). A tight bandage applied over 
the whole head will sometimes have a favorable effect. Another ex- 



176 



DISEASES OF THE BRAIN AND NERVES. 



pedient is to puncture the skull and draw off the water. Tapping 
the brain has effected a cure in many cases, and perhaps promises the 
most relief of any remedy we have. In newly-born children with this 
affection, it is the best means. 



Diseases of the Spinal Cord. 

There are few diseases more interesting, as a study, 
than those which affect the nervous cord which runs 
11 through the centre of the back-bone. This cord is a 
continuation, an appendage or tail of the brain. (See 
Figure 84.) It is the seat and centre of certain ner- 
vous functions, called reflex, by which so many move- 
ments take place which are not under the control of the 
will. 

In order that we may feel what takes place in any 
part of the body or limbs, and that the will may have 
power to move such part, it is necessary that nervous 
matter should be continuous and unbroken between the 
part in question and the brain. 

If the spinal cord be cut, broken, or crushed at any 
point, all those parts which receive nerves from below 
the injury, lose their power of motion and their feel- 
ing. When the injury is in the upper part of the cord, 
the breathing and the circulation will stop, and death 
is the immediate consequence. If the middle portion 
of the cord be the seat of the injury, the bowels and 
other organs may lose their motion and feeling ; if the 
lower portion, then the lower limbs only will be the 
sufferers. 

Disease or injury in the upper part of the cord is 
therefore much more dangerous than the same thing 
occurring in the lower. 

Inflammation of the Spinal Cord. 

The membranes which surround the cord may be inflamed just as 
those are which enclose the brain ; but as the cavity running through 
the spine is quite small, there cannot very well be inflammation of 
the membranes without its involving the cord at the same time. 

Symptoms. — Pains, often intense, running along the spine, extend- 
ing out into the limbs, and made worse by motion. They are similar, 
in some respects, to rheumatic pains. There is rigid contraction, and 
sometimes violent spasms of the muscles of the back and neck, — so 
great, at times, as to bend the body back into the shape of a hoop ; 
also a feeling of constriction in various parts, as if they were girt by 
a tight string ; a sense of suffocation ; retention of urine ; a most 



DISEASES OF THE BRAIN AND NERVES. 177 

obstinate constipation and frequent chills or rigors. The pain which 
is felt along the cord is aggravated by rapping upon the spine, but 
not by pressure. 

The above symptoms are supposed to be the result of inflammation 
predominating in the membranes. When its seat is more particularly 
in the substance of the cord, the symptoms are, — convulsive affec- 
tions of the head and face, inarticulate speech, loss of voice, squint- 
ing, and difficulty of swallowing, if the extreme upper part of the 
cord is inflamed; if the disease be slightly lower, difficulty of breath- 
ing, irregular action of the heart, and tightness of the chest; if lower 
still, vomiting, pain in the belly, sensation of a cord tied round the 
abdomen, pain and heat in passing water, retention of the urine, ina- 
bility to retain the urine, desire to go to stool, or involuntary stools. 

Spasm and stiffness, then, are the results of inflammation of the 
membranes ; convulsions and palsy, of the same affection of the cord. 

Treatment, — When the inflammation is acute, apply a few leeches 
or wet cups along the sides of the spine. In chronic inflammation, 
powerful friction, or mustard draughts, stimulating liniments (190), 
or plasters, will generally answer the purpose. 

Apoplexy. 

Apoplexy is that condition in which all the functions of animal 
life are suddenly stopped, except the pulse and the breathing ; — in 
which there is neither thought, nor feeling, nor voluntary motion ; in 
which the person falls down suddenly, and lies as if in a deep sleep. 

Modes of Attack. — There are at least three ways in which this ter- 
rible disease may make its assault. 

The First form of attack is a sudden falling down into a state of 
insensibility and apparently profound sleep, — the face being gen- 
erally flushed, the breathing stertorous or snoring, the pulse full and 
not frequent, with occasional convulsions. 

From this mode of attack some die immediately, others get entirely 
well, and others get off with the exception of paralysis on one side, 
or the loss of speech, or some one of the senses. 

The Second form of attack begins with sudden pain in the head. 
The patient becomes pale, faint, sick, and vomits, — has a cold skin 
and feeble pulse, and occasionally some convulsions. He may fall 
down, or may be only a little confused, but will soon recover from all 
the symptoms, except the headache, — this will continue, and the pa- 
tient will sooner or later become heavy, forgetful, unable to connect 
ideas, and finally sink into insensibility, from which he never rises. 

This mode of invasion, though not appearing so frightful as the 
first, is of much more serious import. 



178 DISEASES OF THE BRAIN AND NERVES. 

In the Third form of attack there is sudden loss of power on one 
side of the body, and also of speech, but not of consciousness. The 
patient retains his mind, and answers questions either by words or 
signs. This may be called paralytic apoplexy. The patient may 
either die soon, or get well, or live for years with imperfect speech, 
or a leg dragging after him, or an arm hanging useless at his side. 

The Persons Attacked are apt to have large heads, red faces, short 
and thick necks, and a short, stout, square build, though it occurs 
often among those who are thin, pale, and tall. The tendency to it 
increases in advanced life. 

The Forerunners of apoplexy are headache, vertigo, slight attacks 
of palsy, double vision or seeing two objects when there is but one, 
faltering speech, inability to remember certain words, sometimes a 
sudden forgetfulness of one's own name, a frequent losing of the 
thread of ideas attempted to be pursued, and occasionally an unac- 
countable dread, for which no reason can be given. 

Exciting Causes. — Whatever hurries the circulation of the blood, 
as strong bodily exercise, is an exciting cause. So are all those things 
which cause the blood to flow towards the head, as coughing, sneez- 
ing, laughing and crying, straining at stool when costive, lifting heavy 
weights, singing, and playing on wind instruments. To these may 
be added, exposure to the sun, the bad air of crowded rooms, holding 
the head down, or turning it around to look backward, tight cravats 
worn about the neck, and exposure to severe cold. 

Treatment. — If the patient have the appearance of suffering from 
fulness of blood in the head, as evinced by redness and turgescence 
of the face and throbbing of the temporal arteries, and if the pulse 
be full and hard, feeling like a tense vibrating rope under the finger, 
place him in a half -recumbent posture, with Ins head raised ; loosen 
his clothes, particularly his neck-cloth and shirt collar, and whatever 
may press upon the neck, and then as quickly as possible apply cold 
wet cloths to his head, changing them often. Ice is still better, if it 
may be had. Apply wet cups to the nape of the neck, and mustard 
draughts to the soles of the feet. — at the same time applying tight 
ligatures around the limbs, to prevent the blood from returning 
rapidly in the veins. The ligatures should be gradually removed 
when the patient recovers his consciousness.. Also administer a 
stimulating, purgative injection (246), and place two drops of croton 
oil, rubbed up with a little pulverized loaf sugar, far back upon the 
tongue. Repeat the injection every fifteen minutes, till the bowels 
are thoroughly moved. This is one of the few diseases suitable for 
bleeding:. 

If the patient be old, and the pulse small and feeble, with no ful- 
ness or beating of the temporal arteries, or swelling of the veins of 
the neck and forehead, the countenance being pinched, and the skin 



DISEASES OF THE BRAIN AND NERVES. 179 

bloodless and cold, the cupping, purging, and applying the ligature 
must be omitted. In this case it will be better to apply warm 
flannels and hot bricks to the surface, and administer ammonia 
and camphor (283), (135) internally. 

To prevent future attacks, gentle tonics should be used, and the 
skin should be kept healthy by daily bathing and friction. The 
bowels mnst not be permitted to become costive. The diet should 
be light, chiefly vegetable, and almost entirely so in hot weather. 
The food should be well chewed. The mind should be kept cheer- 
ful and hopeful, and free from great excitement. The sexual 
passion should be restrained, and very rarely indulged. Intoxicating 
drinks should be abandoned, if used, and all tight cravats be dis- 
carded from the neck. Direct rays of the hot sun in summer should 
be carefully shunned. No food should be taken for three hours 
before retiring, and a mattress only, of some degree of hardness, 
should be slept upon, — the head being always well elevated. To 
these precautions, I would add dipping the feet every night before 
retiring in cold water; and, if any tendency to cold feet be ex- 
perienced, dusting pulverized cayenne in the bottoms of the 
stockings. 

Sunstroke. — Coup de Soldi. 

This is much like apoplexy; in fact, it is a kind of apoplexy. It 
occnrs in warm climates, or on very hot days in temperate regions, by 
exposure to the sun. 

It begins by headache, thirst, dizziness, and sometimes difficult 
breathing and bilious vomiting. The patient drops down senseless, 
as in apoplexy, and unless immediate relief is obtained, soon dies. 

Treatment. — Take the patient immediately into the shade, and 
employ about the same remedies as for apoplexy (351). Apply ice 
to the head. 

Palsy. — Paralysis. 

Palsy is a loss of the power of voluntary motion and feeling, one 
or both coming on, sometimes gradually, but more often suddenly, 
and extending at one time to a part, at another time to the whole 
body. It is a kind of station-house on the way to apoplexy, where 
passengers stop, not merely to stay over night, but to rest many days, 
or even years. 

A great injury inflicted upon the brain, either by pressure or other 
cause, will induce a complete loss of motion and feeling, and this ex- 
tending to the whole structure, brings likewise a loss of conscious- 
ness, which is apoplexy. A smaller degree of pressure, or a less 
injury upon the same brain, would occasion a loss of motion only, or, 
if a loss of feeling were experienced also, it would only extend to a 
part of the body, and consciousness would remain. This would be 
palsy. The disease is like apoplexy in kind, but stops short of it in 
degree. 



180 DISEASES OF THE BRAIN AND NERVES. 

Hemiphlegia. 

When palsy affects an entire half of the body, dividing it through 
the centre of the face, neck, body, etc., from head to foot, it is called 
hemiphlegia. It is more nearly allied to apoplexy than any other 
form of the disease, and is generally ushered in by pretty well-marked 
apoplectic symptoms. 

Symptoms. — Sometimes there are no premonitory symptoms ; but 
often before the attack there are flushed face, swelling of the veins 
about the head and neck, vertigo, a sense of fullness, weight, and 
sometimes pain in the head, ringing in the ears, drowsiness, indistinct 
articulation of words, or even loss of speech, confusion of mind, loss 
of memory, and change of disposition, — amiable persons being made 
sullen and peevish, and irritable ones mild and simpering. After 
the attack, the countenance generally acquires a vague expression ; 
the mouth is drawn to one side ; the lower lip on the palsied side 
hangs down, and the spittle dribbles away. The speech is altered, 
and the mind is generally impaired. 

In some instances, the patient recovers in a longer or shorter time ; 
in others, little or no improvement takes place, and the patient, after 
remaining helpless, often for a long time, dies either from gradual 
exhaustion, or suddenly from apoplexy. 

Causes. — Hemiphlegia and paraphlegia are caused by pressure 
upon the brain, by the effusion upon it of blood or water, by a tumor, 
by mechanical injuries, by the striking in of eruptions, and by intem- 
perance in eating and drinking. Paraphlegia often results from dis- 
ease or injury of the spinal marrow. 

Paraphlegia. 

This form of palsy divides the body transversely, at the hips, and 
confines itself to the lower extremities, and to the parts about the 
pelvis. 

Symptoms. — When it arises from affections of the brain, it is at- 
tended by pain in the head, giddiness, drowsiness, dimness of sight, 
and impaired memory. Numbness is sometimes felt in the upper ex- 
tremities as a forerunner of this form of palsy. At first there is a 
slight stiffness and awkwardness of the motion of the legs, which 
continue to increase till a cane is needed to balance the body and 
make it steady. From a paralysis of the neck of the bladder, the 
stream of urine grows more feeble, and finally dribbles away involun- 
tarily. The bowels are for a time costive, but when the circular 
muscle which closes the fundament becomes palsied, the feces pass 
without consent of the will. 

When disease of the spinal cord is the cause of the complaint, it 
is apt to come on gradually ; languor and weakness are felt in the 



DISEASES OF THE BRAIN AND NERVES. 181 

knees, the legs are not easily directed in walking, — being thrown 
across each other, causing tripping and stumbling. By degrees the 
loss of power increases in the thighs and legs, until at length the 
whole lower extremities become palsied and useless. 

Local Palsy. 

Palsy is called local when it is confined to a single limb, or muscle, 
or locality. One of these forms is called facial palsy. It affects one 
half the face only, and is a good specimen of these affections. It 
removes all power of expression from one half of the face, and leaves 
the features still, blank, and unmeaning. With the affected side of 
the face, the patient cannot laugh, or weep, or frown, or express any 
feeling or emotion, while the features of the other side are in full 
play. Among the ignorant, who do not comprehend the extent of 
the evil, the drollness of the expression excites laughter. 

Shaking Palsy. 

The nature of this form of palsy is well expressed by its name. 

Symptoms. — The first symptom of this complaint is a weakness 
and tremor of the head or hand. In about a year the other hand, or 
the lower extremities become affected ; and the patient begins to lose 
his balance in walking. Then the trembling becomes perpetual ; no 
limb or part remains still. Reading and writing are no longer possi- 
ble, and the hand cannot even carry the food to the mouth. The 
balance cannot be maintained in walking ; there is a tendency to fall 
forwards, and to avoid it, the patient is obliged to run or move 
quicker, and upon the toes. 

At a later period, the tremor continues during sleep ; there is in- 
creased weakness ; the body is bent forward, the speech becomes in- 
distinct, swallowing difficult, and the bowels torpid. At last the 
urine and feces pass involuntarily, and delirium and coma bring life 
to a close. 

Lead Palsy. 

In this disease the muscles of the forearm are palsied, so that the 
wrists " drop," as it is said, and the hands hang down when the arms 
are stretched out. It is caused by the gradual introduction of lead 
into the system. It is a disease, therefore, peculiar to painters, — 
particularly those who use carbonate of lead, or white lead, as it is 
called. It is generally the sequel of painter's colic. 

Treatment. — A sudden and severe attack of palsy requires the 
same treatment as apoplexy. When the bowels are obstinately con- 
stipated, they must be moved by scammony and croton oil (31), (32) 
and by injections (246). 



182 DISEASES OF THE BRAIN AND NERVES. 

When all the symptoms of determination of blood to the head have 
disappeared, and the disease has become strictly chronic, exciting 
remedies must be employed, as frictions, stimulating liniments, blis- 
ters, stimulating baths, cold affusion, and electricity. Among the in- 
ternal remedies, strychnine has the best reputation (85), (86). The 
tincture of the poison oak is well recommended (284). An altera- 
tive (145) should likewise be used. 

Apply counter-irritants along the track of the spine, such as blis- 
ters, the moxa, the compound tar-plaster, and the pitch-plaster. 

At first the diet should be light ; but after the more active symp- 
toms have disappeared, it should be nutritious, and sometimes stimu- 
lating. Flannel underclothes should always be worn next the skin. 

For lead palsy, the best remedies are iodide of potassium, or sul- 
phuret of potassium . The dose of either of these is from three to ten 
grains, three times a day, dissolved in water, one ounce of the salt to 
six ounces of water, and taken in simple syrup. The affected limb 
should also be soaked an hour each day in a gallon of water, with 
half an ounce of sulphuret of potassium dissolved in it. 

Hydrophobia. — Rabies. 

The bite of the mad dog, or mad wolf, or other hydrophobic ani-, 
mal, is the most dangerous of all poisoned wounds, because it is apt 
to be followed by a disease for which there is no certain remedy. 
Fortunately, the human subject is not as susceptible to the effects of 
the poison as some of the lower animals ; for only about one-tenth of 
those bitten are attacked by hydrophobia. 

Symptoms. — The interval between the bite and the appearance of 
the disease varies from twelve days to two months. The wound 
heals like any other bite of a similar animal. After a time, the scar 
begins to have darting, lancinating pains, which, if it be a limb that 
was bitten, run up towards the body. Sometimes it feels cold, or 
stiff, or numb, or becomes red, swelled, or livid, and occasionally 
breaks open, and discharges matter. The patient feels a strange anx- 
iety, is depressed in spirit, has an occasional chill, and disturbed 
sleep, and spasmodic twitches. The pulse is above its natural state, 
both in quickness and strength, and the nervous system is very im- 
pressible. The senses are all more acute; trifling noises produce 
agitation, and the eyes are so disturbed by the light that the patient 
sometimes hides himself in a dark place. The appetite is lost. This 
is the first stage. 

Thirst now appears, and he attempts to drink. But the moment 
water approaches his mouth, a spasmodic shudder comes over him ; 
he pushes it back with horror ; the awful fact of his condition flashes 
upon him ; and he cries out, " What I have dreaded has come upon 
me." 

Thenceforward he can swallow no fluids ; complains of pain and 



DISEASES OF THE BRAIN AND NERVES. 183 

stiffness about his neck ; is thrown into convulsions by the sight of 
water, or even the sound of liquids agitated in a vessel, or by a 
breath of air blowing upon him, by a bright light, or by the glare of a 
mirror. His throat is full of a viscid, glary matter, which he con- 
tinually tries to clear away. Thus, between convulsions, in which 
he struggles, and sometimes strives to bite his attendants, and com- 
parative stillness, during which he suffers great depression of spirits, 
he passes three or four days, and then dies either in a spasm, or from 
exhaustion. 

Treatment. — Cut off the bitten part, or apply dry cupping, or 
suction, at once. Also the caustic potash. The internal remedies 
heretofore employed have had little success. Perhaps nothing now 
known promises more than to have the patient vaccinated by the 
recently discovered virus. The tincture of scullcap, in two or three 
dram doses, will allay the nervous agitation, and is always worth 
using. It has been proposed to clear the throat of the tough mucus 
by cauterizing it with a strong solution of nitrate of silver (219), ap- 
plied with a shower syringe. The remedy is worthy of a trial. 

Some of the Western physicians declare the red chickweed, or scar- 
let pimpernell, to be an absolute remedy for this disease, and cite 
some quite remarkable cases of its success. Four ounces of this 
plant, in the dried state, are directed to be boiled in two quarts of 
strong beer or ale, until the liquid is reduced one half. The liquid 
is to be pressed out and strained, and two drams of laudanum added 
to it. The dose for a grown person is a wine-glassful every morning 
for three mornings. A larger dose is required if the disease have 
begun to show itself ; and if the case be fully developed, the whole 
may be taken in a day. The wound is to be bathed with the same 
decoction. The medicine, it is said, produces profuse sweating. It 
is worth a trial. 

Considerable has been said of late of a remedy used in some parts 
of Europe, and said to be effectual. It is the " golden cenotides " 
(cetonia aurata), or common rose-beetle, found in large quantities on 
all rose-trees. A similar insect is said to infest the geranium-plant. 
When collected, they are dried and powdered ; and given in this 
form, relieve excitement (so it is said) of the brain and nerves, and 
throw the patient into a sound sleep. Immediate suction and disin- 
fection of the wound is admirable, followed by caustics. 

Muscular and Nervous Derangements from 

Wounds. 

In some persons, a very small local injury will produce violent dis- 
turbance of the nervous system. Some will faint and be thrown into 
convulsions and vomiting from causes scarcely greater than the prick 
of a needle ; and, before Morton gave the world the boon of ether, it 



184 DISEASES OF THE BRAIN AND NERVES. 

was not very uncommon for persons to die under the knife of the 
surgeon. One of the most serious disturbances from wounds, of a 
nervous and muscular character, is 

Locked Jaw. — Tetanus. 

This is spasmodic contraction, with rigidity, or stiffness, of the 
voluntary muscles. Sometimes this rigidity is partial, at other times 
universal throughout the system. 

Tetanus is produced by two causes, exposure to cold (idiopathic), 
and bodily injuries, particularly the injury of a nerve (traumatic te- 
tanus). This last is the most frequent, — perhaps the only form of 
the complaint. 

The Symptoms are long-continued, violent and painful contraction 
or cramp of the voluntary muscles. At first there is difficulty and 
uneasiness in turning the head, with inability to open the mouth 
easily, — then the jaws close gradually, but with great firmness ; 
swallowing now becomes difficult, and a pain, starting from the 
breastbone, pierces through to the back, — probably caused by cramp 
of the diaphragm or midriff. The cramps now extend to the muscles 
of the body, the limbs, the face, the tongue, etc., which continue in a 
state of rigid spasm, — being swelled and hard in the centre, — till 
the disease yields, or the patient dies. At times the abdominal 
muscles are so tense as to make the belly as hard as a board. Occa- 
sionally the patient is drawn backward into the shape of a hoop, so 
as to rest on his head and heels (episthotonos) ; at other times he is 
drawn forward in the shape of a ball (emprosthotonos) . All the con- 
tractions are attended with intense pain. It is the racking of the en- 
tire body with cramps like those which sometimes attack the calf of 
the leg. So violent are the contractions that the teeth are sometimes 
broken by them, and the tongue is often badly bitten. In the mean 
time, the appearance of the sufferer is frightful. The forehead is 
wrinkled, the brow knit, the eye-balls motionless and staring, the 
nostrils spread, the corners of the mouth drawn back, the set teeth 
exposed, and all the features fixed in a ghastly grin. 

Treatment The only known remedies for this disease are chlo- 
roform and ether, taken either into the stomach, or by inhalation, in 
quantities sufficient to control the spasm, and to be pursued as long 
as they continue to occur. The costiveness must be removed by one 
or two drops of croton oil, administered in a spoonful of gruel. Re- 
lieve the nerve or remove the foreign body from wound. 

Epilepsy.— Epileptic Fits. 

This disease has been sometimes called the falling sickness, but 
generally passes under the more vague title of fits. 



DISEASES OF THE BRAIN AND NERVES. 185 

Symptoms. — The disease is characterized by a temporary loss of 
consciousness, strong spasms and intervals between the fits. The at- 
tack is sudden, generally without warning, and attended with a loud 
cry, when the patient falls down, is senseless and convulsed, struggles 
violently, breathes with embarrassment, has a turgid and livid face, 
foams at the mouth, bites his tongue, has a choking in the windpipe, 
and appears to be at the point of death. Presently, in from five 
minutes to half an hour, and by degrees, these symptoms diminish, 
and at length cease ; and the patient falls into an apparent sleep. In 
a short time more he recovers, and is apparently well. These attacks 
come again and again, and at irregular intervals. 

This is the worst form of the disease ; there is another class of 
cases in which the symptoms are much lighter, — there being no tur- 
gescence of the face, no foaming at the mouth, no cry, no convul- 
sions ; but merely a sudden and brief suspension of consciousness, a 
fixed gaze, a feeling of confusion, or a totter, from all of which the 
recovery is speedy. 

Causes. — These are numerous, — as worms, disturbance from indi- 
gestible food in the stomach and bowels, difficult teeth-cutting, ner- 
vous irritation, either direct or by sympathy, sexual excesses and 
masturbation, disease or injury of the brain or spinal marrow, gall 
stones in the excretory duct of the liver, stone or gravel in the kid- 
neys and bladder, fright, distress of mind, passion, great loss of blood, 
and many others. 

Treatment. — But little can be done during the fit, except to pro- 
tect the patient from being injured by the violence of the convulsions. 
To do this, place a piece of leather, cork, or other substance not too 
hard, between the back teeth to prevent the tongue from being bitten. 
Remove the neckcloth, and unbutton the shirt-collar. If the stomach 
and bowels are suspected to be overloaded, give an injection (246). 

The treatment during the intervals must depend on the cause of 
the disease. If worms be the cause, expel them ; if the attacks be 
excited by difficult teething, lance the gums ; if by uterine disturb- 
ances, search out the nature, and give the treatment recommended 
under the proper head ; if masturbation, command its entire discon- 
tinuance as the only hope of relief ; if the complaint arise from in- 
digestible food, great attention must be given to the diet and general 
health. 

In all cases, indeed, the diet should be carefully regulated, being- 
light, nutritious, and easy of digestion. The sleep should be taken 
at regular hours, and daily exercise in the open air be insisted upon. 
The bowels must be kept regular, by the food, if possible ; if not, by 
mild laxatives. Apply along the spinal column 195, once a day, rub- 
bing it well in ; also, now and then, mustard poultices. 

In addition to these remedies, give pills of iron and quinine (72). 
one after each meal, — also oxide of zinc (270), which is one of our 



186 DISEASES OF THE BRAIN AND NERVES. 

very best remedies. Of the pills, one should be taken three times a 
day. Bromide of sodium, 1 dram in 24 hours, mostly at bedtime. 

We can seldom go amiss in giving medicine calculated to relieve 
nervous irritation, and to build up the general system. For this pur- 
pose, the valerianate of quinine, and the extract of black cohosh (79) 
are well adapted. Citrate of iron and strychnine (316), is a very val- 
uable remedy. 

It is said that a black silk handkerchief thrown over the face of a 
person in a fit, will immediately bring them out of it. It is an ex- 
periment easily tried ; and having seen it in a respectable medical 
journal, I give it for what it is worth. The bromides in large doses, 
long-continued, sometimes cure epilepsy (367). 

Catalepsy. — Trance. — Ecstasy. 

Cataleptic fits are simply what is known to all the world under 
the name of trance; and ecstasy is a modification of the same nervous 
disorder. It is a state in which the mind becomes so intensely ab- 
sorbed in something outside of its earthly tenement, that it withdraws 
all control over the body, and all apparent connection with it, leav- 
ing it as if dead. There is a very light ticking of the heart, just per- 
ceptible to a cultivated ear, but the breast does not rise and fall with 
breathing, the features are all inexpressive and still, the eyes are wide 
open and motionless, apparently staring after the departed intellect; 
and the body and limbs are entirely passive, — remaining unmoved 
where they are placed by others, however tiresome and uncomfortable 
the position. In a word, a person in catalepsy is, in appearance, like 
a marble statue, or like a human body suddenly turned to stone, or, 
like Lot's wife, to a pillar of salt. There is as little feeling, or 
thought, or consciousness, as if the bowl had been instantaneously 
broken at the cistern, and the apparent death were real. 

It is a peculiarity in this disease that the patient, on recovery 
from a fit, takes up the thread of conscious life just where it was 
broken by the attack. Thus, if she were lifting a cup of water to 
the mouth, she would hold it steadily, with the mouth open, till the 
return of consciousness, and then place it to the lips, as if no inter- 
ruption had occurred ; or, if conversing, and in the midst of a sen- 
tence, the unfinished words would be uttered at the end of the fit, 
even though it should last many days. 

Persons in a cataleptic fit have much the appearance of one in the 
mesmeric state ; and the statue-like position in winch an attack fixes 
a patient, reminds one of the manner in which the psychologists, so 
called, will arrest a man under their influence, and make him im- 
movable, with one foot raised in the act of stepping. 

The disease attacks females much more often than males. 

The premonitory symptoms are much like those of epilepsy, and 
the treatment should be about the same. 



DISEASES OF THE BRAIN AND NERVES. 



187 



Saint Vitus's Dance. — Chorea. 

This disease is chiefly confined to children and youth between the 
ages of eight and fourteen. But few cases occur after puberty. 

Symptoms — The complaint affects mostly the muscles and the 
limbs. It excites curious antics, — such as we should suppose would 
occur if a part of the muscles of voluntary motion had hatched a 
mimic rebellion, broken away from the control of the will, and in 
sheer mischief and wantonness, were tripping their fellow muscles, 
and playing tricks with the patient. A few of the muscles of the 
face or limbs begin their mischievous pranks by slight twitches, 
which, by degrees, become more energetic, and spread to other parts. 
The face is twisted into all kinds of ridiculous contortions, as if the 
patient were making mouths at somebody. The hands and arms do 
not remain in one position for a moment. In attempting to carry 
food to the mouth, the hand goes part way, and is jerked back, starts 
again, and darts to one side, then to the other, then mouthward 
again ; and each movement is so quick, and nervous, and darting, 
and diddling, that ten to one the food drops into the lap. If the at- 
tempt be made to run out the tongue, it is snatched back with the 
quickness of a serpent's, and the jaws snap together like a fly-trap. 
The lower limbs are in a state of perpetual diddle ; the feet shuffle 
with wonderful diligence upon the floor, as if inspired with a cease- 
less desire to dance. 

It is supposed by some that the disease consists in a partial palsy 
of a part of the muscles. The will in that case not being able to 
control the palsied muscles, when it commands the others to move, 
their action is not balanced, and they twitch the face and limbs into 
all the capricious and fantastic shapes we witness. 

Others, and probably with more truth, hold that the 'seat of the 
disease is in the cerebellum or little brain. It is supposed to be one 
of the functions of this organ to preside over and regulate the loco- 
motion, — that it holds the office of chief engineer, and that its 
duties are to keep the muscles in subjection to the will. The com- 
bined and consenting action of several muscles is needed for every 
movement. It is the business of the cerebellum to maintain this 
oneness of purpose and action — to see that no muscle flinches so as 
to disturb the harmony of the movement. When the cerebellum is 
diseased, all is confusion, — just as the locomotive runs from the 
track when the engineer is smitten with palsy. 

The disease is not dangerous, but when it continues for mam- 
years it is apt to weaken the mind, and it sometimes very nearly 
destroys it. 

Causes. — Whatever excites and weakens the nervous system, as 
powerful emotions of the mind, overworking the mind, reading ex- 
citing novels, eating too much meat, fright, striking in of eruptions, 
self -pollution, etc. 



188 DISEASES OF THE BRAIN AND NERVES. 

Treatment. — In the first place, remove all causes of excitement. 
Take the patient from school, and require some sort of cheerful out- 
door exercise, daily. Take away all books, and be careful not to do 
anything to occasion anger or fear, or any kind of injurious excite- 
ment. Apply spinal ice-bags gradually and regularly. 

In the second place regulate the diet — making it more animal 
and stimulating if it has been to low, and more vegetable and cool- 
ing if it has been too high. 

In the third place, if the above changes have not been sufficient 
for the purpose, open and regulate the bowels with some gentle 
physic (30), (34) for a few days. 

In the last place, build up the nervous system with oxide of zinc 
pills (270), three a day ; or iron (63), (80), or black cohosh, scull- 
cap, etc. (79), or the compound valerian pill (81). Sulphate of 
zinc (82) will sometimes succeed when the oxide fails ; and where 
there is scrofula, the iodide of zinc is to be used. 

To these remedies should be added the shower-bath, beginning 
with tepid water, and making it a little colder every day. If the 
shower-bath frightens the patient, or is not otherwise well borne, take 
the sponge bath. " Fowler's Solution " has the most marked effect 
on the disease. Three drops gradually increased till coryza ensues ; 
stop and begin again. 

Chronic Chorea. 

This can hardly be said to amount to a disease. It consists rather 
in uncouth tricks, arising from some slight disorder of particular 
muscles, and grown into a fixed habit, such as shaking of the head 
every three to twenty seconds, repeated squinting of the eyes in con- 
nection with a peculiar knitting of the eyebrows, wrinkling of the 
nose, shrugging of the shoulders, lifting the ears up and down, or 
even moving the whole scalp back and forth. These movements are 
commonly made without a consciousness of it ; and generally there 
is no power to suspend them without a painful effort which cannot 
be easily continued. 

No medical treatment is of any avail. These tricks can only be 
corrected by great watchfulness and effort on the part of the person 
suffering from them, and in many cases, not even by such means. 

Cramps. 

Cramp is experienced .n the calves of the legs, the thighs, the 
stomach, the breast, the womb, etc. It is a very painful, sudden, and 
violent contraction of one or more muscles. The part is sometimes, 
as the phrase is, " drawn up into knots." When it attacks the stom- 
ach, it is a very dangerous affection. Women are subject to it about 
the third or fourth month of pregnancy. 

They occur more frequently at night as the result of over-fatigue 



DISEASES OF THE BRAIN AND NERVES. 189 

and indigestion during the day. These spasmodic contractions often 
occur in the abdomen and are accompanied by diarrhoea due to indi- 
gestion. Abdominal cramps are also a symptom of locomotor ataxia 
and other spinal diseases. The cramp of swimming is often due to 
an over-straining of some one group of muscles not hitherto much 
used, the sudden fatigue causing cramp. They may be also of ner- 
vous origin. Rheumatism is not infrequently the sole cause of pain- 
ful muscular spasms. 

Causes. — Drinking cold water when very hot and perspiring, ex- 
posure to damp night air, debility, indigestible food, and excesses in 
eating and drinking, and particularly over-straining the muscles. 

Treatment. — Moderate the excessive labor and straining of the 
muscles which produce the cramps. When an attack occurs in the 
legs, tie a cord or handkerchief tight around the leg above the af- 
fected muscle. This will generally produce instant relief. Also 
briskly rub the parts with hot water, alcohol, ammonia, spirits of cam- 
phor, paregoric, or laudanum. 

When it occurs in the stomach, apply warm fomentations, or what 
is better, a mustard paste (165). Take hot Jamaica ginger or neuro- 
pathic drops. The bowels, if confined, should be opened with an in- 
jection. 

Cramps of the limbs which afflict women in the family way, can 
only be mitigated, not cured, till after confinement. As a palliative, 
high cranberry bark, scullcap, etc. (87), will be found useful. 

Pain of the Nerves. — Neuralgia, 

This disease affects one tissue only, — the nervous ; and has one 
symptom, — pain. 

In apoplexy, the nerves, rendered powerless and senseless by an ex- 
ternal force, are like a man under a bank of earth which has slid 
down upon him. In palsy, they are suddenly bereft of feeling and 
motion by a blasting scourge within, — as one is smitten down by a 
pervasive charge from a magnetic battery. In epilepsy, the nerves 
are grasped and for a time held senseless by an unseen power, in 
which they struggle, as a man strives in the folds of the anaconda. 
In catalepsy, they are suddenly stiffened into senseless strings, for 
such automatic use as the bystander may, for the time, choose to 
make of them. In chorea, they are set to dancing by an invisible ex- 
hilaration, as a man is suddenly crazed by brandy. 

In neuralgia, the nerves are neither crushed, nor collapsed, nor re- 
strained for a time, nor stiffened, nor exhilarated. They simply have 
their sense of feeling intensely exalted ; they are filled with pain. 
The pain is generally of a peculiarly darting, piercing character. The 
patient sometimes calls it tearing pain. It comes on in sudden par- 
oxysms, with intervals of freedom between. The attacks are some- 



190 



DISEASES OF THE BRAIN AND NERVES. 



times like an electric shock, and are so agonizing as to bring a tem- 
porary loss of reason. Occasionally there is great tenderness of the 
parts affected, and some fulness of the blood-vessels in the neighbor- 
hood ; but generally the signs of inflammation are all absent, except 
pain. 

Neuralgic pains occur in almost every part of the system. One of 
the most familiar forms of the disease is known under the name of 

Tic Douloureux. 

It occurs in those branches of the fifth pair of nerves which go to 
the face. (See Fig. 85.) Sometimes 
one, sometimes all of the three branches 
are affected, but more often the middle 
branch only. When the upper branch 
is the seat of the disease, the pain is in 
the forehead, the brow, the lid, and some- 
times the ball of the eye. The eye is 
generally closed during the pain, and 
the skin of the forehead is wrinkled. 
When the affection is in the middle 
nerve, the pain is preceded by a prick- 
ing sensation in the cheek, and twitch- 
ing of the lower eyelid. Soon it spreads 
in quick and piercing pangs over the 
cheek, reaching the lower eyelid, the 
sides of the nostrils, and the upper lip. 
If in the lower branch, it sends its light- 
ning shafts to the chin, the gums, the 
tongue and even up the cheek to the ear. 

Face-Ache. — There is a species of nervous pain called face-ache, 
which does not quite amount to tic douloureux, but is nevertheless 
very afflictive. It occurs principally in the jaw, which seems to be 
filled with pain. No one spot seems to be more affected than another. 
From the jaw the pain often goes to the whole head, but it has not 
the stabbing intensity which generally characterizes neuralgia. It 
often proceeds from defective teeth. 




Fig. 85. 



Hemicrania. 

This is a neuralgic pain, confined to one side of the head, — gen- 
erally the brow and forehead. Sickness of the stomach often attends 
it, and in many cases it is periodical, — coming on at a certain hour 
every day, and lasting a given time, and then passing away. . 

It may be caused by whatever debilitates the system, as hysterics, 
suckling an infant too long, or low diet. In fever and ague districts 
it is frequently produced by miasm. In many instances, the cause 
cannot be discovered. 



DISEASES OF THE BRAIN AND NERVES. 191 



Sciatica. 

This is a pain beginning at the hip, and following the course of 
the sciatic nerve. Occasionally it is an inflammatory complaint ; 
sometimes is connected with an affection of the kidney; but fre- 
quently it is a purely neuralgic or nervous pain ; and I have there- 
fore thought it best to place it here, with nervous diseases. 

Besides the various forms of neuralgia now noticed, the disease 
occurs, — sometimes with great severity, — in the female breast, in 
the womb, in the stomach, in the bowels, in the thighs, in the knee, 
and even in the feet. In many of these cases the disease is not where 
the pain is felt, but in the brain or spinal marrow, and consequently 
the true source of the complaint very often escapes detection. An 
excellent Episcopal clergyman in Northern New York, the Rev. M. 

B , with whom I studied Latin and Greek preparatory to college, 

had a neuralgic pain in the knee so intense, persistent and exhausting, 
that the limb had to be cut off at the thigh to save his life. 

Treatment. — This must be as diversified as the causes of the dis- 
ease. For a general IJ use 368. 

For tic douloureux, and some other forms, give internally, valerian- 
ate of ammonia (88); also 89, 90, 91, 92, 93, 316, and 84, as tonics. 

For external use in tic douloureux, and other neuralgic affections, 
the prescriptions 188, 196, 197, 198. 

For the face-ache, above mentioned, muriate of ammonia (134), in 
half dram doses, is a very valuable remedy. 

When the disease is caused by miasm, and has a periodic character, 
like ague, it must be treated with quinine (67), (79), and if there be 
a low state of the blood, iron (72), (93) must be given at the same 
time. The galvanic battery often acts like magic in neuralgia. 

The shower-bath, exercise in the open air, and whatever else will 
build up the general health, must be used according to circumstances. 

Neuralgic pain of various kinds often yields readily to some one of 
the many coal-tar products like phenanthrene, antikamnia and ammo- 
nol: say 10 grains of either every two to four hours according to the 
intensity of the pain. The last named product is quite harmless and 
produces no numbness or faintness which is said to follow at times 
the use of some of the others. 

Avoid rich or fatty foods. Live on a plain nourishing diet. Take 
exercise out of doors as much as possible. 

Derangement of Mind. — Insanity. 

Most writers on this disease have attempted a definition of it. I 
have never seen one which suited me. Here is mine. Insanity is a 
wrench of maris nature, which sets his intellectual and moral faculties 
awry in their relations with the external ivorld. 



192 DISEASES OF THE BRAIN AND NERVES. 

Iii a state of mental and moral health, he looks straight at the out- 
ward world, and sees it as it is ; insanity gives him an angular con- 
nection with it and he sees it as it is not; its objects have all changed 
their relative places ; objects at the right in the panorama of life have 
moved to the centre, or gone quite over to the left ; while things at 
the top have gone to the bottom, and those in the lowest places have 
taken the highest. With the thoroughly insane, the world has gone 
back to chaos. 

These persons have their sensibility very much altered and per- 
verted. Errors of the senses and illusions cheat them. In many 
cases, they cannot read because the letters are mingled in a confused 
mass. They often do not recognize their friends, and regard them 
as strangers or enemies. 

They become awkward in the mechanical use of their hands, and 
their touch loses the power to correct the errors of the other senses. 
Hence they are cheated in regard to the size, form, and thickness of 
bodies. 

They are haunted, at times, with smells which have no existence, 
and they hear voices distinctly speaking to them from clouds, or from 
trees ; and these voices have the familiar tones of a friend, relative, 
or enemy. 

The insane lose the power of comparing ideas. They associate 
things the most unlike, and often in a ridiculous way. 

They also lose the control of themselves, and come under the do- 
minion of their passions ; and then they will do acts which they them- 
selves disapprove. One of strict integrity, of unblemished morals, and 
of excellent standing, becomes insane, and immediately steals what he 
does not want, makes infamous proposals, and indecent gestures, and 
is in every respect the opposite of his past self. 

The insane often become averse to those who were previously 
among the most dear to them. For acts of kindness, they repay 
abuse. They fly from their best friends. This is the result of their 
fear and jealousy ; for they are very cowardly and jealous. This alien- 
ation from friends is almost a characteristic of insanity, and is one of 
its saddest features. The moral affections are always disordered, per- 
verted, or annihilated in insanity. So much is this a leading feature 
of the disease, that it is only when the insane begin to recover their 
moral affections, when they begin to wish to see their children and 
friends, to fold them once more in their arms, and to enter the family 
circle and renew its joys, that we can count upon any certain signs 
of a cure. 

The insane have a thousand strong fancies in regard to themselves. 
One thinks himself inspired of God, and charged with the conversion 
of the world ; while another, equally sincere, believes the devil has 
entered into him, and that the pains of hell are already taking hold 
of him, and he curses God, himself, and the universe. Still another 
is the " monarch of all he surveys," and much more ; he governs the 



DISEASES OF THE BRAIN AND NERVES. 193 

world, and directs the stars. One has all knowledge, and affects to 
teach the wisest. Another is proud, and withdraws from his fellows, 
bidding them not to come into his presence without proper acts of 
homage, — calling himself, it may be, a king. 

There are five kinds of insanity. I will speak of each of them 
briefly. 

Melancholy. — Lypemania. 

This is characterized by moroseness, fear, and prolonged sadness. 
The melancholic person is lean and slender, with black hair, and a 
pale and sallow countenance. His skin is brown or blackish, and 
dry and scaly. His physiognomy has a fixed appearance, the muscles 
of the face are drawn tight, the eyes are motionless, and directed to 
one point, the look is askance and suspicious, and the general expres- 
sion is one of sadness, fear, and terror. He desires to pass his days 
in solitude and idleness. He walks as if aiming to shun some dan- 
ger. His eye and ear are on the watch for evil. 

These persons do not sleep much. They are kept awake by fear, 
jealousy, and hallucinations. If their eyes close, they see phantoms 
which terrify them. 

Their secretions are disordered. The urine is either abundant and 
clear, or scanty and muddy. They sometimes retain their urine for 
days. One patient did not dare to make water lest he should drown 
the world, but was finally persuaded to it by the assurance that he 
would extinguish a fire which was devouring a city. 



Insanity on One Subject. — Monomania. 

This is a chronic affection of the brain, not attended by fever, and 
characterized by a derangement of the intellect, the affections, or the 
will, upon one subject only. The patient seizes upon a false princi- 
ple, and draws from it injurious conclusions, which modify and change 
his whole life and character. In other cases the intellect is sound, 
but the affections and disposition being perverted, their acts are 
strange and inconsistent. These they attempt to justify by plausible 
reasoning. 

Mania. 

This is also a chronic affection of the brain, generally without 
fever. The countenance of the maniac is sometimes flushed, at other 
times pale. The hair is crisped ; the eyes injected, shining and hag- 
gard. Maniacs dislike the light, and certain colors horrify them. 
Their ears are sometimes very red, and are disturbed by a tingling, 
and a rumbling sound. Noise excites and disturbs them. They suf- 
fer from false sensations, illusions and hallucinations; and their ideas 
come with great rapidity, and are confused and without order. Their 



194 DISEASES OF THE BRAIN AND NERVES. 

affections are in a state of turmoil, and their judgments are all erro- 
neous. 

Unlike the monomaniac, their delirium extends to all subjects. 
Their entire intellect, affections and will, are a chaotic wreck. 

Dementia. 

Here is another chronic affection of the brain, without fever, in 
which the sensibility, the intellect, and the will, are all weakened. 
Demented persons have not the power to concentrate their minds on 
anything, and can form no correct notions of objects. Their ideas 
float after each other without connection or meaning. They speak 
without any consciousness of what they are saying. 

Many of them have lost their memory, or, like old persons, they 
remember nothing recent, — forgetting in a moment what is just said 
or done. 

The demented have neither desires nor aversions ; neither hatred 
nor love. To those once most dear to them, they are totally indif- 
ferent. They meet friends long absent without emotion, and part 
from their dearest ones without a pang. The events of life passing 
around them awaken in them no interest, because they can connect 
themselves neither with the past nor the future; they have no remem- 
brances nor hopes. Their brain is inactive ; it furnishes no ideas or 
sensations. They are no longer active, but passive beings ; they de- 
termine nothing, but yield themselves to the will of others. 

They have a pale face, a dull eye, moistened with tears, an uncer- 
tain look, and a physiognomy without expression. They sleep pro- 
foundly, and for a long time, and have a voracious appetite. 

Idiocy. 

Idiocy is in the condition in which the intellectual faculties have 
never been manifested. We are not to infer disease from it, any more 
than we infer it in the lower animals from the absence of intellect. 

In idiocy there is no mind, because the brain is not large enough 
to be the organ of intelligence. It always dates back, therefore, to 
the beginning of life. Everything about the idiot betrays a defective 
organization. The demented person, the monomaniac, etc., once had 
intelligence ; the idiot, never. They, in many cases, may be cured ; 
he is hopelessly incurable. They had blessings which have been taken 
from them ; to him, none were ever given. They were once the pride 
and hope of their friends ; he, from his birth, was the smitten and 
blasted one of his family. He never reaches an advanced age, — 
rarely living beyond thirty years. 

These remarks are sufficient to show the difference between idiocy 
and other forms of mental derangement. In the other forms of in- 
sanity there are brains enough, but they are diseased ; in this there is 
no disease ; the smallness of the brain is the primal and fatal defect. 



DISEASES OF THE BRAIN AND NERVES. 195 

This form of mental derangement is caused by a defective develop- 
ment of the brain. That the other forms are produced by disease of 
the brain, there can be no doubt. 

Some have supposed insanity to be a mental disorder merely, hav- 
ing nothing to do with the body. They might as well suppose the 
delirium of fever to be a disease of the mind only. 

Insanity is an unsoundness of the brain and nerves which proceed 
from it, in every instance. At first it is probably only excitement of 
the brain ; but this, long continued, becomes a chronic inflammation. 
The brain and nerves of an insane person are undoubtedly sore, and 
hence the painful thoughts and feelings which afflict them. When 
the soreness is much increased, they are violent and furious ; when 
it subsides, they are calm. In consequence of this inflammation and 
soreness of the brain, an insane person can no more think, or reason, 
or will, or feel correctly, than a person with an inflamed stomach can 
digest food well, or than one with inflamed eyes can see well. 

Causes of Insanity. — Hereditary predisposition ; painful subjects 
of thought or feeling long revolved in the mind ; injured feelings 
which cannot be resented, mortified pride, perplexity in business ; 
disappointed affection or ambition ; great political, religious, or social 
excitements ; sudden and heavy strokes of misfortune in the loss of 
property and friends ; and in general, whatever worries the mind for 
a long time, and creates a deep distress, may be a cause of insanity. 

But one of the most prolific causes, and worthy of special mention, 
is masturbation, or self-pollution, — a vice contracted by thousands of 
young people, both male and female. 

Besides the above, I may mention several physical causes, as con- 
vulsions of the mother during gestation, epilepsy, monthly disorders 
of women, blows upon the head, fevers, loss of sleep, syphilis, exces- 
sive use of mercury, worms in the bowels, and apoplexy. 

Chances of Cure. — Idiotism is never cured. 

Melancholy and monomania are cured when recent, and do not de- 
pend upon organic disease. 

Dementia is sometimes, though seldom, cured. 

Chronic insanity, of long standing, is not easily cured. 

Insanity which has been produced by moral causes, acting suddenly, 
is generally curable ; if the causes have acted slowly and long, the 
cure is more doubtful. 

Excessive study causes insanity which is hard to cure. 

If caused or continued by religious ideas, or by pride, it is not 
often cured. „ 

Insanity caused and maintained by masturbation is cured with 
great difficulty. 

Treatment. — The treatment of the insane is now almost confined, 
as it should be, to public hospitals. In these institutions, all the 
means are provided which humanity has been able to devise, to lift 



196 DISEASES OF THE BRAIN AND NERVES'. 

from these unfortunate beings the terrible shadow which is upon 
them. Here they have safety, comfort, recreation, friendly guardians, 
rest, and medicine. 

They have safety from the annoyances which well-meaning but 
mistaken friends at home almost always commit in contradicting, and 
reasoning with, persuading, and threatening them ; for only in these 
humane institutions has it been well learned that to do so is no wiser 
than to persuade, scold, or threaten a neuralgic pain in the face, an 
inflammation in the stomach, or a felon upon the finger. They are 
safe, too, from the impertinent scrutiny of neighbors, the hootings of 
unthinking boys in the streets, and especially from the causes, what- 
ever they are, which have produced the disease. And so far, this is 
just the treatment they want, — no contradiction, no impertinent 
scrutiny from neighbors, no abuse in the streets, and a withdrawal of 
the causes which have produced the disease. 

In these institutions, too, they have comforts. They have clean 
rooms, galleries, lodges, bathing-rooms, yards and gardens for exer- 
cise and walking, safe, quiet, well-aired bed-rooms, and clean and 
comfortable beds ; cheerful dining rooms, and plain, wholesome, and 
nutritious food. And this, likewise, is the treatment they require. 

They have recreation, — dances, cards, back-gammon, chequers, 
chess, billiards, nine-pins, walking parties, riding parties, gardening, 
and an indulgence in those arts of painting, music, drawing and 
architecture for which they may have a taste. And such recreations 
are powerful instruments in the cure of all disorders of the nervous 
system. 

Here, too, they have friendly guardians, who have long studied 
their complaints, and have imbued their souls with a sympathy which 
goes down into the depths of their sufferings, and allies itself with all 
their sorrows ; — men and women who are willing to act the part of 
guardian angels ; to be their friends ; who know how to gain their 
confidence ; and who use the influence acquired by love, in leading 
them back towards health and happiness. And this, too, in curing 
the insane, is of great consequence, for none can do them good till 
they have their confidence, and this can be gained only by love and 
wisdom. 

In these insane asylums, they find rest. When the brain is hot 
from inflammation, and they are raving from delirium, they are here 
withdrawn from the noisy crowd, and shielded from the rude shocks 
of the world. If need be, they are placed in solitary rooms, where 
silence spreads its soothing stillness through their excited brains. 
And it is of the greatest importance that the sore and torn feelings 
should rest ; for rest allays excitement, and brings sleep ; and with- 
out a proper amount of sleep recovery is not possible. 

Finally, in these institutions, they receive the best medical treat- 
ment. They have warm and cold bathing, judiciously administered ; 
they have simple cathartics when the bowels are bound, as salts, cas- 



DISEASES OF THE BRAIN AND NERVES. 197 

tor oil, and magnesia ; tonics for debility, such as quinine, iron, cas- 
sia, columbo, chamomile ; and quieting medicines for their excite- 
ment, such as opium, morphine, cicuta, hyoscyamus, belladonna, stra- 
monium, scullcap, and valerian. Prescription 74 is a combination 
much used. Here, too, broth, gruel, and milk, are administered by 
the forcing pump to such as take a fancy not to eat, — an expedient 
which has saved many lives. Fruits of all kinds, as strawberries, 
cherries, currants, plums, apples, peaches, and grapes, are allowed 
freely. Cold water, sweetened or otherwise, is the drink. To these 
things are added lively conversation, and whatever will divert the 
mind from reflection, and internal imaginings and revery. 

Thus I have indicated, very briefly, the treatment which the insane 
receive in public institutions. That the chances of recovery in these 
humane retreats is much greater than at home, does not admit of a 
doubt. When it is not convenient to send an insane person to a hos- 
pital, the treatment should be as near like the one here sketched as 
circumstances will permit. 

« 

Hypochondria. 

The common names of this disease are low spirits, spleen, vapors, 
aypo, and the blues. It produces constant fear, anxiety, and gloom. 
Business, pleasures, the acquisition of knowledge, and all the useful 
pursuits of life, become insipid, tasteless, and even irksome to the hy- 
pochondriac. His mind is full of the belief that something dreadful 
is about to befall him. He is either going to be sick, or to die, or 
lose his property or friends. He has no mind to engage in any busi- 
ness, nor does he wish to go anywhere, or to see anybody. Night 
and day his spirits are down to zero, and his heart has a load too 
heavy to bear. He is wholly occupied with his troubles and his feel- 
ings. He thinks he has various diseases, and wears out his friends 
by talking of his sufferings. He feels of his pulse often, looks at his 
tongue in the glass, and several times a day asks a friend if he does 
not look pale or sick. 

The external senses manifest symptoms of derangement as well as 
the thoughts, feelings, emotions, and passions. There are roarings in 
the ears, like a waterfall, or the noise of a distant carriage. Floating 
black specks, or bright sparks, are seen before the eyes. These indi- 
cate a slight fulness of the blood vessels, and perhaps, in some in- 
stances, sparks of electricity passing to or from the eye, and are in no 
proper sense subjects for the alarm they cause. At one time the per- 
son will feel as large as a barrel, at other times not larger than a 
whip-stock; the head will feel light or heavy, large or small. The 
skin will twitch in different parts, or feel numb, or have the sensation 
of spiders crawling on it. The smell and taste become perverted ; 
the hypochondriac will smell odors and flavors, at times, where there 
are none. 



198 DISEASES OF THE BRAIN AND NERVES. 

These errors of the senses are all owing to some slight disorder of 
the organs of sense ; and they are no more wonderful than that the 
mind should perceive personal danger, poverty, and death itself, when 
none of these things are impending. 

These persons are subject to fainting turns, when the breathing 
will appear to stop, the body become cold, the face pale ; there will 
be distress in the region of the heart, which will apparently stop beat- 
ing, and the person will feel as if dying. At the same time the mind 
will remain clear. These nervous spells are alarming, but pass off 
without danger. 

These persons become changed in their moral dispositions. They 
are jealous, take a joke as an affront, and feel the greatest distress at 
any apparent lack of attention or neglect on the part of friends. 
They put the worst construction upon the actions of friends. They 
are irritable, fretful, peevish, and fickle. 

The complaint is distressing, but does not appear to shorten human 
life. 

The seat of the disease is in the brain and nerves. It is caused by 
anxiety, care, disappointment, working the brain too hard, diseases of 
the liver and stomach, costiveness, sedentary habits, excessive vene- 
real indulgence, and masturbation. 

Treatment. — This disease is more easily prevented than cured. It 
would be almost entirely prevented in this country if in childhood we 
were all taught to be contented with humble competence, to love ac- 
tive labor, and to think it honorable, instead of struggling after 
wealth, and falling into unhappiness when it does not come. 

Remedies. — Of all the remedies for this complaint, that which is 
most important is active employment out of doors. The human body 
was made for motion. Without it the blood cannot be distributed to 
the several organs. The senses, — the eye, the ear, the touch, — 
should be much in communion with nature. In this way they are 
strengthened. Nature is their great physician. Man is a creature of 
sensation; and if too much occupied with feelings, thoughts, and deep 
reflections, the nerves will be irritated, and begin to give deceptive 
sensations. A very nervous man should fly to some active occupa- 
tion, if he would be rid of suffering. 

The open, fresh air is very important to restore the system to 
soundness. 

Temperance, both in eating and drinking, will do much for this 
class of patients, yet they are the very persons who eat largely, and 
they often fly to the excessive use of stimulants to drive away their 
sorrow. By so doing, they aggravate the disease. 

Amusements are very important for hypochondriacs. Lively com- 
pany, cheerful and witty conversation, with mirth and laughter, lively 
songs and instrumental music, are all desirable ; and so are gunning, 
fishing, riding, billiard-playing, and travelling. 



DISEASES OF THE BRAIN AND NERVES. 199 

Never allow these patients to be alone, and to have time to brood 
over their misery. See that they go early to bed, and rise betimes in 
the morning. The warm bath, the cold shower, or sponge bath, with 
brisk friction, are not on any account to be omitted. The diet should 
be light, nutritious, and generous ; but fats, acids, liquors, and coffee, 
must be forbidden. 

But little medicine will be required. If there be costiveness, let 
cracked wheat be eaten; if this does not answer, a little rhubarb 
and bicarbonate of potassa (85), or leptandrin, podophyllin, etc. (36), 
may be given as required by the symptoms. A teaspoonful of cal- 
cined magnesia once a day, or the infusion of thorough wort, drank 
cold, will often answer an excellent purpose. A bowl of warm 
motherwort tea, with a teaspoonful of spirits of camphor in it will do 
well in fits of fainting when there is a sensation of dying. A tea- 
spoonful of sulphuric ether may be given at the same time. If there 
be debility, tonics are sometimes useful (50), (49), (54), ^5^). 

Hiccough. — Singultus. 

This is a sudden, jerking spasm of the midriff, occurring every few 
moments in bad cases, causing the air to be driven out of the lungs 
with such suddenness as to produce a noise something like the invol- 
untary yelp of a puppy. It is generally caused by acidity of the 
stomach, which irritates the nerves distributed to its neighborhood, 
and is not difficult to remove ; but when it occurs towards the close 
of some acute and grave disease, it is sometimes a sign that dissolu- 
tion is at hand. 

Treatment. — Startle the person suffering, by exciting surprise, or 
fear, or anger ; or let a few small draughts of cold water be taken in 
quick succession ; or, let the breath be held as long as possible. If 
the stomach is sour, take a teaspoonful of bicarbonate of soda, dis- 
solved in half a tumblerful of cold water. To expel wind from the 
stomach, if it be present, take some warm aromatic essence of pep- 
permint, ether, or compound spirits of lavender. But one of the 
most effectual remedies is heavy pressure made upon the collar bones. 
It is simple, and very effectual. Cocaine, one-eighth grain every fif- 
teen minutes, is a very simple and often efficacious remedy. 

Fainting. — Syncope. 

Fainting is preceded by a distress about the heart, a swimming 
of the- head, sometimes sickness at the stomach, coldness of the hands 
and feet, and a loss of sight, or a sense of things growing dark. The 
breathing diminishes, the pulse becomes small, the face deadly pale, 
and the patient wilts down, and becomes more or less unconscious of 
what is passing around. 

Whatever causes debility, particularly of the nervous system, will 



200 DISEASES OF THE BRAIN AND NERVES. 

predispose to fainting. Persons much weakened by disease, faint 
easily, especially when they attempt to stand still. When on their 
feet, such persons should keep moving. Fainting is sometimes in- 
duced by sudden surprises and emotions, by violent pains, by the 
sight of human blood, and by irritation of the coats of the stomach 
by indigestible food. 

Treatment. — Lay the patient upon the back,with the head low; let 
fresh air into the room instantly, and apply gentle friction. Sprinkle 
a little cold water upon the face, and hold spirits of camphor, ether, 
hartshorn, or vinegar to the nose, — rubbing a little of the spirits of 
camphor upon the forehead, and about the nostrils. As soon as the 
patient can swallow, give a teaspoonful of compound spirits of lav- 
ender, with ten drops of water of ammonia in it. 

Persons subject to fainting should not go into crowded assemblies 
where the air is bad ; neither should they wear tight dresses, or allow 
themselves to get excited. Cold bathing, a well-regulated diet, and 
vegetable tonics, will do much to break up the habit. 

Dizziness of the Head. — Vertigo. 

This affection makes objects which are stationary appear as if 
moving, or as the phrase is, " turning round." When seized with it, 
one will have a sensation as if falling, and objects about him will 
seem to be in motion. 

It is caused by irritation of the nerves of the stomach in dyspep- 
sia, by long application of the mind, by a weakened nervous system, 
by hysterics, and by a fulness of the blood-vessels of the head. 
When it proceeds from most of these causes, it is not dangerous ; but 
when caused by impending apoplexy, it is a symptom of very serious 
import. 

Treatment. — Find out the cause and remove that, and the dizzio 
ness will disappear. If it come from dyspepsia, eat lightly ; if from 
costiveness, open the bowels either by coarse food, by daily cold 
water injections, or by some gentle physic. Avoid coffee, ardent 
spirits and late suppers, and take much exercise. Keep the feet 
warm, and the head cool. See to the liver and heart. / 

Disturbed Sleep. — Nightmare. — Incubus. 

In this complaint the sleep is disturbed generally by some fright- 
ful image. Whatever of an alarming character is presented to the 
mind in sleep, causes fear, or some other painful emotion, the same 
as when awake. And when the attempt is made to resist, or to flee 
from the danger, it is ineffectual, because the muscles are locked fast 
in sleep. The fear being increased by the inability to escape, the 
sleeper makes all sorts of horrible noises, indicating distress of mind. 
The danger seen is as real to the sleeper as if he were awake, and he 



DISEASES OF THE BRAIN AND NERVES. 201 

tries to do just what he would if awake. Sometimes the sensation is 
that some heavy weight, or perhaps some horrible monster, is upon 
the breast, nearly pressing the breath out of the body. 

At times, the power of motion 'is not absent, and then disturbed 
dreams may cause one to talk, or to rise and walk, or run. Children 
will laugh or cry, or scream, which shows that their minds are agi- 
tated by different passions. Persons who indulge gloomy and troub- 
lous thoughts in their waking hours are apt to be disturbed with 
sleep-walking, sleep-talking, and frightful dreams, as of falling down 
precipices, during the hours for repose. 

There is nothing very wonderful about these disturbances of sleep. 
It is only necessary that there should be an unusual sensitiveness of 
the brain, or that a hearty supper, eaten late, should irritate the 
nerves of the stomach, and that distressing thoughts should be dwelt 
upon during the day and evening, in order to produce all the walk- 
ing, talking, dreaming of hobgoblins, shipwrecks, fires and polar 
bears, which distress so many unfortunate sleepers. 

In night- walking there is simply a little more wakefulness than in 
night-talking, and in this latter, more than when one falls from a high 
place, and in this perhaps slightly more than in real incubus, when 
one is in the greatest peril, but cannot move at all. 

Treatment. — When sleeping persons groan, or make any noise 
indicating nightmare, shake them, and they will come out of it at 
once. As these troubles are often caused by a weakened state of 
the nerves, much out-door exercise should be taken. The diet should 
be simple, and well regulated. The suppers should be light, and 
never taken late. The evening should be spent in some pleasant 
amusement, which will drive away care ; and the last hours of wake- 
fulness be occupied with pleasant reflections. One afflicted with 
nightmare should not lie upon the back, nor with the hands over the 
head. Acidity of the stomach, and costiveness, if they exist, should 
be removed by neutralizing mixture. 

Headaches. 

These are not always caused by disorders of the brain and nerves, 
but they frequently are, and this seems the proper place to speak of 
them. 

It is unwise ever to neglect headaches. They are sources of great 
suffering, and often lead to serious derangements of the health. In 
childhood they have a more serious meaning than in adult life. 
They often indicate the approach of scarlet fever, or measles, or of 
other diseases. 

Headaches are more common among the civilized than the uncivil- 
ized ; more frequent among females than among males ; among those 
of sensitive feeling than among the more obtuse ; among those who 
think much than among those who think little ; among the sedentary 
than among the active. 



202 DISEASES OF THE BRAIN AND NERVES. 

Causes of Headaches. — They are dependent on various causes, 
as derangement of the circulating system, of the digestive organs, of 
the nervous system, etc. Among those dependent on disturbance of 
the circulation, are 

Headaches from Eye Diseases. — Myopia, or near-sightedness ; 
Hypermetropia, or far-sightedness ; Astigmatism, or the inability to 
see equally well horizontal and vertical lines, as well as other irreg- 
ularities of vision, are frequent sources of headache. These head- 
aches are caused by overtaxing certain groups of muscles, or by fixing 
the eyes too long on one objective point, as experienced in prolonged 
study or reading, especially under unfavorable circumstances. These 
headaches are more or less similar in their symptomatology. The 
ache is generally dull, situated mostly in forehead and over eyes, but 
may also be spread from base of brain to the eyes ; oftentimes it is 
accompanied by nausea, especially after prolonged use of eyes under 
improper conditions. 

The treatment of these headaches consists in absolute rest of the 
eye, in case of overwork, and the fitting, by a competent oculist, of 
such glasses as will rectify the irregularity in the eye proper. 

Astigmatism is a common source of headaches, and often is so in- 
sidious in its development as to escape attention. A rough test 
may be made by drawing several horizontal and several vertical 
lines in close proximity, and then placing at some distance (15 to 20 
feet) from the eye. If either set cannot be as clearly seen without 
blurring as the other, you have good cause to suspect Astigmatism, 
and should consult an oculist. Do not dally with these eye-head- 
aches, as you will be doing a permanent injury to your eyes. 

Tea and Coffee Headaches. — In the nervous, and oftentimes in 
the gouty and rheumatic person, the use of tea or coffee will cause 
violent headaches. Tobacco likewise after prolonged use shows a 
tendency to headaches. These luxuries of life should be discontin- 
ued at once for at least one month. An extra strong cup of black 
coffee, to be sure, will stop the headache for the time being, but only 
adds fuel to the fire in the long run. Bromo-caffeine, as ordinarily 
sold by the druggists, taken in teaspoonful doses every half hour, 
will relieve the malady. We would strongly advise any one that has 
constant or periodical headaches, if he uses either tea or coffee, and 
especially coffee, to leave them off entirely for three months. It may 
be the sole cause, and if caused by tea or coffee, there is no possi- 
bility of their cure by medicines while you continue their use. 

Plethoric Headaches These are dependent on a general fulness 

of blood. They are of two kinds. One is occasional, and lasts but 
a few hours. The other lasts for days or weeks. It occurs most 
often in the night or morning. Persons whose occupations require 
stooping have it most. A little dizziness is generally felt on rising 
up from a stooping posture. It is brought on by the bad air of 



DISEASES OF THE BRAIN AND NERVES. 203 

crowded rooms, and is attended by costive bowels, short breath, and 
a white furred tongue. 

The persistent headache is accompanied by a sense of fulness, and 
sometimes of throbbing over the brows and temples, with a sensation 
of dizziness, and of mist before the eyes. The sufferer fears exertion 
and is constantly looking for a rush of blood to the head. Nature 
sometimes relieves this form of headache by a diarrhoea, or by bleed- 
ing from the nose. 

There is another form of plethoric headache, differing slightly from 
the above, in which there is too much blood, and it is made too fast, 
but it does not circulate so rapidly. The muscles are not very firm, 
and the heart does not propel the blood with much force. This form 
of headache is connected with congestion. 

Headaches of Indigestion. — These are caused either by taking 
improper articles of food, or by eating too much of those which are 
proper. The sensation in the head is not always a pain, but some- 
times only a dull weight, attended by languor and disinclination for 
exertion ; a tongue white in the centre, and pale red at the tip and 
edges ; cold and numb fingers ; slight nausea ; languid and feeble 
pulse ; dim and indistinct sight ; eyes aching when employed ; and 
difficulty in fixing the attention. 

Sick Headache. — This has received its name from the constant 
nausea or sickness at the stomach which attends the pain in the 
head. 

This headache is apt to begin in the morning, on waking from a 
deep sleep, or after sleeping in a close room, and when some irregu- 
larity of diet has been committed on the day before, or for several 
previous days. At first there is a distressingly oppressive feeling in 
the head, which gradually merges into a severe, heavy pain in the 
temples, frequently attended by a sense of fulness and tenderness in 
one eye, and extending across the forehead. There is a clammy, un- 
pleasant taste in the mouth, an offensive breath, and the tongue cov- 
ered with a yellowish-white fur. The sufferer desires to be alone, 
and in the dark. The hands and feet are cold and moist, and the 
pulse feeble. 

Accompanying these symptoms, there is a depressing sickness at 
the stomach, which is increased by sitting up, or moving about. 
After a time, vomiting comes, and relief is obtained. 

Bilious Headache. — This is most common in summer and au- 
tumn. It afflicts persons of dark complexion with black hair and 
melancholy dispositions. There are two kinds, one is due to an ac- 
cumulation of bile in the system ; the other, to a large secretion of 
bile. 

In the first variety the skin is dingy and sallow, the spirits de- 
pressed, the bowels costive, and there is wind in the stomach, with a 
dull, aching pain on the right shoulder. The pain is in the forehead, 



204 DISEASES OF THE BRAIN AND NERVES. 

eyebrows and eyelids, and the " white of the eye " is a little yellow- 
ish. The tongue has a brown fur, and is cracked in the centre. 
There is a bitter taste in the mouth on waking in the morning, after 
restless nights, and frightful dreams. 

In the second variety, which is due to an " overflow of bile," the 
symptoms are much like those of the first kind, but the pain is not so 
continuous. In addition to the symptoms named, there is a throb- 
bing, rending pain in the head, the skin is hot and the face flushed, 
the limbs are sore, and there is a luminous halo or ring around ob- 
jects looked at, and a feeling of giddiness. 

Nervous Headaches. — These are more common among females 
than males. They occur most frequently among persons of high sus- 
ceptibility, who are easily elevated, and as easily depressed. They 
are often connected with indigestion. 

The pain is usually acute and darting, and is made worse by light, 
with a feeling as if the temples were, being " pressed together," and 
a " swimminess " in the head. There is sometimes a sense of sink- 
ing, with a dread of falling, and great despondency and restlessness. 
The bowels are generally costive, and the sight dim. The pain comes 
on most commonly in the morning, lasts through the day, and abates 
in the evening. 

Hysteric Headache. — There is a nervous headache dependent on 
the hysterical condition. It is generally confined to one small spot, 
frequently over the eyebrow, and is sometimes compared to a wedge 
or nail driven into the skull. 

Headache from Exhaustion. — Still another species of nervous 
headache arises from extreme exhaustion, produced by great loss of 
blood, by diarrhoea, or by over-suckling. The pain is generally on 
the top of the skull, and is often compared to the beating of a small 
hammer on the head. 

Brow Ague. — This is intermittent in its character, and is brought 
on by exposure to cold and moisture in damp and marshy districts ; 
and in this respect is much like ague. 

Megrims. — This is most frequent among females. It is often de- 
pendent on the same causes as Brow Ague, and is also produced by 
long and exhausting watching over sick children, distress of mind, 
and indigestion. 

In both the above forms, the pain is intermittent, seldom lasting 
long, but being of a sharp, piercing character like that of tic doulou- 
reux. Tin pain of Megrims usually begins at the inner angle of the 
eye, and extends towards the nose ; the parts being red and sore, and 
the eye-ball tender. In Brow Ague, pain and great tenderness cover 
an entire half of the head, compared by the patient, sometimes, to 
" an opening and shutting of the skull." It begins with a creeping 
sensation over the scalp. 



DISEASES OF THE BRAIN AND NERVES. 205 

Rheumatic Headaches. — These generally affect persons who have 
been subject to rheumatism, and are often brought on by uncovering 
the head when sweating. The pain is usually in the brow, the tem- 
ples, or the back of the head, and is dull and aching, — rather an in- 
tense soreness than a real pain ; and the painful part is excessively 
tender upon pressure. The skin is moist, but not hotter than natural. 

Treatment. — In considering the treatment, I will take up the same 
order in which I have spoken of the different forms of headache. 

Plethoric Headaches. — Not much medicine should be taken for 
these, if it can be avoided. A diuretic (131) may be taken twice a 
day, and an occasional dose of gentle physic at night, followed by (7) 
in the morning. This will generally give great relief. 

Meat should be taken but once a day, and the whole diet should 
be spare, the appetite never being fully satisfied. All spirituous drinks, 
including distilled and fermented, should be let alone, and coffee like- 
wise. 

Much exercise should be taken in the open air. The hair should 
be kept short, and the head elevated during sleep. Bleeding at the 
nose, when it occurs, must not be too suddenly stopped. Two drops 
of the tincture of aconite root with three of the fluid extract of gel- 
semium repeated once a half hour for three or four times will be 
found to be of great value in the treatment of this form of headache. 

The hot-water bottle applied to that part of the spine between the 
head and shoulder blades will also give great relief. 

Congestive Headaches. — The exercise, diet, mode of sleeping, 
etc., should be the same as in plethoric headaches. In this complaint, 
there is too much blood in the head, and it inclines to stagnate. The 
feet and hands are cold ; and gloves and stockings of wool, and other 
bad conductors of heat from the body, must be worn. 

Occasionally a little gentle physic (319) is desirable to induce the 
bowels to act every day. If there is great debility, iron (71), (74), 
(75), (320), will be required. The ice bag applied to the last six or 
eight inches of the spine will call the blood to the extremities. The 
aconite and gelsemium recipe as given above is also very useful. 

Headache of Indigestion. — If the pain come immediately after a 
meal, and can be traced to something eaten, an emetic (2) may be 
taken, if the person be tolerably strong. If the pain come on some 
hours after eating, take rhubarb and magnesia (28), (14), or fluid 
magnesia. When the system is debilitated, take a warm draught 
(322) in the morning after a light breakfast, or twice a day, a bitter 
with an alkali (323). If the stomach be very irritable, bismuth, at 
meal times (324), (326). When it occurs after a debauch, take re- 
cipe (325). 

Sick Headache. — When it results from food taken, a draught of 
warm chamomile tea, or a little weak bran dy-and- water, will generally 



206 DISEASES OF THE BRAIN AND NERVES. 

give relief. If the sickness continue, soda and water, with a little 
ginger may do well, or a mustard poultice upon the stomach (165) 
may be required. As soon as it can be kept on the stomach, a dose 
of physic (326) must be taken ; and if relief does not come after the 
operation of this, give a bitter and an aromatic (327). The patient 
must have perfect rest. If there be great lack of tone in the system, 
the mineral acids (328), (329) will be excellent. 

The diet must be carefully regulated, as in plethoric and conges- 
tive headaches. Cocaine, one-eighth grain every fifteen minutes till 
the nausea stops, and then a dose of physic is an excellent method of 
treatment. Ten grains of amenonol (ammonol) every hour will 
stop the pain, and very often the same amount of phenacetine will 
accomplish the same result. 

Bilious Headaches. — These are generally connected, more or less, 
with some affection of the liver. 

During an attack, if the suffering be great, attended by nausea, 
give an emetic (2). In milder cases, give recipe (321). If there be 
costiveness, give recipe (330) at night, and (7) in the morning. 

A few doses of podophyllin, leptandrin, etc. (34), (36), (39), to re- 
lieve the liver when the bile does not flow fast enough, will diminish 
the frequency and force of the attack. The fluid extract of dande- 
lion, taken for some time, often does good service. 

The diet should be light, and chiefly vegetable, and exercise in the 
open air must not be omitted. The daily sponge-bath, with friction, 
is excellent, 

Nervous Headaches. — The first thing to be done is to relieve the 
pain, and this may generally be accomplished either by preparation 
(331), or (332), or (333), or (88), or (93), or two or three drops of 
tincture of nux vomica in a spoonful of water, taken three times a 
day. 351 will be found usually to be of most service. 

In simple nervous headache, diet is of the greatest importance ; in 
hysterical cases, exercise ; in headaches from exhaustion, tonics (81), 
(79), (63), (73), (64), (61), (60). 

Of the simple remedies found on the druggists' counter bromide 
of caffein in effervescent form is very efficacious. 

Rheumatic Headaches. — Take a light diet, with but little animal 
food. Wear warm clothing, and avoid exposure to wet feet and damp- 
ness generally, and go to a mild climate, if convenient. 

When the local pain is great, apply hot fomentations, or a stimula- 
ting liniment (334), or a mustard poultice, to the back of the neck. 
In the beginning of the treatment, a little physic at night (335) is 
useful. 10 grs. potassium iodide, gradually increased, in water, is 
the best medicine. 

Before closing this chapter on headaches, let me enter a respectful 
protest against the indiscriminate use of the thousand and one reme- 
dies advertised to cure headaches ; for in a great majority of cases it 



DISEASES OF THE BRAIN AND NERVES. 207 

is merely a symptom of some other disease ; for instance : Indigestion, 
Fever, B right's Disease, Softening of the Brain, Diseased Liver, etc. ; 
and the use of these remedies serves rather to increase than lessen 
the difficulty. Much has been written and much printed matter been 
given away by patent medicine venders vaunting their specific 
cures for headaches. These venders have grown in numbers of late, 
since the introduction into medicine of the coal-tar products, so that 
samples of headache cures may be found on one's doorsteps every 
little while. For the most part they are composed of what is known 
as acetanilide or antifebrin, because of its cheapness as compared 
with other coal-tar products. It is, however, the most harmful of 
them all, often causing blueness of the lips, fluttering of the heart 
dizziness, faintness, etc. Of other similar products not so much dan- 
ger may be expected, and yet no one ought to resort to these remedies 
without the consent and approval of the family physician. 8 grains 
of phenacetine for an adult, repeated in two to four hours, no doubt 
will cure more headaches of all descriptions than any other single 
drug. Lactophenin and ammonol are some of the newer remedies for 
headache which have the reputation of being efficient as coal-tar pro- 
ducts without any of their ill effects. Antikamnia, a proprietary medi- 
cine of the coal-tar group, enjoys a large sale, not only for headaches 
but for general neuralgic pain, and if employed in six-grain doses 
every two to four hours, according to the severity of the pain, will 
stop a large proportion of these aches. The various combinations of 
the bromides are always safe and often quite efficient in curing head- 
aches, especially if nerve-element is strong in their causation; bromo- 
cafTein, bromo-seltzer, bromo-soda, etc., are generally put up in 
small bottles in an effervescent and palatable form. 



DISEASES OF THE THROAT. 



The diseases which seat themselves in the throat, and in the great 
cavity of the chest, have occupied a large share of my attention for 
the last ten years. My practice in these complaints has been large, 
— being drawn from every part of the United States, and the British 
Provinces. No class of diseases from which men suffer are more nu- 
merous than these, and none have so generally baffled the skill of the 
profession. For this reason, I wish to present here a brief, practical, 
and common-sense view of these complaints, which shall be of real 
value to the thousands of families who consult these pages. 

Increase of Throat Diseases. — A striking increase in the number 
of throat diseases has been witnessed within the last few years. A 
person suffering from any of them will find, on speaking of his com- 
plaint, that a number of his neighbors are afflicted with troubles of a 
similar kind. I have thought that in some of their forms these dis- 
eases have fastened upon the throats of not less than half our popu- 
lation. And when it is considered that they are the natural, and if 
unmolested, the certain harbingers of lung disease, it is wise to make 
a note of the above fact. As I shall describe them in the nasal cavi- 
ties, the pharynx, the fauces, etc., they all have a natural proclivity 
downwards. From these upper cavities they pass, by one short step, 
into the larynx, — the cavity where the voice is formed, — and then, 
by another equally short and easy stage, into the body of the wind- 
pipe. It is a singular fact that their progress is always from the 
upper breathing passages downward, and never from the lower pas- 
sages upward. They afford a parallel to the order of progression in 
the moral world, in which evil tendencies are toward a lower depth. 

A Mistake Corrected. — Before describing the several diseases 
which belong to this family, I wish to correct the mistake which so 
generally classes them all under the term Bronchitis. 

They all consist in a simple inflammation, acute or chronic, either 
of the mucous membrane lining the several cavities to be spoken of, 
or of the small glands or follicles connected with that membrane ; 
and each disease takes its name from its particular location. Thus, 
the inflammation of the membrane lining the upper part of the throat, 
or pharynx, is called Pharyngitis. Inflammation in the top of the 

208 



DISEASES OF THE THROAT. 



209 



windpipe, or larynx, is Laryngitis. In the windpipe, or trachea, it is 
Trachitis. In the bronchial tubes, it is Bronchitis. As the bronchial 
tubes exist nowhere except in the lungs, below the division of the 
windpipe, there can be no Bronchitis in the throat. Nevertheless, it 
is the same disease with Laryngitis and Pharyngitis, and differs from 
them only in being in a more dangerous place. 

As the windpipe descends into the chest, it divides below the top 
of the breast-bone into two branches, one going into the right, the 
other into the left lung. These branches divide and subdivide very 
minutely, and send their ramifications into every part of the pulmon- 
ary tissue. Thus situated, Meckel has compared the windpipe to a 




Fig. 86. 

hollow tree with the top turned downward, — the larynx and trachea 
representing the trunk, and the bronchial tubes, with their innumera- 
ble subdivisions, the branches and twigs. (Fig. 86.) 

If the reader will now understand that the trunk and branches of 
this bronchial tree are hollow throughout, and lined with a delicate 
and smooth mucous membrane, and that the diseases to be described 
are inflammation either upon this membrane or the small glands con- 
nected with it, causing swelling,-redness, unhealthy discharges, rough- 
ness, etc., he will have a good general idea of them. 



Nasal Catarrh. 

I take these diseases in the order of their location. Nasal Catarrh 
consists in inflammation, which begins behind and a little above the 



210 DISEASES OF THE THROAT. 

veil of the palate, and extends upward from thence into the nose. It 
is an exceedingly troublesome complaint, and afflicts great numbers. 
It passes under the name of Catarrh in the Head. 

The inflammation is not confined to the nasal cavities. It extends 
frequently to the air-cavities, called centrums and sinuses* which cover 
a considerable portion of the face, and extend to the lower part of the 
forehead. Persons sometimes feel as if their whole face were in- 
volved in the disease, and were almost in a state of rottenness, — so 
great is the amount of matter discharged from the head. Such free 
discharges cannot be wondered at when we reflect that all the air 
cavities in the face are lined with the same mucous membrane which 
lines the nose, and that they all communicate with the nasal cavities. 

The " horn ail," among cattle, is a similar inflammation of the inner 
surface of the horns ; and the " horse distemper " is an inflammation of 
the air cavities in the head of the horse, and is much the same disease 
with our catarrh in the head. 

The catarrh often creates a perpetual desire to swallow, and gives 
the feeling, as patients express it, " as if something were sticking in the 
upper part of the throat." 

When the inflammation has existed a long time, and ulceration 
has taken place, puriform matter is secreted, and drops down into the 
throat, much to the discomfort of the patient. Indeed, this is one of 
the most distressing features of the complaint, as this matter often 
descends into the stomach in large quantities, causing frequent vom- 
iting, and a general derangement of the health. Many times the suf- 
ferer can only breathe with the mouth open. Upon rising in the 
morning a great effort is required to clear the head and the extreme 
upper part of the throat. There is occasionally a feeling of pressure 
and tightness across the upper part of the nose ; and the base of the 
brain sometimes suffers in such a way as to induce headache, vertigo, 
and confusion. The smell is frequently destroyed, and sometimes 
the taste. The inflammation sometimes gets into the Eustachian 
tubes, the mouths of which are behind and a little above the veil of 
the palate, and extends up the lining membrane to the drum of the 
ear, causing pain or deafness, and occasionally both. In addition to 
this catalogue of evils, there is often added inflammation and elon- 
gation of the uvula or soft palate. 

Treatment. — The following is a fair illustration of my mode of 
treatment : — 

Mr. , of Boston, came under treatment for a bad case of ca- 
tarrh in the head, complicated with follicular disease of the pharynx, 
or upper part of the throat. In addition to nearly all the symptoms 
mentioned above, he had a stench from the nose exceedingly offen- 
sive to all about him. So much had the disease worn upon him that 
he had become bilious, sallow, dejected, and low in strength and flesh. 

When it is said that to all these were added a cough and loss of ap- 
petite, with insidious approaches of hectic, it will not be surprising 



DISEASES OF THE THROAT. ■ 211 

that his friends saw the most serious results impending, even though 
assured by me that the disease had not yet taken a firm hold of his 
lungs. The first thing done for him was to cut off the uvula. Five 
days after, I began to bathe the whole nasal cavity, three times a 
week, with a shower syringe, by pushing the smooth bulb up behind 
the veil of the palate, and throwing instantaneously a most delicate 
shower of medicated fluid up both sides of the septum. The upper 
part of the throat was likewise bathed by the use of a shower syringe 
made expressly for that part, and the larynx, or place where the voice 
is formed, by a long, bent instrument made to reach this part of the 
throat. The solution used consisted of half a dram of crystals of ni- 
trate of silver dissolved in one ounce of soft water. 

The nitrate of silver powder was inhaled once a day with the pow- 
der inhaler. In this way the nasal cavities and throat were kept 
cleansed, and the articles used gradually subdued the inflammation, 
setting up a new and healthful action in place of the diseased one. 
The stomach was relieved of the offensive matter which had daily 
and nightly gone down into it, and the system of the poisonous ef- 
fects of its absorption. The great danger which threatened the lungs, 
and which would soon have been realized in their destruction, passed 
away. The skin gradually resumed its proper color ; the appetite, 
flesh, spirits, and strength came back, and Mr. B. has been since in 
the enjoyment of good health, pursuing his business cheerfully. 

When the above treatment fails, as it does occasionally, I am in 
the habit of changing the solution, using sometimes a weak solution 
of acid nitrate of mercury, twenty drops to an ounce of water. In 
other cases, a solution of sulphate of zinc serves a good purpose. A 
dilution of the tincture of arnica-flowers is a preparation of some 
value in these cases. There are other preparations, too numerous to 
mention, which I am in tHe habit of using. I will add, that the 
nitrate of silver powder, snuffed once a day, a pinch at a time, is far 
more successful than any other snuff ever made, but should be used 
only in severe cases> and with caution. 

Nasal catarrh is such a common affliction in the Eastern States, as 
to be a widespread curse. Douching the nose with salt and water 
(warmed) cleanses the nose of the foul mucus. The douche should 
be from a bag hanging only a little higher than the head, or it may be 
given by means of a common, blunt-pointed syringe, care being taken 
not to use too strong force, nor to point the syringe in the direction 
of the eyes. The stream of water should be directed straight ahead 
parallel with the floor ; the mouth must be open, and the patient as- 
sume the position of the countryman when gazing or gauking at the 
sights on his first visit to the city. The water then runs down the 
throat and also out of the other nostril. This process should be em- 
ployed on both sides till the head is clean. The tablets put up by all 
wholesale druggists, called "Carl Seller's alkaline tablets," is the best 
remedy for a nasal douche. The subsequent treatment is best ad- 



212 DISEASES OF THE THROAT. 

vised by a physician, and usually consists in the use of some inhala- 
tion or spray. 

Inflammation of the Pharynx. — Pharyngitis. 

This is an inflammation of the upper and back part of the throat, 
or all that part which can be seen when the mouth is stretched open. 
It causes a redness of the mucous membrane lining the part, which 
is deep in proportion to the intensity of the inflammation. This 
complaint is generally connected with the one I am about to describe ; 
and since the treatment is the same the reader is referred to what 
next follows. 

Adenoid Growths. 

In young children a very disagreeable catarrhal affection often ex- 
ists in the naso-pharynx just behind and above the uvula. This is 
caused by continued catarrh till at last small growth's occur like 
proud-flesh, and not infrequently block up the passage from the nose 
to the mouth, to that extent that not only is loud snoring produced at 
night, but breathing becomes difficult by day. In severe cases the up- 
per jaw becomes angular, and the face assumes a peaked, pinched look. 
These growths are extremely common in children, and are produc- 
tive of much mischief. The inability, in severe cases, to properly 
breathe deprives the lungs of their proper amount of oxygen, so that 
the little one suffers in nutrition and growth. 

Treatment consists in scraping away with a scoop, or even with 
the finger, these soft, granulating masses. The effect is almost mar- 
vellous : the child breathes quietly, without snoring, the color re- 
turns to the cheeks, and the blood receives a new supply of food from 
the full supply of oxygen. In modern times, nothing has been in- 
augurated in the treatment of children's throat and nose diseases so 
beneficial and happy. 

Clergymen's Sore Throat. — Follicular Pharyngitis. 

This disorder made its appearance in this country in 1830, and the 
attention of the profession was first drawn to it, as a distinct disease, 
in 1832. Some have supposed its origin to have had a hidden con- 
nection with the epidemic influenza which spread over the civilized 
world in 1830, and affected all classes of persons ; but this is only 
conjecture. In its early developments it attracted notice chiefly by 
its visitations upon the throats of the clergy. Hence its popular 
name of Clergymen's Sore Throat. It was soon found, however, to at- 
tack all classes of persons indiscriminately, whether engaged in any 
calling which required a public exercise of the voice or otherwise. It 
was noticed more by public speakers and singers, on account of the 
greater inconvenience it gave them. 

The disease consists in a chronic inflammation of the mucous fol- 



DISEASES OF THE THROAT. 213 

licles, or glands, connected with the mucous membrane which lines 
the throat and windpipe. The office of these little glands is to secrete 
a fluid to lubricate the air passages. When inflamed, they spread an 
acrid, irritating fluid over surrounding parts, which excites inflamma- 
tion in them. Hence a general inflammation of the upper part of the 
throat or pharyngitis usually attends the follicular disease, and I 
shall speak of the two together. This inflammation of the glands 
and the membrane, being neglected, as it generally is, lingers on from 
month to month, or from year to year, making in some cases slow 
progress, in others more rapid, — made a little worse and its step 
slightly quickened by every fresh cold, and finally results in ulcera- 
tion. The expectoration thenceforward becomes puriform, and finally 
undistinguishable from that of consumption, with all the symptoms 
of which the patient finally dies. Indeed, before its nature was un- 
derstood by the profession, it was considered the most fatal form 01 
consumption, because it could be affected only in a very small de- 
gree, if at all, by medicines taken into the general system. For the 
milder cases one will find great comfort in the use of the troches of 
cubebs and ammonia, the inhalation of benzoin with steaming water, 
also from such throat-tablets as the Chloramine. 



Inflammation of Mucous Membrane and Glands 
of Larynx. — Follicular Laryngitis. 

A few strong and beautifully formed cartilages unite to form a 
curious and convenient box or cavity at the top of the windpipe, 
called the larynx. Across this enclosure are stretched two remark- 
able ligaments, called the vocal cords. They are from half to three 
quarters of an inch in length, and are rendered more or less tense by 
the small muscles with which they are connected. Just above these 
cords are two cavities, which, with the ligaments, act an important 
part in the formation of the voice. Here is produced the sound, 
which is modified and articulated by the tongue, the lips, and the 
nasal cavities. 

When disease reaches this cavity, and the fluid secreted to lubri- 
cate these cords becomes acrid, the voice, from this and other causes, 
is made hoarse ; and when, at length, these ligaments are altered in 
structure by inflammation and ulceration, the voice suffers a gradual 
extinction. I have treated a large number suffering entire loss of 
voice, and am happy to say it has been generally restored, where the 
lungs have not been involved in the disease. There is often also a 
little sensitiveness, or even soreness, in some cases, in the region of 
the larynx, which may be felt by pressing upon that prominence in 
front of the throat, called Adam's apple. 



214 DISEASES OF THE THROAT. 



Inflammation in the Windpipe.— Tracheitis. 

This complaint and the one preceding it differ only in their local- 
ity from those described in the upper cavities ; and they are more 
alarming, because two removes nearer the citadel of life. Happily, 
we know that the seat of these diseases may be easily reached, and 
we have a shower syringe, so arranged as to pour the remedial agent 
directly upon them, without any lacerating disturbance of the parts. 

Symptoms. — The approach of these disorders is often so insidious 
as hardly to attract notice, — sometimes for. months, or even years, 
giving no other evidence of their presence than the annoyance of 
something in the throat to be swallowed or hawked up, — an increased 
secretion of mucus, and a sense of wearisomeness and loss of power in 
the throat, after public speaking, singing, or reading aloud. At 
length, upon the taking of a severe cold, the prevalence of an epi- 
demic influenza, or of an unexplained tendency of disease to the air- 
passages and lungs, the throat of the patient suddenly becomes sore, 
its secretions are increased and rendered more viscid, the voice grows 
hoarse, the difficulty of speaking is aggravated, and what was only 
an annoyance becomes an affliction, and a source of alarm and dan- 
ger. These diseases clearly belong to the family of consumption, and 
need early attention. 

Causes. — It is amusing to reflect upon the theories which writers 
were in the habit of constructing, a few years since, to account for 
the throat affection among the clergy. It was attributed by some to 
speaking too often, by others to speaking too loud. One class of 
writers thought it arose from muffling the neck; another, from a 
strain of voice on the Sabbath to which it was not accustomed on 
other days. 

The cause lies deeper than any of these trifling things. As it con- 
cerns ministers it may generally be expressed in two words, — labor, 
anxiety. 

The clerical order are placed just where they feel the force of the 
high-pressure movements of the age. They are the only class of 
recognized instructors of adult men, and are obliged to make great 
exertions to meet the wants of their position. The extremely trying 
circumstances in which they are often placed, too, in these exciting 
times, by questions which arise and threaten to rupture and destroy 
their parishes, weigh heavily upon their spirits, and greatly depress 
the vital powers. And when we add to this the fickle state of the 
public mind, and often the shifting, fugitive character of a clergy- 
man's dwelling place, and the consequent liability to poverty and want 
to which himself and family are exposed, we have a list of depressing 
causes powerfully predisposing to any form of disease which may 
prevail. 



DISEASES OF THE THROAT 215 

It will be pardoned me, I think, if I suggest here, that the nature 
of a clergyman's calling is of so serious a character, that he some- 
times carries himself with too much sedateness, keeps himself too 
much braced up, and does not allow himself hours enough of that 
cheerful, light-hearted abandon, which is essential to the health of 
every sedentary man of mental habits. The hard-thiDking and hard- 
working minister, who will retain his health and save his throat, must 
have some moments, at least, when the weighty responsibilities of his 
office are lifted up from his soul, and he becomes, for the hour, the 
jocund, playful boy of earlier days. How far he can consistently re- 
lax and let himself down, or in my view of the matter, raise himself 
up to the simplicity and mirth of childhood, he alone can be the judge. 
As a physician, I prescribe ; as a minister, he must decide how far 
my prescription can be followed. 

Reading Sermons. — There is one practice, which, though it has 
not much to do with inducing this disease, does frequently aggravate 
it when once established ; I mean the habit of reading sermons from 
manuscripts, — especially when it is done in a sort of mechanical 
way. Every person who has suffered from throat-ail has doubtless 
noticed that to read aloud, for half an hour, from a book, occasions 
more fatigue and irritation in the throat than extemporaneous speak- 
ing, in the same tones, for one or two hours. The reason is, that in 
the latter case the mind conceives the thought in season for the or- 
gans of speech to fall into a natural attitude, and utter it with ease. 
The two work harmoniously together, — the instruments of articula- 
tion following the mind, and easily and naturally uttering its concep- 
tions. Whereas in the case of reading, the mind itself is, at least 
partially, ignorant of what is coming until it is just upon it, so that 
the organs of speech, being warned of what is to be done only at the 
moment their service is required, do their work under a perpetual 
surprise and constraint. The difference is, in some respects, like that 
between walking freely at large, without regard to where the feet are 
put down, and being obliged to step exactly in the footprints of some 
traveller who has gone before. In the latter case, the muscles tire 
much sooner, because they work in fetters. 

I have thus spoken particularly of the clergy, though it is not by 
any means they only, but all classes of people who are afflicted with 
this dangerous malady. 

These diseases often begin with a cold. But colds are seldom taken 
except when the nervous system is depressed, so that they are, in fact, 
to be traced back to the same cause which I have assigned to catar- 
rhal or throat complaints themselves. 

These Complaints Worse at Night. — It is worthy of note, that all 
these complaints, and many others, are worse during the night. This 
is easily explained when we remember that the atmosphere has the 
least amount of electricity in it at three o'clock in the morning, and 
that the first minimum atmospheric pressure, which happens twice a 



216 DISEASES OF THE THROAT. 

day, occurs not far from the same hour. From three to four in the 
morning, therefore, the nerve-power si?iks to its lowest ebb; and those 
diseases which owe their existence to anxiety, overwork, etc., suffer, 
at this time, their greatest daily aggravation. Death occurs, too, more 
often during these hours, than in any other portion of the twenty- 
four. 

Treatment — Some years ago these diseases were thought to be 
incurable ; and by all the appliances of medical art then known, they 
were so. But time has brought a successful method of treatment, as 
well as a clearer knowledge of their nature. 

This treatment consists in what is called topical medication, or the 
applying of the medicine directly to the diseased part. The medici- 
nal agent more extensively used than any other is a solution of crys- 
tals of nitrate of silver. This substance is not, however, adapted to 
every case, — other articles succeeding better in some instances. Mod- 
ern chemistry has given us a variety of agents from which the skilful 
physician may select a substitute, should the nitrate of silver fail. 

The operation of applying this and other substances to the air pas- 
sages, is a delicate one, requiring tact and experience. Surgeons had 
supposed it an anatomical impossibility to introduce an instrument 
into the larynx ; but this has been practically demonstrated to be a 
great mistake. 

Instruments. — The instrument devised and used by Dr. Horace 
Green is a piece of whalebone, bent at one end, to which is attached 
a small, round piece of sponge. This, dipped in the solution, is dex- 
terously introduced into the laryngeal cavity, and applied directly to 
the diseased part. 

I formerly used this instrument myself, and am happy to know, 
that, notwithstanding its defects, it was generally successful. Yet 
where the larynx was highly inflamed, with a swollen and ulcerated 
condition of the epiglottis and lips of the glottis, I am sure I some- 
times had the singular powers of the nitrate of silver put at defiance 
by an irritation evidently produced by the sponge of the probang. 
Upon its introduction, in such cases, the parts contract upon and 
cling to it, and suffer aggravated irritation, almost laceration, upon 
its withdrawal, however carefully effected. 

Laryngeal Shower Syringe. — Such defects in the probang led me 
to contrive an instrument, which I call a Laryngeal Shower Syringe. 
It is in the form of a syringe, the barrel and piston of which are 
made of glass, silver, or gold, as may be desired. To this is attached 
a small tube, made of silver or gold, long enough to reach and enter 
the throat, and bent like a probang, with a globe or bulb at the end, 
from a quarter to a third of an inch in diameter, pierced with very 
minute holes, which cover a zone around the centre about one-third 
of an inch in breadth. 

This silver bulb I daily introduce into highly inflamed and ulcer- 



DISEASES OF THE THROAT. 217 

ated larynges, generally without any knowledge of its presence on 
the part of the patient, until the contained solution is discharged. 
The instrument, being charged, is carried to the proper place, when a 
delicately quick pressure upon the piston causes very fine streams to 
flow through the holes in the form of a delicate shower, and all sides 
of the walls of the larynx are instantaneously bathed. 

How Introduced. — The introduction of this instrument into the 
larynx is easy. Upon the approach of any foreign substance, the epi- 
glottis instinctively drops down upon the entrance to the larynx, 
guarding it against improper intrusions. It has been found, however, 
that when the root of the tongue is firmly depressed, this cartilage 
cannot obey its instinct, but stands erect, its upper edge generally ris- 
ing into view. Availing himself of this, the surgeon has only to de- 
press the tongue with a spatula, bent at right angles, so that the left 
hand holding it may drop below the chin out of the way, and as the 
epiglottis rises to view, slip the ball of the instrument over its upper 
edge, and then with a quick yet gentle motion, carry it downward and 
forward, and the entrance is made. I have often admired the faith- 
fulness of this epiglottic sentinel, who, when overborne by superior 
force, stands bolt upright, and compels us to enter the sacred temple of 
speech directly over his head ! 

Pharyngeal Shower Syringe. — For washing the upper part of the 
throat, I construct the instrument with a straight tube, with holes 
over the outer end of the globe, and extending to the centre. This 
washes instantaneously the fauces and pharynx, but does not throw 
the solution back upon the tongue. Its main advantage over the 
probang is, that it bathes every part of the fauces and pharynx in- 
stantaneously, and does not subject the patient to the coughing and 
gagging which follow the slower and rougher process of drawing the 
sponge from side to side across the cavity of the throat. 

Nasal Shower Syringe. — Inflammations in the back passages to 
the nose, called catarrh in the head, have been almost inaccessible by 
any reliable healing agent, and consequently incurable. The probang 
could only reach a short distance, and occasioned great suffering. I 
have had a syringe constructed with the tube bent at an angle of 
forty-five degrees, and the globe, very small, pierced with a few fine 
holes at the upper end. Carrying this globe up behind the velum 
palati, with a single injection I wash both passages clear throu gh. I 
have had the pleasure of curing a large number of bad cases, of many 
years' standing, to the surprise and delight of the patients. 

About nineteen-twentieths of the physicians who have examined 
these instruments, and so far as my knowledge extends, all who have 
used them, think them much better than the probang. As to patients, 
I have yet to see one who will allow the sponge to be used after try- 
ing both. 

Have Superseded the Probang. — In my own practice the syringes 



218 DISEASES OF THE THROAT. 

have superseded the probang altogether. My reasons may be briefly 
stated. I have already said there is less irritation produced. A piece 
of sponge drawn over an inflamed surface, especially when clung to 
by the irritated and quivering parts, must necessarily, in some cases 
at least, aggravate the symptoms of disease. To this consideration 
add the comfort of the patient during the operation. It is so quickly 
and delicately done with the syringe, that it is scarcely known when 
the act is performed. The straight syringe does not touch the throat 
at all. On touching the probang to the throat, the nitrate of silver 
unites with the mucus upon the surface, instantly covering the sponge 
with an albuminous pellicle, something like that which lines the shell 
of an egg^ preventing, in a degree, the further pressing out of the 
solution, and rendering its contacts with other parts of the surface 
comparatively powerless. For this reason, the sponge pushed down 
into an ulcerated bronchus, as Dr. Green recommended, must be ut- 
terly valueless as a remedial agent. Mopping, as it does in its whole 
course, a larynx and trachea, lined in some cases with puriform mat- 
ter, and generally with mucus, every inch of its descent doubles the 
gravity of this objection. Let it be considered, too, that in applying 
the remedy to an ulcerated larynx, the sponge cauterizes the healthy 
parts above, in its descent, and thus unfits itself for doing much for 
the diseased part ; whereas the syringe retains its solution till it 
reaches the affected place, and then pours a clean shower directly 
upon it, and upon no other part. 

Considering these manifest advantages of the syringes, I am sur- 
prised that any physician should still use the probang, — especially as 
one of these instruments, the Nasal Syringe, accomplishes an object 
which the probang cannot effect at all, not even in a rough way. I 
have wondered, too, how any parent can allow a child, suffering with 
croup, to be tormented by having a sponge pushed down its throat, 
when a syringe would give it so much less pain. 

I will mention briefly one or two cases of croup and diphtheria, se- 
lected from a great number treated by me for the last few years, where 
the syringes were successfully used, after several attempts to use the 
probang had been made, and failed, and where the pain caused by 
using was so small, and the relief so instantaneous and complete, that 
the patients were anxious for my return to use it again. 

I was called to see a little boy of Mr. R., five years old, who had 
had an attack of membranous croup some days previous ; and when 
I saw him the voice had sunk to a whisper, and the cough was en- 
tirely muffled, so that I had no doubt of the fatal termination of the 
case, and expressed my opinion to that effect to the astonished parents. 
The probang had been used by the physician in attendance, which 
had caused so much suffering that for the two days previous the par- 
ents had prohibited its use. It had no doubt increased the irritation, 
besides nearly causing strangulation. 

It was, therefore, with great reluctance that they consented to let 



DISEASES OF THE THROAT. 219 

me use the syringe, which I did, to the great relief of the little suf- 
ferer, and to the entire satisfaction of the parents. 

The strength of the solution of the crystals of the nitrate of silver 
used was 20 grains to the ounce of water, which I injected freely, 
once in three hours for the first day, and then two or three times a 
day for two or three days. His recovery was rapid and complete. 

I will now mention the case of a young woman, with diphtheria, 
where the syringe was used with success. 

I was called to see a young lady, who had an attack of diphtheria 
the day previous. Found her in bed, very much prostrated, breath- 
ing with great difficulty, and uttering at every inspiration a croupal 
sound, which at times was followed by a short, convulsive cough. 
The face was flushed, pulse 124, small and feeble, and she complained 
constantly of a sense of suffocation and of great distress in the lar- 
yngeal region. 

On inspecting the throat, the fauces and the pharyngeal mem- 
brane, as far down as it could be seen, presented the appearance of a 
high degree of inflammation. One of the tonsils was nearly covered 
with the diphtheric membrane, and the upper and back part of the 
throat were thickly studded with small white or cream-colored spots. 

The physician in attendance had tried first a swab, or mop, as she 
termed it, and then the probang, which gave her so much pain that 
he was obliged to give it up. He then gave up the case as hopeless. 
At my earnest solicitation she consented to the use of the syringe. 
With a solution of the crystals of the nitrate of silver, of the strength 
of 60 grains to the ounce of water, I injected freely the fauces and 
the upper part of the cavity of the larynx. For a few moments the 
difficulty of breathing and feeling of strangulation was increased, 
but very soon a large amount of viscid, ropy mucus was discharged. 
In the course of half an hour after the use of the syringe, the symp- 
toms had improved, the respira- 
tion was less laborious, so that 
in a short time the patient ob- 
tained some sleep. I was after- 
ward called, as she thought her- 
self worse, but found that an 
application of the caustic with a syringe was all that was required. 
There was no further trouble with the case. 

These syringes or similar ones can now be bought of any large 
dealer in surgical instruments. Figure 87 represents the syringes as 
they lie in a case. 

Mode of Using. — The glass barrel and piston of my instruments 
are delicate, but they need not be broken. I handle them with the 
same ease that I do a spoon in feeding myself, and not in a very dis- 
similar way. The last three fingers are placed on the under side of 
the barrel, with the thumb on the upper side, — the index finger be- 
ing poised over the end of the piston, ready to drive it home at the 




220 DISEASES OF THE THROAT. 

proper instant. The motion of the piston should be quick, so as to 
cause the streams to leap out in jets ; yet delicate, that they may not 
impinge with too much force upon the diseased surfaces. 

They should be rinsed with water immediately after being used. 
But even with this precaution, a small residuum of the nitrate re- 
mains and crystallizes, and after a time partially closes the holes. 
They must then be picked out with the point of a needle. 

When the silver tube becomes detached from the glass, it may be 
fastened on with common sealing wax ; first melting the wax and 
sticking it around the glass; then heating the silver over a lamp, and 
pressing it on. 

Amount of Solution to be Used. — The amount of solution to be 
used should be small. Half a dram is enough. The piston of the 
syringe need be drawn up only from an eighth to a third of an 
inch. Strangling is not often produced by these operations ; but to 
make its prevention still more sure, let the patient be directed to fill 
the lungs with a long inspiration while the operator is depressing the 
tongue. 

Strength of Solution. — The strength of the solution in ordinary 
cases of chronic folliculitis, etc., should generally be about forty 
grains of the crystals of the nitrate of silver to the ounce of water. 
But in all acute diseases of the air passages, it should be considerably 
stronger, — varying from one to two drams. A preparation of this 
strength is powerfully antiphlogistic and sedative. In those cases of 
chronic disease, where the inflammation is of a low grade, and the 
mucous membrane is in a relaxed, atonic condition, looking either 
sodden and pale, or of a dark color, like the cut surface of beef some 
days exposed to the air (as is often the case in throats of literary dys- 
peptics), then a solution of fifteen to thirty grains to the ounce is 
sufficient. This strength acts as a stimulant, and is well suited to 
throats in such condition, but would be injurious in high grades of 
inflammation. Catarrh in the head generally requires only about this 
strength. I am sorry to say, the topical mode of treating throat affec- 
tions has been in some places injured, in the public estimation, by a 
lack of knowledge and judgment on the part of the operator, in 
choosing the strength of his solution. 

To determine the proper frequency of the operation, also requires 
judgment and experience. In an ordinary case of chronic disease, 
the treatment may begin by showering the throat once a day for a 
week. Then the operation should be repeated three times a week, for 
a shorter or longer period ; then twice a week, and at last once a week. 

Attendant Diseases. — Among the persons I am treating for dis- 
eases of the air passages, many are dyspeptic and suffer with depres- 
sion of spirits. So often does this symptom present itself that I re- 
gard it as almost one of the peculiarities of throat disease. Persons 
thus depressed generally have the dark and dingy look of the face 
which indicates functional derangement of the liver. They are often 



DISEASES OF THE THROAT. 



221 



emaciated, nervous, hypochondriacal, irritable in temper, and are ex- 
hausted by an excessive secretion of urea. The urine of such per- 
sons is always acid, and loaded with crystals of oxalate of lime. 

An explanation of this fact has been attempted, by supposing that 
the oxydation of carbon (of which these persons have a superabun- 
dance), imperfectly accomplished in inflamed respiratory organs, is 
vicariously effected in the capillaries of the kidneys, — oxalic acid 
(C 2 2 ) instead of carbonic acid (C0 2 ) being the result. 

The crystals of oxalate of lime are octahedral in form, and, in the 
field of a good microscope, are beautiful objects for inspection. 

Lawyers, clerygmen, statesmen, and, in general, those who labor 
hard mentally, with but little bodily exercise, and who have a great 
weight of care resting on them, are the persons who suffer most from 
this complication. Generally the inflammation in the throat is of a 
low grade, and must not be treated with a very strong solution of ni- 
trate of silver. 

Of course when these attendant diseases exist, something more is 
needed than the local treatment. For the troubles just described, the 
treatment for hypochondria and dyspepsia will be proper. 

Elongation of the Uvula. 

The uvula is the small teat-like or 
pendulous organ which hangs down 
from the palatine arch, just over the 
root of the tongue. It is very apt to 
get inflamed, and its parts becoming re- 
laxed, it stretches out lengthwise, so 
that its lower extremity sometimes rests 
upon the tongue. (Fig. 88.) When 
this happens, it flaps about, backward 
and forward, and to the right and left, 
— touching the throat at various points, 
and by the tickling sensation produced, 
exciting a most incessant, uncontroll- 
able, and racking cough. Some of the 
most distressing coughs I have ever 
heard have been produced and kept up 
by this cause alone. Many a fatal con- 
sumption has begun in this way. When 
long inflamed, it often gets much out 
of shape, being sometimes bent nearly 
double. 

Treatment. — In some cases, the 
uvula, thus elongated, may be reduced 
back to its natural size, by an astrin- 
gent gargle, composed of an infusion of 
white-oak bark, with a little alum dis- 




FlG. 88. 



222 DISEASES OF THE THROAT. 

solved in it (232) ; but it will generally stretch out again and again, 
upon the appearance of any fresh cold, and, therefore, the only certain 
cure is to cut it off. 

To do this, take hold of it with a pair of common forceps, and 
having stretched it down a little, clip it off above the forceps, with a 
pair of curved scissors. Nearly the whole of it should generally be 
removed. To take off a part only leaves a stump, which is often 
more objectionable than the whole organ. Its removal never injures 
the speech in the least. In many cases of nasal catarrh, this organ 
is a sort of diseased centre, from which inflammatory action spreads 
upward into the nasal cavities, and no medicine or power on earth 
can effect a cure until this offending member is snipped off. 

Acute Inflammation of the Tonsils. — Tonsilitis. 

The tonsils are chiefly a collection or mass of small mucous folli- 
cles or glands. They secrete a portion of the fluid which keeps the 
throat moist. 

There is a class of persons who suffer about every winter, some- 
times often er, with an attack of acute inflammation of these glands, 
which causes gieat suffering for several days. The trouble usually 
is ushered in by high fever, backache, headache and often by chills ; 
the temperature often reaches to 103° and 104° F. ; swallowing is 
difficult on account of the swollen glands, while pain in the ear is 
not infrequent. The tonsils are at first swollen, reddened and in- 
flamed ; later a whitish patch of secretion forms on the surface of 
the gland and is distinguished from that of diphtheria by being 
whiter and less tenacious ; if removed, the underlying surface does 
not bleed as in the case of diphtheria. It is, however, very difficult, 
at times, to distinguish between the two diseases at first. 

Another form of Tonsilitis occurs without patches, and is in 
reality an inflammation of the substance of the gland itself. This 
variety, often called Quinsy, goes on developing into an abscess, the 
anterior pillar of the fauces becomes intensely red, swollen and 
shiny. 

Treatment. — For the more common variety some antipyretic to 
reduce the fever and allay the intense aching of the head and bones 
is properly indicated. For this purpose 10 grains of Phenacetine 
(for an adult), repeated every two to four hours according to the 
effect produced, is quite efficacious. Ammonol in same dose may 
also be used. Some simple astringent and soothing gargle will next 
be found to render signal relief. Tannin, 30 gr., strong Carbolic 
Acid (95%), 30 drops, Glycerin, 1 oz., and peppermint water, 3 oz., is 
an admirable gargle for the average case : this should be used hourly. 

Equal parts of Glycerin, Alcohol and Water makes a very sooth- 
ing gargle, while equal parts of Peroxide of Hydrogen and Water is 
preferred by many. The diet should be limited in amount and con- 
sist only of liquids. 



DISEASES OF THE THROAT. 223 

The second variety, tending to pus formation, is to be treated sur- 
gically by first applying a solution of cocaine and lancing. The 
relief resulting from evacuating the pus is immediate. 

It has been found that Tonsilitis is apt to be recurrent and that 
he who has suffered once is very prone to have one or more attacks 
annually thereafter. This class requires constitutional treatment in 
the intervals as outlined below. 

These inflammations are likewise found to be an expression often- 
times of rheumatism, and need corresponding treatment. But the 
only cure is to be found by cutting off the tonsils, after the inflam- 
mation has subsided. This will put an end to the attacks at once. 

Tonsils which are subject to these periodical attacks of acute in- 
flammation are always more difficult than others to operate upon, as 
they are almost invariably bound down very tight to the throat, and 
cannot be raised up for convenient excision. 

Chronic Inflammation of the Tonsils. 

Ik many of the follicular diseases of the throat, these glands are 
affected by a chronic inflammation, and are found enlarged, and 
sometimes very much hardened. In such cases they secrete a thin, 
unhealthy, irritating fluid, which is spread over the throat, increasing 
and perpetuating its disease. Much of this secretion finds its way 
into the stomach, and thence into the circulation. 

In the throats of many young persons and children, these glands 
are permanently so large as nearly to fill the fauces. The respiration 
of many children thus afflicted is difficult, and when asleep they can 
only breathe with the mouth open. The defective breathing of such 
children often occasions contractions of the chest, and thus lays the 
foundation for consumption. From these diseased parts, the inflam- 
mation often spreads upwards, into the posterior nares, and many 
times enters the eustachain tubes, causing deafness or pain in the ears. 
Such children often breathe as though they had a bad cold in the 
head. Their health and safety require an immediate attention to 
this state of things. 

Chronic inflammation of the tonsil, likewise the recurrent acute 
form, maybe dependent on poor blood or rheumatism. Those causes 
are met by blood-building medicines like Syrup of the Iodide of Iron 
in 10-drop doses three times daily, cod liver oil, and by some one of 
the many preparations of iron, arsenic, and strychnia combinations. 
It is found that generally the excision of the tonsil may be averted 
by visiting the surgeon, who will hunt out the little crypts or holes 
with which the gland is studded, and by gently cutting the narrow 
bridges which separate these holes, destroy these cavities. These 
little holes retain small particles of food and decomposed secretion, 
which after a while, if allowed to remain, set up a follicular tonsil- 
itis. The size of the gland is thus greatly diminished and the little 



224 DISEASES OF THE THROAT. 

secreting follicle destroyed. Many a little sufferer can thus be spared 
the harsher method of excision, and bear with good grace, especially 
if cocaine be used, what otherwise might be a painful and bloody 
operation. But, as has been said, excision in many cases must be 
resorted to. 

Curability of Throat Diseases. — I have dwelt somewhat upon 
the preceding forms of throat disease, because they prevail to a fear- 
ful extent, and are, in thousands of cases, but the first stages of fatal 
disease of the lungs. 

If not connected with lung disease in the beginning, my experience 
in treating them enables me to say, emphatically, they are generally 
curable. 

But patients often put the question to me — " If cured, will I ever 
have the complaint again ? " My answer is — " Unless I can plant 
in your constitution a better protection than your Maker put there at 
your creation, you will of course be liable to a second attack." But 
then, where the lungs have been entirely free from disease, I have 
never yet seen a case of simple throat complaint relapse and become 
dangerous after proper treatment with the syringes. Let not those, 
therefore, who have been benefited, but not entirely cured by this 
treatment, undervalue what has been done for them. Even in such 
cases, the advantage derived to them amounts to just the value they 
attach to the continuance of life. 

Dangers of Delay. — In closing these remarks, let me warn the 
reader against the dangers of delay. Many of those who finally seek 
medical attendance in these complaints, first try all nostrums, and 
tamper with their disease till the case is either critical or hopeless. 
Too many wait till they are near enough to the engulfing whirlpool 
to hear it roar, before they seek in any practicable way to escape its 
dangers. 

Many persons neglect a slight inflammation of the pharynx, which 
might have been cured in a few days, but which, from long neglect, 
has gradually crept down the windpipe, spread over the widely dis- 
tributed mucous lining of the bronchial tubes, and thus become cur- 
able only in a partial degree, and after long and tedious treatment. 
Hundreds of persons are now suffering from slight attacks of this 
sort, who might be rid of the affliction in a week or a fortnight, but 
who will either carelessly give it no attention at all, or resort to use- 
less nostrums, until it has run through its primary stages and invaded 
the constitution, and will finally die of some of the forms of pulmo- 
nary disease. 

A Cold. — Influenza. 

A slight attack of the disease about to be described, affecting only 
here and there -a person, and lasting only for a few days, is called a 
cold. When it affects a large part of the community at the same 



DISEASES OF THE THROAT. 225 

time, lasting many days, or even weeks, it is then an epidemic, and 
passes under the name of influenza. In this latter form, it sometimes 
spreads over a whole country, and has at times, as in 1832 and 1894, 
extended to nearly the whole civilized world. It often shows marked 
severity in its progress, and leaves serious results behind. 

Symptoms. — A tingling, with dryness, and a sense of fulness in 
the mucous membrane of the nose, are among the first indications of 
an attack of this complaint. Sneezing is a common symptom. Soon 
pain is felt in the forehead, and breathing through the nose becomes 
difficult. The eyes are red and watery, the throat is sore ; there is a 
dry cough, hoarseness, thirst, general lassitude, chills, and a desire 
to get near the fire. The mucous membrane of the nose, throat, 
windpipe, and breathing-tubes is inflamed, red, swollen, and some- 
times painful. 

In a short time, water begins to run from the nose and eyes, and 
the cough becomes a little more moist. There is also a slight dis- 
charge from the throat and tubes, which gradually increases, and, at 
length, as the disease declines, and becomes less acute, the expectora- 
tion is thick and yellow. 

Aching of the back and limbs, thirst, loss of appetite, flashes of 
heat, and chills whenever the patient is exposed to air a little cooler 
than he is accustomed to, are almost constant attendants upon the 
disease. 

Causes. — It is not always easy to say what the causes of this com- 
plaint are. Frequently, it can be traced to an improper exposure to 
cold or dampness ; but in a great majority of cases, especially when 
it takes the form of influenza, the causes are not obvious. They 
probably exist in some peculiar states of the atmosphere, and in a 
depression of the nervous system. 

The influence upon disease of the different degrees of density in 
the air which surrounds us, and of other circumstances affecting it, 
have not been much studied. Some valuable facts will be drawn 
from this source before many years. The putting upon the body, or 
taking from it, several tons of pressure every time the barometer rises 
or falls, must have, of itself, no small influence upon its health. The 
comparatively new science of Physical Geography, by spreading be- 
fore us its interesting facts in regard to temperature, storms, atmos- 
pheric currents, etc., is opening the way for the physician to learn a 
great deal more about the cftuses of disease than he now knows. 

Treatment. — In mild cases, only the most simple treatment is re- 
quired, — such as remaining in the house for a few days, soaking the 
feet in warm water, taking a gentle sweat, drinking warm infusions 
of flax-seed, mullein, slippery elm, or warm lemonade, and taking 
only a spare vegetable diet. If the bowels be costive, some gentle 
physic (34), (41) may be used. A laxative drink (132) will like- 
wise be useful. 



226 DISEASES OF THE BRAIN AND NERVES. 

At the outset, especially when the nose runs water, a small dose of 
atropia, ^^ grain, taken every two hours till the throat is dry, will 
entirely arrest the disease at this point. The coryza pill found at 
the druggists' is a more valuable remedy still. 

When the attack is more severe, sweating must be induced by de- 
cisive measures. This may be affected by the spirit vapor-bath, or 
by putting the patient in bed, putting bottles of hot water to the feet 
and sides, and administering warm drinks, and the compound tinc- 
ture of Virginia snakeroot. Five drops every hour of the tincture 
of veratrum viride will often cause very free perspiration, and will 
reduce the inflammation upon the mucous surface. 

An emetic is sometimes very useful. To produce vomiting, use 
the powder of ipecac, ten to twenty grains, or the compound tincture 
of lobelia. 

It soothes the inflamed mucous surfaces very much to inhale the 
vapor from half a pint of hot water, with five drops of tincture of 
veratrum viride, or the same amount of the tincture of aconite root. 

If the cough is severe, use the preparations recommended under 
bronchitis and consumption. 

In the latter stages of the disease, if there be debility, — as there 
generally is, — quinia, iron, mix vomica, etc. (75), should be taken ; 
or, to support the nervous system, the extracts of scullcap, and bone- 
set, and the sulphate of quinia (81) will be found useful. At this 
stage of the complaint, the diet should be more liberal and nourishing. 

The patient should not venture into the open air until the unpleas- 
ant sense of chilliness, peculiar to the disease, ceases to be produced 
by exposure. 

La Grippe. 

This is a variety of influenza with which the world has become 
well acquainted within the last few years. Its history is interesting 
and its symptoms and results are severe and annoying. It is one of 
the most severe forms of catarrhal disease of the nose or throat with 
which we are acquainted. It owes its origin to a germ which found 
its birth in the filth and pollution of eastern Europe, and has visited 
the globe with terrible ravages on several occasions since the Middle 
Ages. It spreads by travelling the most frequented paths of com- 
merce, and attacks those in a depressed state of health. The varieties 
of la grippe are as numerous as that of any other disease. The catar- 
rhal form is much like that of ordinary head influenza, only it is more 
severe and prostrating ; the bronchial assumes the influenza type, at 
first, but soon attacks the lungs and sets up a severe, prolonged and 
harassing bronchitis ; the intestinal variety, besides producing the 
general symptoms of malaise, fever, cough, severe aches and pains, 
gives rise to a diarrhoea which lasts many days and is very debilita- 
ting; the most common variety, however, is the rheumatic, which is 
ushered in by chills, fever, muscular pains, coryza, cough and general 



DISEASES OF THE THROAT. 227 

rheumatic pains. The characteristic feature of all of these forms is 
the great prostration which accompanies these symptoms and the ob- 
stinacy with which it clings to the patient. 

The sequelae of the disease, though much exaggerated, are numer- 
ous. The aged are often left infirm with heart weakness, the young 
with lessened resistance to disease, and the middle-aged with chronic 
coughs. 

Many an undiscovered disease has passed unnoticed under the dis- 
guise of " la grippe." It has no doubt served as a broad mantle to 
cover our ignorance of real disease and been made an easy refuge for 
the complaining; still its affects at times cannot be over-estimated, 
and death has not infrequently resulted. 

Treatment. — The onset is to be met with large doses of quinine, 
say 10 grains on retiring, by phenacetine and salol, 10 grains each, 
taken with some hot lemonade on retiring. This latter may be re- 
peated every three hours. The coryza is checked by small repeated 
doses of belladonna, camphor and quinine, as found in the coryza 
tablets bought at the druggist's — one taken every two hours till the 
throat is dry, then once in four to eight hours. The debility is to 
be met by tonics. 

Acute Inflammation of the Epiglottis. 

This is the disease by which our country lost its most loved and 
distinguished citizen, George Washington. This complaint was not 
understood at the time of his death, — the intelligent physicians who 
attended him supposing it to be inflammation of the windpipe. From 
their very clear description of the symptoms, we now know it to have 
been an acute inflammation of the epiglottis and glottis. 

From the rapid inflammation of the epiglottis, water is effused into 
this cartilage, so as to puff it up, and prevent it from shutting down 
in the act of swallowing. The lips of the glottis are swollen from 
the same cause, and brought so near to each other that air passes 
through to the lungs with great difficuly, and unless relief is soon 
obtained, the patient is strangled. 

Symptoms. — The disease begins with a severe chill, accompanied 
with some pain, and a sense of stricture or tightness in the upper and 
fore part of the throat. There is cough, with difficult and sometimes 
painful swallowing. These symptoms are soon followed by quick 
and laborious breathing. Speaking aloud is from the first difficult, 
and soon becomes impossible. As the complaint runs its rapid course, 
the breathing grows more difficult, and death soon results from com- 
plete strangulation. 

Treatment. — Apply immediately to the parts a strong solution of 
nitrate of silver. The solution should be of the strength of ninety 
to one hundred and twenty grains to the ounce of soft water. It 



228 DISEASES OF THE THKOAT. 

should be applied every hour or two till the feeling of suffocation 
subsides, and should be done with the laryngeal shower syringe, 
though if this is not at hand the sponge probang may be used. 

While this local treatment is being employed, liberal doses, from 
five to twenty drops, of tincture of veratrum viride should be given 
every hour, watching the effect, and discontinuing when the pulse 
sinks too low. 

Hot fomentations applied externally, and filling the room with 
steam, as recommended in cases of croup, would be usef 

Mumps. — Parotitis. 

This disease appears most often among children ; but as it is not 
confined to them, I have not placed it among their complaints. 

Symptoms. — It begins with soreness and stiffness in the side of 
the neck. Soon a swelling of the parotid gland takes place, which is 
painful, and continues to increase for four or five days, sometimes 
becoming very large, and making it difficult to swallow, or open the 
mouth to receive food. After the fourth or fifth day the swelling 
subsides, and disappears in from seven to ten days. 

Both glands generally swell about the same time, but sometimes 
the swelling appears in one only after it has subsided in the other, 
and occasionally the swelling is wholly confined to one side. 

When the swelling is great, there is heat, and sometimes fever, 
with dry skin, quick pulse, furred tongue, constipated bowels, and 
scanty and high-colored urine. 

The affection is sometimes translated, as we say ; that is, in females, 
the breast swells, and in males, the testicles become swollen and pain- 
ful. This accident generally happens in consequence of taking cold 
from some imprudence. 

The disease is contagious ; that is, it is communicated from one 
person to another. 

Treatment. — In mild cases, very little treatment is required. 
Keeping the face and neck warm, avoiding exposure to cold and 
damp, drinking warm infusions of balm, spearmint, or sage, and ap- 
ply a poultice of flax-seed over the glands until the patient is fully 
relieved ; or the compound powder of jalap, if there be costiveness, 
is about all that is required. The diet should consist of rye hasty 
pudding, or brown bread and sweetened water. 

If the case be severe, and other glands swell, physic must be freely 
used, leeches must be applied, and cooling lotions, or poultices. 
Sweating must also be induced by the compound tincture of Vir- 
ginia snakeroot, or by a vapor bath. 

In young girls mumps often attack the ovaries and make the in- 
valid a great sufferer for a few days ; the testicle of the male is simi- 
larly affected at times. These complications call for soothing appli- 
cations and rest in bed. 



DISEASES OP THE CHEST. 



Consumption. — Phthisis. 

At the head of the diseases of our climate stands Consumption, — 
at their head both as it respects prevalence and fatality. Small-pox, 
yellow fever, and cholera are terrible in their visitations ; but what 
are all their aggregated slaughters compared with the ceaseless, silent 
march of this fell disease, which steals away in their fresh prime the 
brightest and the best ? 

Boston, from its population of 475,000, loses by consumption about 
twenty per week, eighty per month, or about nine hundred per 
annum. An equal mortality from any disease not often among us 
would send our citizens in terror to the country, and cause the 
stoutest hearts to feel that "in the midst of life we are in death." 
Massachusetts loses about seven thousand per annum ; New England, 
not less than twenty thousand ; and with the State of New York 
added, the victims of this single disease swell to forty thousand a 
year ! What an army ! Picked from the choicest ! All sundered 
from life untimely, and leaving more blight and sorrow behind than 
would perhaps twice or thrice the number whom any other pestilence 
would have selected. The magnitude of the evil places the question 
of the remedy before all others that pertain to the healing art. 

The greatest number of deaths occur in Massachusetts, being in 
the neighborhood of one in every two hundred and fifty. The smallest 
number is in Georgia, being about one in two thousand one hundred 
and fifty. New England is most unfavorable as a place of residence. 
The Northern Middle States, Western Central and Pacific Coast 
States are most favorable. The most healthful for consumptives, I 
would place in the following order : Georgia, New Mexico, Wiscon- 
sin, Colorado and California. A permanent residence in any of them 
will cure most cases if taken in first stages, and will greatly prolong 
life, unless in the last stages, in which case I would strongly advise 
the patient to remain at home among friends and home comforts. 
After a change of climate it is dangerous to return unless a perma- 
nent cure has taken place. 

Methods of Examining the Chest. — Before speaking further of 
consumption, I propose to do what has never been done, namely, to 

229 



230 DISEASES OF THE CHEST. 

instruct the general reader very briefly in the method of examining 
the chest to learn the existence of disease. Perhaps this will be 
considered a departure, in some slight degree, from my purpose to 
make this entire book intelligible to the general reader. If so, my 
reply is, that there are many school teachers, mechanics, masters of 
vessels, and farmers, who have inquiring minds, and sagacity enough 
to learn the physical signs of chest-disease, and to make them, in 
many cases, practically useful; and that even readers of little re- 
flection cannot fail to comprehend a portion of my explanations. 

Position of the Patient. — In performing percussion upon the 
front of the chest, the patient should be required to sit in a square 
position, with the arms hooked over the corners of the back of the 
chair, and the head thrown a little back. 

Instrument with which to Thump. — The index and middle 
fingers of the right hand are to be brought together, into a line, and 
used as the percussing instrument. The blow given with these is to 
be smart and quick, rather than heavy. 

Medium to Thump Upon. — Either the index or middle finger of 
the left hand is to be pressed firmly upon the surface of the chest to 
be percussed or struck, and thus used as a pleximeter. 

Auscultation. — Listening for the purpose of hearing within the 
chest the sounds produced by breathing, talking, coughing, etc., is 
called auscultation. 





Fig. 90. Fig. 91. 

Instruments with which to Listen. — The naked ear is generally 
considered best for hearing low and delicate sounds ; but for hearing 
loud and rough ones, it is not so good as the stethoscope, repre- 
sented by Fig. 90. A still better instrument is the double-eared 
stethoscope, Fig. 91. It magnifies the sounds very much, and is apt 
to confuse an examiner not accustomed to it ; but when the ear is 
once familiar with it, the aid it affords is very valuable. 



DISEASES OF THE CHEST. 



231 



The examiner should pass from side to side, continually comparing 
the sounds upon one side, with those upon the other. 

The patient must be calm, and the examiner in no hurry. 

Healthy Sounds. — To become skilful either in percussion or aus- 
cultation, the examiner's ear must first be trained to healthy sounds. 

These are best heard in the child, in whom they are louder than 
in the adult. 

In describing the healthy sounds in the different regions of the 
chest, I shall refer the reader constantly to Figs. 92 and 93. 

Clavicular Region. — This, in Fig. 92, is represented by 1, 1. 
Upon thumping upon the collar-bones, the sound given out at the 
breast-bone end should be very clear ; less clear in the middle ; and 
dull at the shoulder end. 

Subclavian Region. — This is represented by 2, 2, and lies be- 
tween the collar-bone and the fourth rib, on both sides. It covers a 
considerable portion of the upper lobe of the lungs. The sound 
upon striking this place should be very clear. 





Fig. 93. 

The Mammary Region, represented by 3, 3, extends from the 
fourth to' the seventh rib, on each side. In the upper part of this 
region, the healthy sound is clear ; but at the bottom of it, on the 
right, the sound is deadened by the liver ; on the left, by the heart. 

The Infra=Mammary Region, 4, 4, lies between the seventh rib 
and the edge of the cartilages of the false ribs. On the right side, 
the liver makes the sound dull ; but under the left side lies the 
stomach, which is hollow, and the sound is generally quite loud. 



232 DISEASES OF THE CHEST. 

In the Sternal Region, 5, 6, 7, which covers the breast-bone, the 
sound is generally clear. 

The Axillary Region, 8, 8, is in the arm-pits. In this the sound 
should be clear. 

The Lateral Region, 9, 9, is immediately below the above, and 
yields, likewise, a clear sound. 

The Lower Lateral Region, gives a dull sound on the right side, 
and on the left a very hollow one. 

Fig. 93 represents the back part of the chest. In looking at this, 
we see the 

Acromial Region, represented by 11, 11. In this space the sound 
is dull, but it has not much meaning. 

The Scapular Region, 12, 12, covers the part occupied by the 
shoulder-blades. It gives rather a dead sound. 

The Intra=Scapular Region, 13, 13, lies between the shoulder- 
blades, on each side of the back bone. If the patient's arms are 
crossed, and the head bent forward, a clear sound will be obtained. 

The Dorsal Region, 14, 14, covers the base of the lungs, and, in 
health gives, a clear sound. 

Observation. — If, now, on thumping upon the chest, we find a 
dull, dead sound in any spot where a clear one ought to be yielded, 
we are to conclude that underneath there is not the usual quantity 
of air ; but we cannot tell merely, by percussing, whether tubercles 
are deposited there, "or the lung has become solid by inflammation, 
or water has been poured out into the cavity of the pleura. This 
point must be determined by auscultation, etc., to be explained 
gradually as we go along. 

Auscultation of Breathing. — On applying the ear or the stetho- 
scope to the chest, two sounds are heard which immediately succeed 
each other, — the louder is produced by the ingoing breath, or in- 
spiration ; the weaker by the outgoing breath, or expiration. These 
sounds will be further explained as we go along. 

Auscultation of the Voice and Cough. — The chest of a healthy 
person speaking communicates to the ear no distinct sound, but only 
a vibratory sensation, called, in technical language, the pectoral fre- 
mitus. 

Over the larynx and windpipe, the examiner may hear natural 
pectoriloquy ; between the shoulder blades, in the space correspond- 
ing to the roots of the lungs, natural bronchophony. 

Philosophy of Chest Sounds. — The fullness and clearness of 

sound upon percussion, depends upon the amount of air in the chest. 

The sounds called breathing murmurs, are caused by the expansion 



DISEASES OF THE CHEST. 233 

and contraction of the air-cells or vesicles, as the air passes in and 
out ; hence they are called vesicular murmurs. 

The friction of the air against the sides of the windpipe and large 
bronchial tubes causes the blowing sound heard in those parts. 

In children a larger amount of air enters the lungs, and the air 
vesicles are expanded with more force ; hence their breathing has a 
louder sound, which is called puerile respiration. This kind of 
breathing, heard in the grown person, is a sign of disease. 

The lung tissue is a bad conductor of sound; and the voice is ac- 
cordingly heard only over those parts where large bronchial tubes 
are near the surface ; heard elsewhere, it indicates disease. 

Division of Consumption. — Consumption may be divided into 
two kinds, the tubercular and the bronchial. The former has a con- 
stitutional, the latter a local origin. 

First Stage of Tubercular Consumption. 

Physical Signs. - — Dullness of sound on and under the collar- 
bones. Inspiration shortened ; expiration augmented both in duration 
and intensity. This dullness often first perceived in armpits, or at 
base and back of lungs. 

Occasionally a pulmonary, crumpling sound. Dry, crackling rat- 
tles. 

The resounding of the voice increased at the top of the lungs. 

General Symptoms. — A sense of weariness and languor. 

Occasionally, slight, flying pains about the chest and shoulders. 

A peculiar sensitiveness to the effects of cold. 

Breathlessness on moving quick, or ascending a hill or stairs. 

In many cases a blue lividity of the lips and roots of the finger- 
nails, and coldness of the hands and feet. 

Occasionally, in females, even at this early stage, a cessation of 
the monthly turns. These usually stop later in the disease. 

Observations. — The formation of tubercles almost always begins 
at the top of the lungs. Laennec and others thought they appeared 
oftenest on the right side first; Louis, Andral Watson, Sir James 
Clarke, and others, believed they appeared more often on the Ze/^side. 
Recent investigations show that they were all mistaken. Tubercles 
appear first about as often upon one side as upon the other. 

The pulmonary crumpling sound is caused by a mechanical ob- 
struction to the expansion of the lungs. It is generally heard only 
during the drawing in of the breath. The sound is like that pro- 
duced by blowing upon very fine paper. 



234 DISEASES OF THE CHEST. 



Second Stage. 

Physical Signs. — Marked dullness of sound on the collar bones, 
and extending below them. 

Inspiratory murmur diminished in duration and intensity ; expira- 
tory murmur augmented in both. 

In upper lobes of lungs, moist, crackling rattles, succeeded by 
mucous rattles. Also bronchial respiration, or tubular breathing. 

In lower lobes of lungs, puerile respiration. 

Sounds of the heart heard under the collar bones. 

Bronchophony heard in the same parts as bronchial respiration. 

General Symptoms. — A quickened pulse; slight fever towards 
evening, oftentimes amounting to quite high fever. 

Great susceptibility to the effects of cold, and liability to take cold 
easily. 

Bowels generally costive ; oftentimes seat of pain. 

The eye has a peculiar whiteness and lustre. 

The skin and mouth become dry in the afternoon ; chills occur 
about midday, followed by fever, during which the cheeks are flushed. 

As the second stage advances to its close, a dry, burning heat 
afflicts the palms of the hands and soles of the feet. 

Nio-ht-sweats occur at this time. 

Observations. — A hollow, elastic body, containing air, gives, 
when struck, a clear sound. The dullness of sound on percussing 
the chest, arises from the absence of air in the air-cells, — these 
having been pressed together, or obliterated by the deposit of a mass 
of tubercles. The destruction of these cells causes the cessation of 
the respiratory murmur. 

This stage of the disease is often accompanied by an inflammation 
of the mucous membrane lining the air-tubes. The air, pushing its 
way through the mucous secretions in these tubes, forms bubbles, the 
bursting of which causes the rattle. The crepitant rattle is produced 
by inflammation around the tubercles. The moist, crackling rattle 
is caused by the softening of the tubercles. 

The lungs, rendered more solid by the deposit of tubercles, become 
better conductors of sound ; and this causes the beating of the heart 
to be heard as far off as under the collar bones. 

Bronchial respiration gives the idea of air blown through a tube ; 
cavernous respiration, of air passing into a large enclosed cavity. 

Third Stage. 

Physical Signs. — In this stage cavities are formed. If the cavi- 
ties be small, and considerable tuberculated lung surrounds them, the 
sound, upon percussion, is still dull. 



DISEASES OF THE CHEST. 235 

If the cavity be large, and near the surface, there is occasionally a 
tympanitic sound with musical tone. 

Sometimes a sound is heard like striking a cracked pot. 

Gurgling ; cavernous rattle ; cavernous breathing ; amphoric breath- 
ing; now and then, metallic tinkling; pectoriloquy; cavernous cough. 

General Symptoms. — Great loss of flesh, and weakness ; diarrhoea 
and night-sweats ; swelling of the feet and legs ; sore mouth ; and 
raising of matter with specks of tubercle in it like crumbs of cheese. 

Observations. — The gurgling rattle is caused by air displacing 
liquids, and the formation and bursting of bubbles. It resembles the 
sound produced by blowing through a tube immersed in soap-suds. 

Cavernous breathing is nothing more nor less than the sound pro- 
duced by air, breathed in and out, entering and retiring from a 
cavity. The air appears, sometimes, to one listening with the stetho- 
scope, as if it were sucked into his ear during inspiration, and blown 
back again during expiration. 

Amphoric respiration is simply an augmentation of cavernous 
breathing, and results, of course, from an increase of size in the 
cavity. 

In pectoriloquy, words uttered by the patient seem to pass through 
the stethoscope into the ear of the listener. The cavity should be 
empty, moderate in size, and have dense walls, in order to furnish 
the best specimen of this sound. 

Air suddenly driven backward through the windpipe, and out of 
the mouth and nose, by smart raps upon the chest over a cavity, 
gives the sound of the cracked pot. It is best heard when the pa- 
tient's mouth is partly open. The same sound is produced, on the 
same principle, by locking the fingers of the two hands, and joining 
the palms, so as to leave a small space or cavity between them, and 
then expelling the air from that cavity, by gently striking the back 
of one hand upon the knee. 

Causes of Consumption. — The human constitution, as shown by 
Liebig, in his profound work on Animal Chemistry, is governed by 
two forces, the nervous and the vegetative. The former disposes the 
particles composing the body to a state of motion ; the latter inclines 
them to a position of rest. 

In vegetative life there is motion in one direction only, so to speak ; 
that is, motion which tends to the opposite of motion, namely, rest. 
In vegetables, whose life is wholly under this power, there is no waste ; 
for here, all ultimate particles, having once taken a place of rest, 
remain undisturbed. In a tree, a layer of matter once deposited, 
always remains. Hence there is growth as long as the tree lives. 
There is no power to break up and destroy. 

But in the animal body there is motion in two directions, or a 
circuit of motion. Particles which under the vegetative force have 
been put to rest, are perpetually being displaced by the nervous energy, 



236 DISEASES OF THE CHEST. 

and reduced to unorganized amorphous compounds, to be burned in 
warming the system, or cast out by the several excretory processes. 

So constant is the action of these two forces, that John Hunter 
compared the human system to a whirlpool, into which the particles 
of matter are perpetually poured, under the influence of the vegeta- 
tive power, and out of which they are as constantly whirled by the 
nervous force. 

By a little reflection upon these antagonisms, the reader will see 
that it is just when the vegetative force transcends the nervous, that 
the body increases in weight, and acquires that state in which the 
blood corpuscles abound, and the tendency, if to disease at all, is to 
that of the inflammatory kind. It is the tonic condition of the sys- 
tem. Nutrition is more rapid than destruction. New particles are 
laid down faster than old ones are taken up. The body grows. 

On the other hand, when the nervous force overmasters the vegeta- 
tive, when the outward or centrifugal motion of the whirlpool prevails, 
then it is that the body is attenuated, the blood thinned and made 
serous, and the consumptive or atonic condition is established. Now, 
there is too much motion. The nutritive particles, instead of tending 
to a state of deposit for the re-supply of waste matter, become fugi- 
tive in their habits, perpetually fleeing, like convicts escaped from 
prison. Introduce this power, in excess, into the vegetable kingdom, 
and the matter deposited upon the tree, instead of remaining to swell 
its bulk, would be driven off by the nervous force ; and the tree, in- 
stead of growing, would be annually lessened, become sickly, and die 
of consumption. 

In Tubercular Consumption, the system is like a field deluged by 
a flood ; nothing can take root. The repeated shocks of the nervous 
battery sent to the absorbents so quicken them in their work of re- 
moving waste matter, that they dislodge much which is not yet worn 
out, and assist in casting out of the system not a little designed to be 
used in its renewal. A healthy deposit is thus prevented, and nutri- 
tion is at an end. The nutritive arteries, those little builders of the 
human frame, are overmastered by the stimulated lymphatics ; the 
constructive material is wrested from them, and borne beyond their* 
reach, and the body wastes from want of nourishment. The blood 
becomes thin and watery; and from the increased serous portion, 
chiefly albumen, are deposited upon the lungs and other tissues the 
albuminous tumors called tubercles. 

Here is found the cause of _ that peculiar smallness of bone and 
muscle, and thinness and tallness of person, so peculiar to consump- 
tives. The absorbents, under the power of a very active nervous 
system, take down "the house we live in" faster than the nutritive 
arteries, confused by the motion around them, can effect its recon- 
struction. It is simply an unbalancing of the antagonistic forces, 
which build and pull down our earthly tenement. The men that de- 
molish are more numerous and better fed than the artisan builders. 



DISEASES OF THE CHEST. 237 

It is this destructively nervous force which gives to consumptive 
persons their proverbial mental activity ; which causes them often to 
dazzle the world with the splendor of their gifts, and to bless their 
friends with the warmth of their affections. They are usually the 
choice spirits, the idols of their relatives, and the favorites of the com- 
munity in which they live. Their mental movements, and the exer- 
cise of their affections, are characterized by brilliancy and warmth. 
Of all persons, they are best fitted to enjoy life, and to impart happi- 
ness. Loving all, they are by all loved in return. They are speci- 
mens of partially etherealized humanity, stepping lightly across the 
earth, to whom friends passionately stretch out their arms, and em- 
brace — their shadows ! 

These views will appear the more reasonable, if we consider that 
in children the vegetative power is very active, while the nervous 
energy is comparatively weak. The preponderance of the former 
over the latter causes the rapid growth of children. The little arterial 
builders work faster than the lymphatic demolishers. This explains 
why so few children die of consumption. 

But from the age of seventeen to thirty-five, when the vegetative 
power is losing something of its extraordinary activity, and the nerv- 
ous force is showing its highest capabilities, — then it is, as this 
theory indicates, that tubercular consumption does its dreadful work, 
— then, that the outward world of this physiological Maelstrom casts 
upon the shores of mortality so many thinned, exhausted, and lifeless 
human forms. More than three-fourths of all who sink under this 
disorder die between the ages just named. The brain, between these 
points of time, acquires its full size and force. 

This disease prevails most, too, in those countries where an enlight- 
ened civilization gives to the nervous system its fullest development, 
as in Great Britain, France, and the United States, and in those 
where the nutritive process is most retarded by a relaxing climate ; 
and it is scarcely known among those people who are but little en- 
lightened and have small brains, and among those who live in high 
and invigorating latitudes. As the most enlightened, however, are 
generally found in temperate climates, and those with the least culti- 
vated brains in low latitudes, the rule is not perfectly explained by 
facts ; yet it shows itself sufficiently to establish its validity, and to 
afford another proof of my theory. 

Bronchial Consumption. 

The persons exposed to bronchial consumption are generally of an 
opposite habit to those described above, — having the nervous force, 
in health, well subordinated to the vegetative, the assimilation good, 
and the blood well supplied with red globules. They have usually a 
full habit and an active circulation. The absorbents, and other ves- 
sels in the lungs, working in the midst of a large amount of caloric 



238 DISEASES OF THE CHEST. 

evolved by an energetic respiration, often take cold, which brings on 
Inn g-f ever and pleurisy, and these lay the foundation for the ultimate 
destruction of the lungs. For the same reason, the skin of this class 
of persons becomes diseased, and more often the inner skin, or mu- 
cous membrane, and most often that portion of mucous membrane 
which goes down into the lungs and lines the air-tubes. It is inflam- 
mation of this which constitutes bronchitis, and which lays the foun- 
dation for true bronchial consumption. 

As that class of persons who are exposed to the tubercular form of 
the disease suffer a general loss of carburetted hydrogen in its several 
forms, colliquative diarrhoea, sweats, increased breathing, and all con- 
ditions that carry fat out of the system, so those who suffer from 
attacks of the bronchial type of the disorder are generally afflicted 
with the opposite condition. They have too much carbon. 

It is well ascertained that carburetted hydrogen, accumulated in 
the system, acts as a poison. And that class of bilious persons who 
are subject to this disease often have their excretions badly performed. 
For this reason, carbonaceous compounds accumulate in the system, 
and give rise to the symptoms of morbid poison circulating in the 
blood. This led Dr. Madden to suspect the presence of such poison 
in the blood of all consumptive persons. He saw the evidence of it 
in numerous cases, and not distinguishing the one class from the 
other, he inferred its presence in all. 

Constitutional Difference. 

The constitutional difference between the two forms of consump- 
tion appears to be this : the tubercular type is usually attended, in its 
origin, by a tolerably good state of the digestive function, in connec- 
tion with bad assimilation ; while the bronchial form generally has 
its foundation laid in connection with bad digestion, accompanied 
with healthful assimilation. In the former case, the food is well di- 
gested, the pabulum is properly prepared, but the nutritive arteries do 
not use it for renewing the tissues. In the latter case, the digestion 
is bad, the pabulum poorly elaborated ; but the re-constructive vessels, 
under the control of a well-developed system of organic nerves, use 
it to the best advantage. In the one case there are good hiaidk-makers, 
and lazy brick-foyers ; in the other, the reverse. 

It happens, however, that before the fatal close of the disease, tu- 
bercular patients usually become afflicted, more or less, with bad 
digestion, and bronchial patients with defective assimilation ; so that, 
in the end, they present us with much the same class of symptoms. 
Starting from opposite poles in life's celestial sphere, they meet at 
the culminating point of death, and disappear under identical aspects 
of the heavens. 



DISEASES OF THE CHEST. 239 

Exciting Causes of Tubercular Consumption. 

The preponderance of the nervous force being the state which pre- 
disposes to disease, whatever unduly excites the nervous energy in- 
vites an attack. 

These causes relate, mostly, to the prolonged exercise of the intellect, 
the passions, and the sentiments. 

Few are aware of the mischief done by excessive stimulation of 
the mind during the most active period of life, — especially if the 
muscular system be left half developed. Here is where ambitious 
students commit great errors. 

The constant plying of the mental powers, in the present modes of 
educating children, leads to a dreadful abridgment of human life. 
Better to train the bodily powers first, and let* the mental culture 
come in later time. He who would build a lasting structure must 
lay a solid foundation. 

The age in which we live abounds in the causes of excitement. 
The world is trembling with excess of mental life. The pine trees 
burned by the steam-engine are scarcely more numerous than the 
human constitutions consumed by the train of thought it has set on 
fire. 

Nor are the passions and sentiments less exercised, or less destruc- 
tive. 

Briefly, the causes of consumption embrace all those things which 
bring a destructive force against the digestive and assimilative func- 
tions, as insufficient and improper food, debaucheries, night-watches, 
sedentary habits, anxiety of mind, etc. ; and those which act injuri- 
ously upon the breathing organs, as impure air, inflammation of the 
lungs, pleurisy, measles, hooping cough, etc. ; and such as disturb the 
sweating process, as insufficient clothing, sudden changes of temper- 
ature, sleeping in damp sheets, etc. These exalt the nervous force, 
or depress the vegetative, or inflame the mucous lining of the air- 
tubes, or the substance of the lungs, or the membranous sack which 
encloses them, so as to induce one form or other of consumption on 
the principles I have explained. 

The immediate cause of consumption we know, now-a-days, to be 
due to a deposit of tubercles either in the neighborhood of the vocal 
cords, the upper parts of the lungs, or, not infrequently, at the bases 
of the same. These tubercles contain a germ called the Tubercle 
Bacillus, which can only be seen with a high power microscope, 
and then only after being stained with certain aniline colors which 
they absorb. These little germs are of the rod-shaped variety of 
bacilli, and appear under the microscope as little straight lines or 
rods about -^ inch in length. Their presence in the sputum of a 
person means tuberculosis of some part of the air-passages ; when 
they are associated with the presence of yellowish fibres (seen under 
the microscope) they are a proof of the deposit being in the lungs 



240 DISEASES OF THE CHEST. 

proper. The examination of one's sputum, therefore, in the early 
part of any prolonged and suspicious cough, becomes an absolute ne- 
cessity, since thereby one is made aware, in the earliest stages, of 
this dreadful disease, and an opportunity offered of attacking it at once 
in its incipiency. This modern discovery has given rise to much 
experimentation in treatment with the aim in view of killing out the 
germ. Robert Koch of Berlin announced to the world, a short time 
ago, that he had discovered an agent, which he called Tuberculin, 
that would eradicate these death-producing germs, but time has 
shown his efforts to be unsuccessful as yet, although promising of 
great results in the future. These germs are contagious in character, 
so that we now can explain why many contract consumption in whose 
ancestral blood there never existed any tubercular taint. 

We know that husband may impart the disease to w^ife and mother 
to daughter if only the system is in a receptive state to offer a lodg- 
ment to the germs. These tiny but most enduring bacilli retain 
their life for an indefinite time in the midst of dust and other dried 
secretions, so that a practical point is that all persons suffering from 
tuberculous diseases should be exceedingly careful where they spit 
and with whom they sleep. To raise the sputum into small paper 
cups which may be burned is a common and very prudent custom. 

This discovery, while not disproving the old theory of heredity, 
nevertheless explains many a case of acquired Phthisis, and clears up 
many an old-fashioned theory. 

These are indisputable facts from which the medical profession at 
present hope to derive practical benefit by the discovery of some 
germicide which may be applicable and safe for internal administra- 
tion. 

Can Consumption be Cured ? — In many cases it can. It maybe 
cured, first, by the absorption of the tubercles. The celebrated John 
Hunter shows, in his work on the blood, that the absorbent vessels 
have a sort of elective affinity, by which they take up and remove " all 
adventitious new matter, as tumors" (tubercles are albuminous tu- 
mors), more easily « than those parts which were originally formed." 
Were this not so, an activity in these vessels equal to the removal of 
tubercles would cause them to waste all the tissues, and aggravate 
rather than cure consumption. Probably this does occur where 
proper hygienic means are not used to quicken the excretions. This 
hygienic treatment, to be spoken of hereafter, is not generally em- 
ployed, — certainly not as effectually as it should be. Here is the 
source of Laennec's fatal remark, so often quoted and so widely en- 
dorsed, that nature's efforts towards effecting a cure are injurious, 
and those of art are useless." Laennec's position cannot be true, if 
Hunter's statement is correct. If the absorbents, by an elective in- 
stinct, take up adventitious matter rather than the natural tissues, 
then the reason why they reverse this rule in consumption is, that by 
a weakened state of the constitution, the ultimate particles are not 



DISEASES OF THE CHEST. 241 

well put together, and are more easily taken apart than those of the 
adventitious tubercular tumors ; and if we would restore these vessels 
to their natural activity, we must improve assimilation, and knit the 
unloving molecules into a firmer brotherhood. We must make the 
flesh hard, so that the absorbents cannot pick it to pieces. Do this, 
and "nature's efforts to effect a cure" will not "be injurious." 

A second form of cure is the reestablishment of the assimilative 
function, the building up of the general health, the arresting of the 
tubercular deposit, the reducing of tubercles already formed to an 
indolent state ; and then, by a strict observance of the laws of health, 
keeping them in that condition through life. 

A third mode of cure is the healing of the cavities after the tuber- 
cles have softened, broken down, and been expelled in the form of 
expectoration. 

A fourth method of cure is a change of tubercles to calcareous 
matter. These calcareous tubercles, Laennec says, "are consequent 
to tuberculous affections that have been cured" And Andral, at one 
time, hoped to learn how to effect cures by changing tubercles to 
" the calcareous phosphate." 

I have had several cases of cure by this last method, and have 
quite a collection of calcareous substances which my patients have 
coughed up, — one of which was raised in my presence by a lady 
who was a few years before in hopeless consumption, but is now in 
good health. 

Treatment. — This should be of two kinds, local and general. 

The local treatment of consumption is by the inhalation of vapors 
and powders into the lungs. It has been practised, more or less, by 
individuals, for many years, particularly in Europe ; but for some 
unaccountable reason, the profession generally have never used it, 
and do not know much about it. I had the honor, some years ago, 
to bring it freshly before the American public, in some articles writ- 
ten for popular reading, since which time it has been rapidly gaining 
public confidence, and is now attracting much attention. Conveying 
the remedy directly to the diseased parts, it strikes the common- 
sense mind as eminently reasonable and necessary. 

I shall speak of inhalation, therefore, very earnestly, not as a 
palliative of consumption only, but as far more, as a remedy. After 
long and patient use, my experience allows me to say, that I know 
it, in many cases, to be such ; and knowing this, I should be criminal 
not to press it upon the public ; for it is the great multitude of 
sufferers, pressing fast through the gate of death, who need to hear 
words of hope. 

Consumption a General Disease. — It is not denied that con- 
sumption is a general disease, needing constitutional treatment; but 
it has also a local development in the lungs, first in the form of al- 
buminous tumors, called tubercles, and then, after the softening, 



242 DISEASES OF THE CHEST. 

breaking down, and discharge of these, in the more formidable shape 
of ulcerous cavities, which, beginning at the summit, devour the 
lungs down to the base. Can it be reasonable to apply no remedy 
directly to this local disease ? Not so does our profession deal with 
other local diseases. To an inflamed skin we apply poultices, cold 
compresses, solutions of acetate of lead, nitrate of silver, etc. ; to 
leprous or scaly affections, sulphuret of potash, bichloride of mer- 
cury, zinc ointment, nitrate of mercury ointment, sulphur, creosote, 
etc. ; to weak and inflamed eyes, sulphate of copper, sulphate of 
zinc, nitrate of silver, and opium ; to chronic ulcers upon the skin, 
tannin, pulverized rhubarb, opium, or cinchona ; and to an inflamed 
throat, nitrate of silver and other articles. These are but specimens 
of the thousand cases in which we use local remedies. Why, then, 
when the mucous membrane, which lines the air tubes, becomes in- 
flamed through all its branches, should we neglect, by the inhalation 
of medicated vapor, to apply a remedy directly upon the whole in- 
flamed surface ? Why, when tubercular matter is beginning to be 
deposited upon the surface of the air cells, and of the small bronchial 
tubes, should not the vapor go right to those parts, and cause, as it 
would, the immediate expulsion of this offending and dangerous 
matter ? 

Uneducated common sense sees the reasonableness of these sug- 
gestions at a glance. Many a person, with pulmonary disease, dies 
of suffocation, not because there is not muscular strength to expel 
the matter which is strangling him, but because the lungs below the 
large pellets of mucus, which plug up the bronchial tubes, cannot be 
inflated, and have therefore no means of driving out the offending 
substance. Yet a proper medicated vapor, drawn in with the breath, 
would either dissolve the mucus, or rouse up the expiring membrane 
to cast it off. 

If the reader were to place one end of a stethoscope directly over 
the disease upon the breast of a person in the third stage of consump- 
tion, and should then ask him to talk, the words spoken would seem 
to rise up through the instrument, and enter, well articulated, into 
his ear. This, in technical language, is called pectoriloquy, — a word 
signifying chest-talking. It implies a cavity in the lung. If now the 
patient be asked to cough, a gurgling and splashing sound will be 
heard. This denotes that the cavity is partly filled with fluid, which 
is dashed about by the air explosively driven through it by the portion 
of lung below. Here we have an excavated ulcer, with all its filthy 
contents, composed of pus, mucus, serum, and dissolved tubercles, 
lying in it day and night to aggravate its unhealthy condition. What 
more reasonable, what more necessary, than that a soothing, altera- 
tive, or astringent vapor should be drawn into this cavity, to cause 
its sides to heal, and its absorbents to remove this fluid ? A surgeon 
who should permit an ulcer upon the surface of the body to remain 
in that condition without a local dressing would be deemed unfit to 
practise his profession. 



DISEASES OF THE CHEST. 243 

Both in tubercular disease and in simple bronchitis, the bronchial 
tubes almost always sutler some physical change. The mucous 
membrane lining these tubes is generally softened. At other times 
the tubes become enlarged through their whole length, so that many 
of them, from the size of a quill, reach the bigness of the finger of a 
glove. In still other cases, the straining produced by coughing 
causes a tube to belly out at some point, forming a sack, which is 
generally filled with mucus or purulent matter. At still other times, 
a tubercle will press against a tube so as to flatten it and convert it 
into a musical instrument, the air, as it is drawn laboriously through, 
producing a high or low note, according to the size of the pipe. 
These physical changes are all produced by causes which the inhala- 
tion of a suitable vapor, at the proper time, would almost infallibly 
remove. How strange that this remedy, — so simple, so effectual, 
so easily comprehended, — should have been so little used ! 

Right at this vital point in the lungs, where the blood runs in a 
ceaseless current, — where the whole of it goes every two minutes to 
renew its vitality by contact with atmospheric air, — we have, in 
thousands of cases daily occurring, inflammation with roughening or 
softening of membrane, with its consequent harsh breathing ; we have 
mucus, tough or glairy, to impede and interrupt respiration ; we have 
tubercles in the hard or soft state, adding to the general embarrass- 
ment, and not only lessening the vitality of the blood, but disturbing 
all the sympathies of the system ; — and yet the practice has been, 
and is, to attack these central disturbers of life only through the cir- 
cuitous path of the stomach, lacteals, etc. 

I have investigated faithfully the effects of the various substances 
proposed for inhalation by European physicians, and have explored a 
wide field of new remedies, not before used, several of which have 
proved to have qualities of great remedial power. 

The chief remedies I employ for inhalation are the following . 

Alterative Inhalant, composed of iodine, six grains ; iodide of 
potassium, twelve grains ; tincture of ipecac, one ounce ; tincture of 
balsam of tolu, six drams ; ethereal tincture of conium, one and a half 
drams ; alcohol, half a pint. These are to be mixed. The dose is 
one to two teaspoonfuls, to be inhaled ten or fifteen minutes, in 
about a gill of hot water. 

The ethereal tincture of conium is made by keeping a dram of 
powdered conium in one ounce of sulphuric ether a week. 

The above inhalant is used in the tubercular forms of consump- 
tion, particularly that of the scrofulous kind, and in many cases of 
bronchitis. 

Expectorant Inhalant. — Take pleurisy root, half an ounce ; 
squill, one ounce ; ipecac, two drams ; black cohosh, two ounces ; 
queen's root, one ounce and a half; American hellebore, two drams; 
diluted alcohol, one pint. Grind the roots, etc., and add the alcohol. 



244 DISEASES OF THE CHEST. 

Let the whole stand one week, shaking or stirring daily. Draw off 
and filter through paper. Two teaspoonfuls make a dose, to be in- 
haled same as preceding. 

This is to be used when the cough is hard and dry, and the expec- 
toration difficult. It makes the raising easy, lessening the soreness 
of the chest, and the harshness of the cough. 

Soothing, Febrifuge Inhalant. — Take belladonna leaves, half an 
ounce ; black cohosh, two ounces ; American hellebore, half an ounce ; 
poke-root, two drams ; aconite root, one ounce ; diluted alcohol, one 
pint. Grind the roots, etc., add the alcohol. Let the whole stand 
one week, stirring daily. Pour off and filter through paper. Dose, 
one to two teaspoonfuls, to be inhaled as the preceding. 

This is excellent in all cases where the skin is hot, the pulse 
quick, the tongue and mouth parched, the chest sore, and the system 
suffering during the whole or a part of each day, from a general 
feverish condition. It is proper in all the forms of chest disease. 

Astringent Inhalant. — Take of wild indigo, one ounce ; catechu, 
half an ounce ; Peruvian bark, one ounce ; golden seal, one ounce ; 
diluted alcohol, one pint. Mix, and let the whole stand one week, 
stirring daily. Drain off, and filter through paper. Add two drams 
of creosote. One to two teaspoonfuls to be inhaled as preceding. 

This is to be used when the expectoration is profuse and easy, un- 
attended by fever, either in the latter stages of chronic bronchitis, 
when the mucous membrane of the tubes is in a relaxed condition, 
or, in the third stage of tubercular disease, for the purpose of con- 
stringing, cleansing, strengthening, and healing. 

Antiseptic Inhalant. — Take wild indigo, one ounce ; belladonna 
leaves, half an ounce ; diluted alcohol, one pint. Mix, and let the 
whole stand one week. Pour off, and filter through paper. Then 
add solution of chloride of soda two ounces. Dose, one to two tea- 
spoonfuls, to be inhaled as the preceding. 

This is used in cases of gangrene of the lungs,, generally distin- 
guished by considerable expectoration having a very fetid smell. 

Anti=Hemorrhagic Inhalant. — Take witch-hazel bark, two 
ounces ; black cohosh, four ounces. Grind, and add one pint of 
diluted alcohol. Let the mixture stand one week, stirring daily. 
Pour off, and filter through paper. Add to this two drams of creo- 
sote. Dose, one to three teaspoonfuls, to be inhaled as preceding. 

This is an excellent remedy for bleeding from the lungs. When 
there is a tendency to bleed, it should be used for a long time. It 
may frequently take the place of No. 4, as an astringent inhalant. 

For immediate relief give strong solution of salt water. 

Object of Inhalants. — Being vaporized and inhaled, these articles 
enter every air-cell throughout the lungs. Their object is to soothe 
and mollify inflamed mucous surfaces, to reduce enlarged bronchial 






DISEASES OF THE CHEST. 245 

glands which press upon neighboring parts and cause bleeding, to 
stimulate the absorbents to take up and remove tubercles, to dissolve 
tubercles out of the pulmonary tissue, to cause ulcerous cavities to 
expel their mattery contents, and to stimulate their sides to take on 
a healing process. They should be used from three to six times a 
day, the inhalation continuing from ten to fifteen minutes. 

Other Inhalants. — Great numbers of other articles have been 
used, which I have not space to describe. I will mention, however, 
that the following are sometimes employed with advantage : — 

For an Expectorant Inhalant, take alcohol, four ounces ; tincture 
of camphor, half an ounce ; tincture of tolu, two drams ; naphtha, 
one dram ; benzoic acid, thirty grains ; oil of bitter almonds, four 
drops. Mix. 

For an Anodyne Inhalant, take alcohol, four ounces ; naphtha, one 
dram ; benzoic acid, thirty grains ; chloroform, twenty-five drops ; 
tincture of henbane, half an ounce. Mix. 

For an Astringent Inhalant, take alcohol, four ounces ; naphtha, 
one dram ; benzoic acid, thirty grains ; chloroform, one dram ; tannin, 
eight grains. Mix. 

Mode of Inhaling. — For inhaling these, a sponge is fitted into a 
glass cup, to which a flexible tube is attached. A small quantity of 
the mixture is poured upon the sponge, and the vapor arising is 
drawn into the lungs through the tube. 

To the expectorant inhalant may be added, occasionally, half a 
dram of nitric acid. 

These latter formulas are the principal ones used by those who 
practice what is called cold inhalation. 

A very common mode of inhaling volatile remedies is by saturat- 
ing a little cotton, contained in a wire basket, with the desired oil or 
fluid, and placing it over the mouth and nose. It is to be worn 
throughout the day. Oil of peppermint, creosote, menthol, oil of 
eucalyptus, etc., etc., are among the more common remedies thus 
used. 

A good inhaler can be bought of any dealer in surgical instruments. 

Constitutional Treatment. — The rapid breathing in consump- 
tion creates too much oxydation of the blood, — so much, that the 
muscles, especially the heart, are usually of a bright red. To prevent 
the patient from being literally burned up by oxygen, the blood 
must be de-oxydated as fast as possible. 

While there is too much of oxygen, there is, at the same time, a 
deficiency of carbon. Hence the cold hands and feet, and the gen- 
eral inability to bear frosty weather. The little nutritive arteries, in 
these thin-blooded persons, stand shivering and torpid with cold, un- 
able to perform their allotted function of nutrition. There is not 
fire enough, and fuel must be had in the form of carbon. Hence one 
of the advantages of cod-liver oil. This oil, too, as carbon, devours 



246 DISEASES OF THE CHEST. 

the oxygen of the blood, and prevents its destroying the patient. 
This idea also explains the fact mentioned by Bennet and others, 
that in their post-mortems they found the evidences of healed ulcers 
in numerous persons who had been spirit-drinkers while living. And 
Liebig helps the explanation by saying that alcohol, taken into the 
system, circulates in a free state in the blood, and devours its oxygen. 
To which I beg to add, that the malaria of intermittent and bilious 
fever districts, has been pretty satisfactorily proved to be an instable 
organic body, consisting of sulphur, carbon, and Ir^drogen, all of 
Avhich have an affinity for oxygen, and devour it in the system. 
Consumption is not found in such districts. 

As I am here treating of the chemical effects of remedies (and to 
this test most remedies must finally come), I will mention that tar- 
trate of antimony and potassa arrests the circulation in the pulmonary 
arteries, — which fact gives a complete and luminous view of its 
power to prevent oxidation. But I am obliged to detract from its 
merits, by stating that it also retards the circulation in the capillaries 
of the system generally, and so hinders Je-oxidation. 

Phosphorus. — There is an article which has more recently pre- 
sented itself to the notice of the profession, to which I wish to invite 
special attention. I refer to phosphorus. This agent, for a time, 
challenged our notice in the shape of phosphate of lime ; but we could 
never feel sure that this article was dissolved in the fluids of the 
body. We now use, and with far more marked effect, the hypo- 
phosphites of lime, soda, potash, and iron. These are used in the 
form of the syrup of the hypophosphites. The dose is a teaspoonful 
before each meal. The effect ivoon tubercular disease is immediate 
and gratifying. 

Need of Phosphorus. — Cerebric acid contains nitrogen and phos- 
phorus, and is the peculiar component of the brain and nervous sys- 
tem. By combustion and the changes of oxidation in the brain, the 
phosphorus of cerebric acid is converted into phosphoric acid ; so that 
every act of the brain produces phosphoric acid. How rapid, then, 
must be the consumption of the phosphoric element of the cerebric 
acid, in that highly active and excitable state of the nervous system 
which I have described as peculiar to consumption. And how neces- 
sary, in order to save the brain from destruction, to meet this increased 
demand for phosphorus, by introducing it into the system. 

Mulder regards the fibrin of the blood as the carrier of oxygen; and 
by this oxidation, the fibrin becomes converted into the binoxide and 
trioxide of protein, — its phosphorus and sulphur (for it contains 
both) being converted into phosphoric and sulphuric acids. Adding 
phosphorus and sulphur, therefore, as medicinal agents, would seem 
to be the proper way to supply the fibrin with materials destructive 
of its freight of oxygen. 

It is well known that the salts of phosphoric acid are essential for 



DISEASES OF THE CHEST. 



247 



the formation of azotic compounds, — compounds which are neces- 
sary to sustain animal life. It should be remembered, too, as collat- 
erally illustrating this fact, that the tribasic phosphates of potash, soda, 
lime, and magnesia, play an important part in the growth and perfec- 
tion of plants. They are always found in the seeds of the cerelia, and 
no mature grains are produced where phosphates are absent from the 
soil. For the production of abundant grain-crops, it is necessary 
that these salts should exist in the soil, or be applied to it in manures. 

It is known, moreover, that in all chronic diseases distinguished by 
wasting of the tissues, a much larger quantity of phosphates is ex- 
creted by the kidneys than in the normal state. Hence there is no 
healthful growth ; and the human organism, like the soil, exhausted 
of its phosphates by successive croppings, brings nothing to perfec- 
tion, and needs to have its drained salts re-supplied. 

I cannot but call attention here to the inorganic substances found 
in healthy human blood. According to very careful analyses, by 
Schmidt : 



1000 parts of blood-corpuscles, contain : 

Chlorine 1.686 

Sulphuric Acid 0.066 

Phosphoric Acid 1.134 

Potassium 3.328 

Sodium 1.052 

Oxygen 0.667 

Phosphate of Lime 0.114 

Phosphate of Magnesia .... 0.073 



1000 parts of liquor sanguinis (serum 
and fibrin), contain : 

Chlorine 3.664 

Sulhuric Acid 0.115 

Phosphoric Acid . .. . . . . 0.191 

Potassium ........ 0.323 

Sodium 3.341 

Oxygen 0.403 

Phosphate of Lime 0.311 

Phosphate of Magnesia .... 0.222 



Iron is omitted. Now, I venture the prediction, that out of these 
figures, mainly, in connection with those which represent the consti- 
tuents of the saliva, the bile, the gastric juice, the pancreatic secretion, 
and the organic compounds of the blood and tissues, are to be evolved 
within a few years a correct and partially demonstrative system of 
medication. In consumption, all the inorganic bodies represented by 
the above figures, with the exception of oxygen, are deficient in quan- 
tity. By reflecting upon the proportions of these several bodies, par- 
ticularly upon the large amount of chlorine and soda in the plasma, 
and of potassium in the corpuscles, the mind can hardly fail to obtain 
useful hints. I have not hesitated to make one of these hints the 
ground of a very free use of alkalies, — particularly in the form of 
bathing. 

Sugar of Milk. — There is one other medicinal article which I deem 
worthy to be mad prominent, and to be placed side by side with cod 
liver oil and the hypo-phosphites. I refer to sugar of milk. It belongs 
to that class of non-nitrogenized articles which Liebig has denomi- 
nated supporters of respiration. Its great affinity for oxygen is well 
worthy to be taken into the account, in considering its value in con- 
sumption. So great is this attraction, that, with ammonia and other 
alkalies, it has the power of reducing some of the metallic oxides. 



248 DISEASES OF THE CHEST. 

When taken into the stomach, it is rapidly absorbed into the blood, 
which, being an alkaline fluid, augments its great de-oxidating power 
to a considerable degree. It unites rapidly with oxygen after enter- 
ing the blood, forming carbonic acid and water. A part of it, how- 
ever, does not enter the blood in an uncompounded state, but is 
changed in the stomach into lactic acid ; and this, in the blood, be- 
comes an alkaline lactate. But the portion thus changed appears 
also very useful ; for Lehmann says : " We know of no substance 
which could better act in the blood as food for the respiration, than 
the alkaline lactates." 

Corroborative of these views is the fact that all those kinds of 
milk, such as goat's, ass's, etc., which contain the largest amount of 
sugar of milk, have at different times, and in various countries, ob- 
tained a reputation for curing consumption. Goat's whey, in winch 
this article abounds, and from which it is largely manufactured, has 
been celebrated for its virtues in this line. Ancel speaks of it as an 
excellent remedy ; and Pereira says, " Sugar of milk, in consumptive 
cases and chronic 'diseases of the digestive organs, is a most valuable 
aliment." 

One of the best forms of taking sugar of milk is that of a gruel, 
which is quite palatable, and may be freely eaten by consumptive 
persons. 

Creosote, Guaicol, etc. — Modern researches having proved that 
consumption, as well as many throat and other diseases are propa- 
gated by germs or bacilli, as explained on page 239, medical investi- 
gators have for a long time been seeking some agent that would 
destroy these germs without at the same time injuriously affecting 
the human system. A few years ago Dr. Robert Koch, a celebrated 
German scientist, who had long been investigating the consumption, 
cholera, and other microbes, thought he had discovered a lymph that 
would destroy or at least counteract the consumption bacillus ; but 
unfortunately it proved a failure. Creosote, carbolic acid, guaicol 
and similar drugs kill the germ when outside the body, and for this 
reason most therapeutists of to-day use these remedies in as large a 
quantity, and for as long a time as the system will tolerate. At all 
events, whatever may be the outcome of thecustom at present in 
vogue, creosote certainly arrests the rapid proliferation of germ-life 
in the lungs, improves the appetite and digestion, lowers the temper- 
ature, and apparently helps the patient. The only offset to the use 
of this class of remedies lies in the fact that one cannot thoroughly 
disinfect the blood sufficiently to kill these germs completely. Creo- 
sote made from beechwood, taken in three-drop doses with a wine- 
glass of milk, after food, three times a day, is the usual form of 
administration. This dose should gradually be increased till ten and 
even twenty drops are taken at a time. The carbonate of creosote is 
a more elegant and perhaps more effective form of the drug. This 
medicine may also be procured in the form of capsules .and pills. 



DISEASES OF THE CHEST. 249 

By Dr. Cyrus Edison's recently discovered product of carbolic 
acid, asepsin, it is claimed that seventy per cent of consumptive 
cases can be cured. It can only be administered as a hypodermic 
injection, however, at the hands of an experienced practitioner. 

The Cough. — The best article I have ever used for this is the 
"Pulmonic Cherry Cordial." I was five years in compounding this 
article to suit me, and I believe it to be the very best cough prepa- 
ration ever made. Dose, from one to two teaspoonfuls. 

Pulmonic Cherry Cordial. — Wild-cherry bark, ground, 10 pounds 
ipecac root, 20 ounces ; bloodroot, 24 ounces ; squill root, bruised, 12 
ounces ; pulverized liquorice root, 5 ounces ; cochineal, bruised, 2 
ounces ; anise seed, 32 ounces ; fennel seed, 8 ounces ; orange peel, 
16 ounces ; acetate of morphine, 12 drams ; alcohol, 8 gallons ; water, 
8 gallons ; pulverized white sugar, 40 pounds ; sulphuric acid, 1 
ounce. 

Directions for making. — Grind all the articles to a coarse powder 
except those directed to be bruised or pulverized, and put them all 
to the alcohol except the wild-cherry bark, the water, the sugar, and 
the sulphuric acid. Let them stand one week, shaking or stirring 
thoroughly twice a day. Then, having kept the wild-cherry bark two 
days in a covered vessel, with water enough upon it to wet it through, 
place it in a percolator, and run eight gallons of water through it. 
Add this to the alcohol and other ingredients. Let the whole stand 
three days longer, stirring as before, twice a day. Draw off, and fil- 
ter through paper. Now add the sugar, and lastly the sulphuric acid. 
The acid is intended mainly to improve the color, by acting chemi- 
cally upon the cochineal. The color is a fine cherry red, tinged with 
orange. 

I have given the directions for making sixteen gallons — this being 
the smallest quantity in which I make it. Any person can easily 
make the calculation for reducing the quantity. The assertion pre- 
viously made that this is the " best cough preparation ever made," I 
see no cause to modify in the smallest degree. Were it kept in 
every apothecary shop, and were physicians to prescribe in pul- 
monary complaints, adding a little syrup of squills or wine of ipecac 
when a more expectorant effect is wanted, or a little morphine if 
greater narcotism is sought, it would save them much trouble in com- 
pounding cough syrups, and give them much more satisfactory re- 
sults. I have compared its effect, again and again, with the best 
other preparations in use, and I pledge my word that it will succeed 
in twice as many cases as any other compound that may be chosen. 
Let physicians try it; and I will be responsible for ever hair's 
breadth in which they find this proportion of successful results 
abridged. 

When a more quieting effect is needed, a little morphine may be 
added to this preparation ; if a more expectorant influence is required, 
add a few drops of the tincture of veratrum viride. For the great 



250 DISEASES OF THE CHEST. 

majority of cases, it will be found to be right without any addition. 
When this is not at hand, any of the preparations (108), (112), (109), 
(113), (110), etc., may be used. Another good preparation is Dr. 
King's consumption cure. 

Night Sweats. — The very best preparation for these sweats is a 
compound of the oxide of zinc, one dram ; extract of conium, half a 
dram ; to be made into twenty pills, of which one or two are to be 
taken every night. The sponge bath also does much to check these 
sweats, and vinegar baths (369). Atropia, T £ 7 of a grain on retiring, 
and especially Agaricin, i grain, will cause the sweats to stop abso- 
lutely. 

Diarrhoea. — This is a most exhausting symptom in the latter 
stages of consumption. The only remedy which has much effect in 
controlling it is the tris-nitrate of bismuth. This should be given in 
doses of thirty grains immediately after, or at the time of each meal. 
These doses are much larger than used to be given ; but they will 
do no harm. Given to this extent, I find the bismuth very effectual. 

Iron. — This preparation, in some of its forms (316), (73), (159), 
(102), is almost always needed in consumption. If the scrofulous 
habit be strongly marked, give syrup of iodide of iron, in thirty-drop 
doses, three times a day. It should be taken in a glass of water. To 
the feeble administer Gude's pepto-mangan in teaspoonful doses three 
or four times daily. This is one of the simplest and most effica- 
cious forms of iron we have. 

External Irritants. — These are needed where there is much in- 
flammation and soreness of the chest. Blisters should very seldom 
be used. Croton oil, from two to half a dozen drops, rubbed over 
the sore part, generally answers very well. Sometimes the mustard 
paste, applied to the extent of producing redness, two or three times 
a week, is sufficient. Nitric acid, reduced with water to a strength 
a little above the strongest vinegar, answers a good purpose for 
keeping up an irritation. 

Atmospheric Inhalation. — It has been said by Laennec and others, 
that asthma has sometimes the effect of arresting tubercular consump- 
tion. Dr. Ramadge thought this was effected by an expansion of 
the vesicular structure of the lungs ; and he reasoned that the same 
expansion, by mechanical means, would secure a similar end. To ef- 
fect this, he made his patients take long breaths through a tube con- 
structed for the purpose. 

It is manifest that the philosophy of atmospheric inhalation was 
not understood by Dr. Ramadge, nor has it been by any of his fol- 
lowers in this country. 

Rokitansky thinks the tubercular habit depends upon the excess 
of fibrin in the blood ; and says that the reason of consumption being 
arrested by pregnancy is, that this condition offers a mechanical ob- 



DISEASES OF THE CHEST. 251 

stacle to the transmission of blood through the lungs, — thus pre- 
venting its excessive oxidation, and keeping it in a venous state. 
This destroys the fibrinous condition, on which he thinks tuberculosis 
depends. 

Now this is precisely what is done by atmospheric inhalation. The 
trachea divides, on its entrance into the lungs, into two branches, 
which again divide and subdivide until the tubes become smaller 
than can be seen, each terminating in a minute air-cell. Over this 
entire surface the air is intended to be brought into communication 
with the blood for the purpose of oxidating it. By forcible inhala- 
tion, the air-vesicles are inflated to the extent of their capacity, by 
which means the extreme branches of the pulmonary arteries are so 
flattened between these extended cells, as to be able to convey but a 
small amount of blood, and but little is oxidated. This furnishes a 
mechanical obstruction to the transmission of the blood, and secures 
the defibrination of which Rokitansky speaks. 

This is my view of the philosophy of atmospheric inhalation. The 
benefit results, not from a larger amount of oxidation, as is generally 
supposed, but from a smaller. Asthma does the same thing by pro- 
ducing spasmodic contraction of the extreme bronchial tubes, and 
preventing air from entering the cells. 

The same end is gained in part by certain kinds of employment, as 
glass-blowing, playing upon wind instruments, and the like. Writers 
of distinction mention cases of recovery from incipient consumption 
by a vigorous use of the lungs in singing. Dentists subject their 
lungs to a similar process of expansion in the use of the blow-pipe ; 
the writer has known several instances in that profession, in which 
recoveries have taken place. 

The Conclusion to which I come is, that atmospheric inhalation 
may be used with great advantage in some cases, but should never 
be resorted to. except under the direction of a competent physician. 
In a congested state of the lungs, with hsemorrhagic tendencies, or 
with inflammation and soreness, it is well fitted to produce fatal 
bleeding and is of course dangerous. 

External Use of Water. — As a relaxation from severe exertions, 
the ancients had frequent recourse to bathing. Those who contended 
in the race, throwing the javelin, and wrestling, at Rome, plunged 
into the Tiber while warm and panting with their efforts. That this 
promoted prowess and physical endurance, none can doubt. 

Louis, the great French authority on pulmonary diseases, lays 
down several rules to be observed by consumptive patients, and par- 
ticularly mentions cold bathing. 

Few things give tone to the capillaries of the skin like cold water, 
systematically applied. It rallies the powers of the constitution, and 
improves assimilation. And by it another object is gained of scarcely 
less importance, — that of guarding the system against taking cold. 



252 DISEASES OF THE CHEST. 

Those in the daily habit of applying cold water to the whole person 
seldom suffer from colds and catarrhs ; they generally become har- 
dened so as to endure the assaults of the elements. 

Consumptive persons should generally use the sponge bath, with 
cold water, if it can be endured, otherwise the tepid bath, to be fol- 
lowed, in all cases with brisk rubbing, with a coarse towel. If a sense 
of chilliness and discomfort follows the bath, a large portion of the 
water must be squeezed from the sponge, so as to use but very little, 
and the washing must be speedy, and the rubbing more lively than 
usual, — beginning with tepid water, and gradually lowering the 
temperature till it can be borne cold. A large teaspoonful of salera- 
tus to each quart of water should be used. 

Diet. 

The diet, like all other parts of the treatment, must have reference 
to the present condition of the patient. If the disease take the bron- 
chial form, and rapid breathing, and other conditions calculated to 
carry fat out of the system have not yet supervened ; or if the pa- 
tient have thirst and hectic, the diet must be spare and simple, — 
consisting chiefly of milk and farinaceous substances. 

But in all cases where the disease is tubercular, or, being bronchial, 
has reached the stage of emaciation, the very earliest moment at 
which the fever can be subdued should be improved to build up the 
patient with a generous diet. I have seen cases where the stuffing 
sometimes resorted to for fattening turkeys for Thanksgiving would 
seem to be almost justifiable. A good rule is to give the most gener- 
ous diet that can be taken without disturbing the stomach, or increas- 
ing the feverish symptoms. Animal food with a good quantity of 
salt should be freely taken. Fat meats, if well received by the stom- 
ach (and they generally are if taken cold), are particularly useful. 
The same is true of sweet butter and cream. 

Out=Door Exercise. — Without exercise, as a general thing, the 
consumptive patient will die. Exercise involves muscular exertion, 
which is attended by the tension, compression, and greater compact- 
ness of the muscles used. This compression of the muscles within 
the sheaths (fasciae) which enclose them sends out their blood, and 
pushes it forward towards the surface. Reaching the extremities of 
the arteries, the blood passes through capillary tubes, almost incon- 
ceivably fine, into the capillary veins of similar fineness, whence it 
flows through larger and larger veins back to the heart. At the mo- 
ment of its passage from the capillary arteries to the capillary veins, 
it ceases to be red or arterial, and becomes purple or venous blood. 
The oxygen in the arterial and the carbon in the venous blood unite, 
forming a literal combustion, just such as we produce in our stoves 
and grates by bringing together the carbon of the wood and the oxy- 
gen of the atmosphere. By this combustion our bodies are warmed, 



DISEASES OF THE CHEST. 253 

and the little secreting, exhalant, and other vessels, are raised to a 
temperature that enables them to work. 

Every muscular contraction and compression helps push along the 
venous blood in larger quantities to the right auricle of the heart, 
which, receiving a fuller supply of its natural stimulus, contracts more 
energetically, forcing the fluid into the right ventricle. From thence 
it is expelled with increased energy likewise along its only pathway, 
the pulmonary artery, into the lungs. Rushing in here in greater 
volume than natural, a demand is made for deeper inspirations of 
air to vitalize and tit it for its descent by the pulmonary vein, to the 
left auricle. Coming here also as the natural stimulus, in larger 
quantities than usual, it gives increased energy to its own propulsion 
into the left ventricle, from whence it is driven out through the arte- 
ries to all parts of the system, by the powerful strokes of that strong 
muscle. 

Thus it goes its round, urged on by exercise, parting with its oxy- 
gen more and more freely in the capillaries, giving more activity to 
the vessels of the skin and other tissues, increasing the depth and 
strength of breathing by carrying more venous blood to the lungs ; 
improving the digestion, carrying a better elaborated pabulum to the 
nutrient arteries, and causing them to work it up more diligently in 
renewing the tissues. 

Nor is this all. Every wrench of a muscle forces some old, worn- 
out particles from their places, allowing none to remain except such 
as are firm, and able to bear the brunt of exertion. The flesh of those 
who exercise much becomes hard and enduring. 

I say then to the consumptive, if you would live and not die, exer- 
cise, exercise, exercise. It is the first, second, and third thing. If 
you ask for the modes of exercise, I say take it on foot, out of doors, 
every day, to the extent of a small amount of fatigue. Don't be 
frightened by a single cloud, or even by a cohort of them. You have 
as good a right to be out as the clouds ; and they will not look more 
angry, but rather more agreeable from finding you abroad in their 
company. The elements of nature are at war with organic life. 
Against them the vital principle has to maintain a perpetual struggle ; 
and he who loses the power to meet and gain the victory over them 
by out-door exercise, is beginning to die. 

Go abroad, therefore, often. Try it again and again. Extend 
your walk a little every day. Stretch it out to the distant fields. 
Gather flowers from the top of the hills and from the bosom of the 
valleys, and bring them home as trophies of your victory. 

If not able to begin with walking, ride as often as possible in a 
carriage. The jolting of a vehicle will jog the blood along much 
better than no exercise. 

Horseback riding is still better. It combines, in some measure, 
the passive exercise of carriage riding, with the active exertion of 
walking on foot. 



254 DISEASES OF THE CHEST. 

Numerous other modes of exercise may be resorted to with advan- 
tage. Dumb-bells, adapted in size to the strength of the patient, 
and used with caution, are highly serviceable. The battledoor, the 
football, bicycle riding, pitching quoits, and the athletic sports of the 
gymnasium, all have their appropriate place. The greater the variety 
the better, as by it all parts of the system are brought into play, and 
both the mind and the muscles get the change winch they need. 

It is hard to impress patients with the importance of this subject. 
Say what you will, they somehow or other get the idea that a mod- 
erate amount of exercise, taken when they feel like it, is all that is 
required. Fatal mistake ! Whatever the physician may do, the pa- 
tient has a great deal to do for himself. He must strive to develop 
his physical powers to the utmost. He must train himself as runners 
and fighters do when preparing for their surprising feats ; for he is 
running against the swiftest disease (or the surest winner) of our cli- 
mate, and fighting with the elements. 

If he regards life as not worth this exertion, of course he will not 
make it ; but I beg him to consider that without it recovery will be 
uncertain, and in many cases, impossible. Do as I have directed, and 
if your medical attendant is skilful, the current of health will, in 
many cases, begin to flow back to you. Life will renew to you its 
policy of insurance, and multiply your days. 

Travelling: — Consumptive patients have generally been sent to a 
southern climate. But where the case involves dyspepsia and affec- 
tions of the liver, low latitudes are generally unfriendly. Liver com- 
plaints are the bane of a southern climate, and a sallow complexion is 
the inheritance of a southerner. 

Tubercular persons, chilled by our northern climate, are sometimes 
temporarily relieved by the warmer atmosphere of the south. But 
the relief is only temporary ; for, having lost the pow3r, as they im- 
agine, to bear the frowns of our northern sky, the}^ are dying, and 
will die anywhere unless they recover this power. And the way to 
retrieve a lost advantage over an enemy, is, not to retreat to a point 
where recovery will be harder, but to meet him at once. If the con- 
stitution cannot bear up against an enemy under the bracing of a 
northern atmosphere, it will be still harder to do so under the wilting 
of a southern. 

After all, the objects aimed at should be change and travelling. 
The exercise involved, the constant exertion required in getting from 
place to place, the agreeable sensations produced by the motion of 
cars and steamboats, the ever varying change of sights and sounds, 
and the constantly increasing stock of one's ideas of men and things, 
— these are what rally the constitution, and open anew the springs 
of life. 

Especially should all journeys for health be taken, if possible, with 
an object in view. Let the consumptive start with the view of see- 
ing the cave of Kentucky, the prairies of the West, the great lakes 



DISEASES OF THE CHEST. 255 

of the North, the falls of Niagara, the fortress of Quebec, the Sague- 
nay river, the doctor, who he has reason to think will cure him, — 
anything which he is willing to make exertion to see, and that he is 
sure his eyes will rejoice in beholding. 

I have thus spoken of consumption more at large than of other 
complaints, because it is the great disease of the world, and is in- 
creasing with the advancement of civilization. 

Acute Bronchitis. 

This is an acute inflammation of the mucous membrane lining the 
air-tubes in the lungs. , It is generally quite a serious disease. 

Physical 5igns. — The sound upon percussion is generally good. 
If there be any dullness, it is commonly in the lower and back part 
of the chest. This occurs only in " Capillary Bronchitis." 

The breathing murmurs are sometimes more, sometimes less in- 
tense than natural. Occasionally they are almost extinct. 

In the early stage, sibilous and loud rattles. 

In the more advanced stage, mucous rattle. 

Now and then sub-crepitant rattle accompanies the inward-drawn 
breath. 

General Symptoms. — The disease begins with chills followed by 
fever ; tightness across the chest, difficulty of breathing, hoarseness, 
loss of strength, costive bowels, and a quick and hard pulse. Water 
runs from the eyes and nostrils, and there is a dry, harsh, croupy 
cough. 

After a few days, mucus begins to be raised. This expectoration 
gradually becomes more copious, and is opaque, yellowish, or green- 
ish, and occasionally streaked with blood. This mucus is very ropy 
and adheres to the vessel. 

There is more or less pain in the chest ; pain across the forehead, 
which is increased by coughing; and a pale and anxious countenance. 

In severe cases, the tightness across the chest is extreme, with a 
sense of suffocation, causing the patient to call for the opening of 
the windows. There is great difficulty of breathing ; a paleness and 
lividity of the cheeks and lips ; a loud wheezing and rattling in the 
throat, followed by cold sweat, insensibility and death. 

In children the disease comes on like a common cold, attended by 
a sore throat, a great desire to drink, but a disinclination to take 
food. But two or three swallows of drink can, be taken at a time 
for want of breath. The phlegm is frequently vomited up spon- 
taneously. 

Observations. — The loud and sibilous rattles are produced by 
similar causes, namely, the passage of air along tubes whose interior 
is dry and rough from inflammation, or whose calibre is contracted or 
altered in form by the swelling of the membrane, effusion upon its 



256 DISEASES OF THE CHEST. 

inner surface of a tough, mucous substance, or a pressure upon its 
external surface of tubercles, swollen glands, aneurismal tumors, 
etc. The two sounds differ mainly in the key upon 'which they are 
pitched, — the sonorous, or low-keyed, coming from the larger tubes; 
the sibilous, or high-keyed, from the smaller, — just as the low notes 
of an organ come from the large pipes, and the high notes from the 
small ones. 

The sibilous rattle has been compared to the chirping of birds, the 
squeaking of puppies, the whistling of air passing through a key- 
hole, etc.; the sonorous, to the snoring of a sleeping person, the 
cooing of doves, and the sound of the bass-string of the violoncello 
rubbed with the ringer. 

Causes. — It is generally brought on by a sudden cold, by changes 
of the weather, and by inhaling irritating substances. It is a second- 
ary result, too, of scarlet fever, measles, small-pox, hooping cough, 
and the remittent fever of infants. 

Treatment, — In mild cases, give warm balm or flax-seed tea, hot 
lemonade, or other similar drinks, — at the same time soaking the 
feet in hot water, and, on retiring to bed, apply bottles of hot water 
to the feet and sides, to produce sweating. If the bowels be costive, 
some gentle physic, as rhubarb and magnesia, or salts and senna, may 
be taken. 

In the case of infants, an emetic of wine of ipecac, or compound 
tincture of lobelia, should be given, and followed with slippery elm 
and flax-seed tea. The compound tincture of lobelia, with tincture 
of veratrum viride, may be continued for a time as an expectorant. 

In more severe cases, both of adults and children, an active emetic 
is required, — perhaps the compound powder of lobelia is as good as 
any. This must be followed with tincture of veratrum viride, in full 
doses, so as to reduce the pulse at once, and keep it down to the 
natural standard. This is one of the very best articles in this com- 
plaint, and will generally very much lessen its violence and duration. 

If there is much difficulty of breathing, the air of the room must 
be kept moist, as recommended in croup. 

The room should also be kept warm, — decidedly warmer than in 
the case of other fevers. 

A gentle perspiration should be kept up by small doses of com- 
pound tincture of Virginia snake-root, and by frequently bathing the 
surface, or else by tincture of veratrum. 

Mustard should be applied to the chest, and to the soles of the feet. 

The cough may be managed by preparations (104), (106), (110), 
freely given. 

The diet should be confined to barley-water, toast-water, apple- 
water, rice-water, and a solution of gum-arabic, 






DISEASES OF THE CHEST. 257 



Chronic Bronchitis. 

This is an inflammation of the mucous membrane of the air-tubes, 
which continues a great length of time, without any sudden or re- 
markable changes. 

Physical Signs. — The percussion-sounds are similar to those of 
acute bronchitis. When a bronchial tube is dilated, we sometimes 
have dullness around the dilated part. 

The breathing murmur is always accompanied by a mucous, sono- 
rous, or sibilant rattle, — sometimes by a subcrepitant. 

When dilatation of the tubes exists, the intensity and duration of 
the sound of the ingoing breath is decreased, — of the outgoing 
increased. 

In this state of the tubes, we also have cavernous breathing, bron- 
chophony, sometimes pectoriloquy, and bronchial or cavernous cough. 

General Symptoms. — A cough is generally present, which is in- 
creased in wet weather, and by every slight cold. This comes on in 
paroxysms ; is generally worse in the morning ; and is relieved by 
raising freely. The matter raised is generally yellowish, but some- 
times whitish and sticky; and in the latter stages is thick, and 
sometimes very much like that of consumption. Indeed, the disease 
often ends in bronchial consumption. • 

Remarks. — The breathing is bronchial or cavernous when the 
dilated portion of the tube is empty ; if it contain fluid, the 
mucous rattle will be heard. 

Dullness on percussion will exist if a dilated tube press upon the 
surrounding portion of lung so as to condense or make it solid. 

Dilatation of the tubes occurs only in chronic bronchitis of long 
standing. Its physical signs are much like those of a cavity in ad- 
vanced consumption. The examiner may learn to distinguish them 
by considering that in consumption, dullness precedes the cavity, while 
in bronchial dilatations, the cavity precedes dullness. 

The dilatation or swelling out at some point of a bronchial tube 
is caused by obstructions to the passage of air through it, — just as 
an India-rubber tube, partially closed up at a given point, will bulge 
out just in front of the obstructed place, when air is forcibly blown 
through it, and just as the left ventricle of the heart enlarges when 
the blood is obstructed in its passage through the aortic valve. 

Causes. — It often occurs as the result of acute bronchitis, and 
also of measles, hooping-cough, etc. But taking cold, and damp and 
changeable weather, are more frequently its causes. It most often 
follows chronic inflammations of the throat, which, being neglected, 
gradually creep down the windpipe into the tubes, and become very 
obstinate in their character. 




258 DISEASES OF THE CHEST. 

Treatment. — Medicinal inhalation is one of the best remedies for 

this complaint. The inhaling powder has, in many cases, great 

efficiency. The dose is about what can lie on a ten-cent piece. It 

should be used once a day, in an instrument represented in the cut. 

This instrument I had constructed for my use. It consists mainly 

of a glass tube and a receiver, — 
the latter being something like a 
tube-vial, pierced with fine holes 
around the lower end. The pow- 
FlG 94 der is poured into the receiver, 

which is placed in the larger tube, 
and twirled between the thumb and finger while inhaling. 

When the powder cannot be easily got down into the tubes in the 
lungs, — as often happens, — the inhalation of medicated vapor will 
do better. If the expectoration be difficult, the expectorant inhalant, 
described under " consumption," should be used; if the expectoration 
be too profuse and free, the astringent inhalant must be taken. 

The cough preparations recommended for consumption, also (113), 
(112), will be the proper ones in this complaint. 

The daily alkaline bath, and brisk friction, are particularly service- 
able. 

Out-door exercise is almost as necessary in this disease as in con- 
sumption. 

Enlargement of the Air=Cells, — Emphysema. 

This disease consists in enlargement of the air-cells, the oblitera- 
tion of their vessels, and the wasting of their walls. 

Physical Signs. — Thumping upon the chest gives a clearer and 
louder sound than natural, — one which is tympanitic, or drum-head 
like. 

The murmur of the ingoing breath is diminished both in duration 
and intensity, — of the outgoing breath, it is increased. 

Dry, crepitant rattle attends the ingoing breath only; occasionally, 
sibilous rattle. 

General Symptoms. — Habitual shortness of breath, and very 
great difficulty of breathing, occurring in paroxysms, which cause 
the patient to rush to the open window for air. 

There is generally a cough, and the matter raised is frothy, liquid, 
and mucous, or watery. 

The face has a peculiar dusky color, and the countenance an anx- 
ious, melancholy expression. The nostrils are thick, and the lower 
lip full. The muscles of the neck are large, and the gait of the pa- 
tient is stooping. The strength is wasted in proportion to the diffi- 
culty of breathing. 

Emphysema tends to produce disease of the heart, Blight's disease, 
and venous congestions in the head. 



DISEASES OF THE CHEST. 259 

Observations. — The tympanitic sound is caused by the increased 
amount of air in the cells. 

The air-cells have lost their elasticity, the air, in a great degree, 
remains in tliem, — not passing in and out, — hence the absence of the 
vesicular murmur. 

The crepitant rattle attends the ingoing breath only, and is sup- 
posed to arise from the expansion of the lungs which are in a drier 
state than natural. It has been compared to the sound producd by 
blowing into a dried bladder. 

Treatment. — To whatever extent the air-cells are destroyed, to 
that extent, of course, the disease is incurable. It may, however, be 
palliated and relieved to a great extent. 

Generally, bronchitis exists in connection with emphysema ; and 
when this is found to be the case, the remedies for that disease must 
be employed. (370) often is curative. 

The inhalation of tincture of stramonium, in one or two teaspoon- 
ful doses, the same as the alterative inhalant is used, will be useful. 

To be taken internally, an excellent preparation may be made by 
uniting one dram of etheral tincture of lobelia with two drams of 
tincture of ipecac, and two ounces of ammoniac mixture. The dose 
is one or two tablespoonfuls. Half-grain to grain doses of extract of 
cannabis indica are excellent to relieve the difficulty of breathing. 

The diet must be very carefully regulated, as overindulgence at the 
table aggravates the symptoms. 

Change of air is often highly beneficial ; but it is impossible to 
predict its effect beforehand in each individual case. 

Swelling of the Lungs. — Hypertrophy of the Lungs. 

This can hardty be regarded as a disease. It generally takes place 
in but one lung, and is the result of the inaction of the other. Thus, 
when one lung is diseased, the other has to do the work of both ; and 
being overworked, it enlarges, as the heart or an arm does when very 
much exercised. 

The only treatment required is to eat sparingly, and exercise with 
great moderation, so as not to increase the rapidity of the breathing. 

Pulmonary Apoplexy. 

This is generally the result of a disease of the heart, particularly 
of the mitral valve. 

Physical Signs. — Percussion yields a clear sound, except where 
the engorgement of blood is large, and near the surface, — in which 
case, it is dull. 

The sound of breathing is feeble or absent over a limited space. 



260 DISEASES OF THE CHEST. 

Bronchial breathing is heard in some places, and bronchophony in 
part, in the same regions. 
Mucous rattle is also heard. 

Observations. — In this disease the small air-tubes and air-cells are 
the seat of bleeding ; and the blood becoming coagulated here, closes 
these vessels against the entrance of air. This explains the feeble- 
ness or absence of the breathing murmur. 

The fluidity of blood in the immediate vicinity gives rise to the 
mucous rattle. 

General Symptoms. — These are, difficulty of breathing, tightness,, 
and dull pain in the chest. The mucus raised is tinged or streaked 
with blood. The blood raised is darkish, and dirty-looking. This 
last symptom, the dirty look of the blood, is peculiar in this disease. 

Treatment. — The most important remedy is dry-cupping upon the 
chest. This will often arrest the disease at once. Counter-irritation 
by croton-oil is also useful. A free movement of the bowels by a 
preparation containing croton-oil, or elaterium (31), (33), has an ex- 
cellent effect. 

Air in the Chest. — Pneumothorax. 

This disease consists in the presence of air in the cavity of the 
pleura. Generally, there is also water in the pleural sac at the same 
time ; the water, being the heavier fluid, occupying the lower part of 
the cavity, and the air the upper part. 

Physical Signs. — Tympanitic or drum-like sound over the upper 
part of the side. Dull sound over the lower part. Breathing mur- 
mur diminished or suppressed. Amphoric breathing. Metallic tink- 
ling. 

General Symptoms. — Great oppression of the chest, and difficulty 
of breathing ; generally attended by palpitation of the heart, and fre- 
quently by severe pain under the breast-bone, on the affected side. 
The patient generally has to remain in the sitting posture, and can- 
not lie an instant on the sound side. 

If, on percussion, one side of the chest sounds louder than the 
other and the breathing murmur is heard distinctly on the side which 
gives only a moderate sound, and is not heard at all on the loud- 
sounding side, we may be sure it is a case of air in the chest. 

Observations. — The metallic tinkling is like the sound produced 
by dropping a pin's head into a metallic dish, or like the distant tink- 
ling of a sheep-bell, or the gentle pulling of the string of a violin. 

It is supposed that when the fluid in the cavity of the pleura hap- 
pens to be higher than the orifice, the air, when it enters at each 
in-drawn breath, forces its way up through the fluid, in the shape of 



DISEASES OF THE CHEST. 261 

bubbles, and, bursting at the surface, gives the tinkling sound. This 
sound is sometimes produced, too, by the falling of drops of liquid 
from the upper part of the cavity, upon the surface of the fluid. 

The amphoric breathing is like the sound produced by blowing 
obliquely into an empty cask. One writer says he heard the same 
sound when out shooting on a rough day, produced by the wind blow- 
ing sideways into the gun-barrel. 

Treatment. — I would recommend the use, two or three times a 
day, of the antiseptic inhalant, mentioned under the head of con- 
sumption. 

To this should be added dry-cupping over the whole chest, which 
generally gives great relief. Blisters may also be used. 

Sweating must be encouraged in the manner recommended under 
acute bronchitis. 

For the difficulty of breathing, give half-grain doses of cannabis 
indica, or five-drop doses of tincture of aconite, or one-sixth of a 
grain doses of svapnia. Extract of belladonna, or of stramonium, is 
also worthy of trial. 

Water in the Chest. — Hydrothorax. 

This disease consists in a collection of water in the cavity of the 
pleura. 

Physical Signs. — There is a dull sound over the effusion. 

The breathing murmur is diminished, and gradually disappears 
altogether over the space occupied by the effusion. 

Bronchial breathing is heard in the same part. 

When the amount of fluid is small, egophony is heard in the mid- 
dle regions of the chest. 

Bronchophony is heard when the effusion is larger. 

General Symptoms. — Either upon lying down, or using active 
bodily exercise, the patient finds his difficulty of breathing increased. 
When in bed, he lies with his head and shoulders raised, which, by 
causing the fluid to settle at the bottom of the cavity, prevents, in a 
measure, its pressure upon the lungs, and gives him a little rest. 
His sleep is interrupted by sudden starts with alarm and terror. The 
pulse is hard, the thirst great, the urine scanty and high-colored, and 
has a sediment. After a time the feet swell, the face is pallid and 
livid, and the countenance expresses anxiety and alarm. There is a 
short, dry cough. 

When the quantity of fluid in the chest becomes large, the patient 
cannot lie down at all, and only gets short and disturbed naps in the 
sitting posture. 

Of all the symptoms, the starting in sleep is the most certain sign 
of the disease. 



262 DISEASES OF THE CHEST. 

Causes. — In some rare cases, this may occur as a primary disease, 
— that is, as a disease not dependent upon any other as its cause. 
The greater number of cases, however, are secondary. They arise 
from organic disease of the heart, or liver, or stomach. Inflammation 
of the pleura is a very frequent cause. 

A plethoric, or full state of the system, predisposes to this com- 
plaint, — particularly in those persons who indulge freely at the 
table. 

It may arise, too, from the striking in of skin eruptions ; from the 
free use of liquors ; and from frequent excessive bleedings or purg- 
ings. 

Treatment. — Dry-cupping is a valuable remedy, and should al- 
ways be practised. 

The chest should be painted with the tincture of iodine, and a 
good degree of substantial soreness be kept up. 

The internal remedies are purges (31), (14), (30), and diuretics 
(123), (129), (130), (131) when the patient is not very weak. 

The iodide of potassium, in doses of five or six grains, once in 
three or four hours, is an excellent remedy. The following is a good 
form of taking it : iodide of potassium, one ounce ; fluid extract of 
pipsissewa, two ounces ; water, half a pint. Dose, one teaspoonful. 

The skin should be bathed and rubbed daily, three or four times, 
with much friction. Tapping the chest should be done when the 
fluid persists any length of time, otherwise a simple hydrothorax may 
become a doubly serious empyema or pus in the chest. 

Pleurisy. — Pleuritis. 

Pleurisy, or pleurisy fever, as it is sometimes called, is an in- 
flammation of the pleura, or the membrane which lines the chest, 
and, at the same time, is folded back so as to cover the outer surface 
of the lungs. 

The pleura, as is elsewhere explained, is a short sac or bag, whose 
inner sides are kept moist, so that they may slide easily upon each 
other as they are moved by the alternate contractions and expansions 
of the lungs in the act of breathing, and whose outer sides are made 
to grow, — one to the inside of the chest, and the other to the out- 
side of the lungs. 

Pleurisy and lung-fever, then, must be kindred diseases, and exist, 
more or less, together. In truth there is almost always some affec- 
tion of the pleura in lung-fever, and some affection of the lungs in 
pleurisy. The pain in lung-fever is owing to some inflammation of 
the pleura ; and the appearance of the rusty-colored phlegm in pleu- 
risy indicates that the lungs have been reached by the inflammation 
of the membrane which covers them. 

Physical Signs. — Flatness on percussion, at the lower part of the 
chest, which ascends as the effusion of water increases. 



DISEASES OF THE CHEST. ZbS 

If the effused fluid is not great, there is puerile breathing- at the 
top of the lung. 

Friction sound is heard occasionally in first stage of disease. 

Egophony is heard when the amount of fluid in the pleura is 
small. 

As the amount of water increases, bronchophony appears. 

General Symptoms. — This disease is most frequently introduced 
by shiverings, which are soon succeeded by high fever, with a pecu- 
liarly hard, resisting pulse; sharp, stabbing pain in the side, — gener- 
ally just below the nipple, but sometimes extending to the shoulder, 
arm-pit, and back ; hurried and interrupted breathing ; and a short, 
dry cough. 

The pain is greatly aggravated by motion, coughing, or an attempt 
to take a long breath. It holds the patient under constant and 
powerful restraint. We find him lying upon his back, or his well 
side ; his countenance full of anxiety, — fearing to move, cough, or 
even breathe needlessly ; and often crying out from the keen torture 
these necessary acts inflict in spite of all his caution. 

At a more advanced stage, when the tenderness has somewhat 
abated, he will prefer to lie on the diseased side, as this leaves the 
healthy lung more at liberty. 

Observations. — The first effect of the inflammation of the pleura 
is to dry up the moisture with.which its inner surfaces are lubricated, 
or made smooth and slippery. As a consequence, these surfaces be- 
come rough, and rub harshly upon each other, and produce a sound, 
in the early stages of pleurisy, like that of rubbing two pieces of wet 
leather together. It may be imitated by rubbing the finger back and 
forth upon a table. It is sometimes a creaking noise, like that of 
new shoes. 

As the disease advances an important change takes place in the 
state of things. Instead of an unnatural dryness, a watery fluid is 
poured out copiously from the inflamed surfaces of the pleural sac. 
This is called the period of effusion. This generally, though not al- 
ways, relieves the pain. But, by compressing the lung, causes dan- 
gerous difficulty of breathing. 

The air-cells are compressed by the effused fluid, and are not 
penetrated by air. Hence the absence of the breathing murmur. 

The pouring out of water between the layers of the pleura, com- 
presses the lung, and removes it from the walls of the chest. Hence 
the dullness or deadness of sound upon percussion. 

When listening with the stethoscope, the voice of the patient 
sounds feeble and interrupted, like the bleating of a goat, and is 
hence termed, egophony, or goat-voice. 

This peculiar voice is heard only when the effusion of water has 
been moderate in quantity, and only a thin layer of liquid lies be- 
tween the ribs and lung. It is caused by the voice passing over this 



264 DISEASES OF THE CHEST. 

thin layer, which is thereby thrown into vibrations, or wavy, quivering 
motions. When thus agitated, the fluid reacts upon the voice, 
making it sharp and tremulous. 

When the effusion has become large, these effects cease ; but an- 
other sign then shows itself, and distinguishes pleuris}^ from the 
healthy state, and likewise from the solid, hepatized state of the 
lung in lung-fever. It may be discovered thus : 

If the hand be laid flat upon the chest of a healthy person, while 
he is speaking, a vibration or thrill will be left. If, in like manner, 
the hand be laid upon the chest of a person having lung-fever, with 
hepatized lung, this thrill will be found still more perceptible. But 
when the hand is placed over the place of watery effusion on the 
chest of a person having pleurisy, there will be discovered, when the 
person speaks, no thrill whatever. The absence of this thrill, then, is 
one of the very best signs of pleurisy ivith effusion. 

Persons recover from pleurisy sometimes very rapidly, before effu- 
sion has taken place. It is then said they have had an attack of dry 
pleurisy. When liquid has been poured out, even in considerable 
quantity, it is sometimes reabsorbed, and the patient recovers per- 
fectly. In other instances, it compresses the lungs, interferes seri- 
ously with breathing, reduces his strength, and he sinks rapidly. 

Treatment. — Pleurisy has been divided for description and treat- 
ment into three stages, following the natural events of the inflamma- 
tion. The first stage comprises the period from the first onset to the 
time when effusion commences. The second stage, or stage of effu- 
sion, extends to the time when the liquid begins to diminish ; and 
the third stage consists of the period occupied by the absorption of 
the liquid. 

Should the quantity remain stationary or diminish very slowly 
after the lapse of two or three weeks, the disease becomes chronic. 

The indication for treatment during the first stage is to arrest the 
progress of the disease, to diminish its intensity, to limit the amount 
of morbid products, and to relieve suffering. 

If the patient is robust, has a hard, frequent pulse, accompanied 
with extreme pain and fever, blood-letting is indicated. The abstrac- 
tion of ten to fifteen ounces of blood will give great relief and 
diminish the intensity of the attack ; but if the patient is not seen 
early, and is of a feeble constitution, some other measures should be 
substituted for it. The mass of blood may be lessened by saline 
cathartics, such as the sulphate of magnesia, or the bitartrate of 
potash in combination with jalap. 

The effect of a full dose of Epsom salts is equal to the abstraction 
of a pint of blood from the system. Depletion is obtained this way 
without the impoverishment of the blood. 

The frequency and force of the heart's action may also be affected 
by the nauseant sedatives, such as tartarized antimony and ipecacu- 
anha, and by the direct sedatives, such as the tincture of aconite and 






DISEASES OF THE CHEST. 265 

of veratrum viride ; therefore, if blood-letting is contra-indicated, the 
first thing to be done is to give the sulphate of magnesia, and follow 
it with some diaphoretic like (130), to alleviate the painful stitch in 
the side and to tranquillize the system. 

It is well to administer salicylate of soda in 10-grain doses every 
three hours till a little ringing is heard in the ears, then once in four 
hours. This drug increases the action of the skin and kidneys and 
overcomes the rheumatic element present in most if not all pleurisies. 
The diet should be dry, all liquids being excluded, that the abstrac- 
tion of water from the chest may be favored. 

Nothing gives so much and such immediate relief to pain as a 
subcutaneous injection of morphine. Aconite also is a valuable 
sedative in this stage. It may be given in half or whole-drop doses 
every fifteen minutes for two hours ; then afterwards a drop, to be 
repeated hourly till some impression is made upon the heart's action. 
Smaller doses are to be given if the pulse becomes feeble. 

In the second stage, if the acute symptoms have yielded to treat- 
ment, as they usually do, the object of treatment is to promote the 
absorption of the fluid. This is done by the judicious use of saline 
cathartics and by diuretics, for the bowels and the kidneys are the 
natural pumps of the system. 

The application of counter-irritants is also of use for this purpose, 
such as the tincture of iodine, and small blisters, which are to be 
allowed to remain on till vesication, and then the blister is to be 
dried up and a new one applied. If at any time during this stage 
the effusion is rapid and excessive, so as to endanger life, it is to 
be drawn off by puncturing the chest between the fifth and sixth 
ribs on the side with a small trocar, and the fluid is to be drawn off 
by suction. 

Convalescence commences when the liquid begins to be absorbed ; 
and active medication should then cease, and that course should be 
pursued which will lead to the restoration of the general health. 
This is done by tonics, a nutritious diet, and other hygienic means. 
If the effusion ceases to be absorbed or the process takes place very 
slowly, then that state of things exists which is called chronic pleu- 
risy. Then the main objects of treatment are to effect the removal 
of the fluid, and to develop and sustain the powers of the system. 
Under these circumstances, it is better to discontinue remedies which 
act upon the bowels and kidneys, at least for a time, and try general 
treatment. This consists of tonics, stimulants, and general exercise 
in the open air, and with this the surgical removal of the fluids from 
the cavity of the chest. 

The operation is now so much improved, and is so safe and simple 
and attended with so little pain, that it has become an every-day 
practice, and an operation which was only resorted to as an extreme 
measure to save life, is now admissible whenever the pleural cavity 
remains filled with liquid, after only a brief trial of the remedies 
assigned to promote absorption. 



266 DISEASES OF THE CHEST. 



Lung Fever. — Pneumonia. 

This disease, by common usage, has been called a fever ; but by 
physicians it is reckoned as one of the inflammations. It is inflamma- 
tion of the lungs or lights ; and whatever fever there may be results 
entirely from this local inflammation. 

Signs and Symptoms. — A patient suffering with lung fever is 
generally found lying upon his back, with some pain in the side ; 
more or less difficulty of breathing ; a cough, at first dry, but soon 
accompanied by raising a thick, sticky, rusty-colored matter, composed 
of a mixture of phlegm and blood. As the disease increases in 
severit}', this matter will become more sticky and tenacious, so that 
it will adhere to a spit-cup turned upside down. There will be more 
difficulty of breathing, greater prostration, and perhaps some delirium. 

For the purpose of more clearly describing this complaint, it is 
found convenient to divide it into three stages, or degrees of progress. 

First Stage. — This is called the stage of engorgement. The lungs 
during this stage are engorged or crowded with blood. If we could 
inspect them, we should find the inflamed portion redder, thicker, and 
heavier than usual. We should find them weaker, that is, more 
easily torn than in the natural state ; with less air in them, and con- 
sequently crackling less upon pressure, — yet not entirely destitute 
of air and crackling, and not so heavy as to sink in water. Rapping 
upon the chest at this period gives out a flatter, duller, or less hollow 
sound than usual. On applying the stethoscope, we hear less of the 
natural rustling sound of health ; and, either mingling with, or over- 
coming it, we hear a minute crackling sound, as the air passes in and 
out in breathing. 

This crackling has been compared to that produced by fine salt 
thrown upon red-hot coals ; or by that of rubbing a lock of fine hair 
between the thumb and finger near the ear. It is caused by small 
bubbles of air being forced along the moist and sticky sides of the 
small tubes and air-cells. It is heard only while the breath is being 
drawn in. 

Second Stage. — If the inflammation advances to the second stage, 
the swelling of the diseased lung increases so as to force out the air 
entirely, and it becomes solid, and wholly useless for the purpose of 
breathing. In solidity and general appearance, it resembles a piece 
of liver. Hence it is said to be hepatized, or liverized ; and this is 
called the stage of hepatization. 

As the lung grows more solid, its vitality and strength diminish ; 
it is not near as strong as a piece of healthy liver, though it looks 
like it ; it is soft and easily broken ; indeed it seems to be in a state 
of commencing decay or rottenness. Hence some writers, in order 
to be more precisely correct, call this the stage of red softening. 



DISEASES OF THE CHEST. 267 

With increased solidity, there is of course increased dullness on 
percussion. When the stethoscope is applied to the chest, we hear 
no sound of air passing into and out of the diseased lung ; no natural 
rustling, or minute crackling ; but in their stead, we have a kind of 
whistling, produced by the air passing back and forth in the wind- 
pipe and its branches, but finding no entrance into the solidified air- 
cells. The breathing sometimes sounds like a sort of puff, — owing 
to the column of air rebounding when refused admission to the 
closed-up cells. 

The general symptoms now increase in severity. There is greater 
difficulty of breathing; the phlegm is more gluey; perhaps some 
delirium shows itself ; and the patient grows weaker. 

Third Stage. — At this period, the lung changes from red hepa- 
tization or red softening to gray hepatization or gray softening, and 
matter is now found diffused through its whole substance. The 
percussion sounds are much the same as in the second stage. On 
listening, we hear more of the rattling sound produced by disturbed 
phlegm. The matter raised is thinner, — more like liquid ; and 
looks like prune-juice. The symptoms generally indicate that the 
patient is sinking. Patients may recover from the first and second 
stages, but rarely from the third. 

Treatment. — Pneumonitis has been divided into three stages, 
corresponding to the inflammatory events of the disease: the first 
stage is that of active congestion, the second, that of solidification, 
and the third, that of resolution. The duration of the first stage is 
from twenty-four to forty-eight hours, of the second from two to 
four days, and the stage of resolution lasts from eight to ten days. 
Different cases vary, however, in these times. These different stages 
furnish different remedial indications. 

The objects of treatment in the first stage are to arrest the disease, 
to lessen its intensity, to relieve pain, and to promote toleration of 
the disease. 

When high fever, a hard pulse, and extreme pain are present in a 
robust constitution, the abstraction of blood from the arm is indi- 
cated. These cases are not frequent, for lung fever mostly occurs 
in patients with feeble constitutions, but when practised in the 
proper cases, the relief to pain and embarrassment of breathing is 
often immediate and marked. In those cases where blood-letting is 
contra-indicated, the same end can be secured, but more slowly, by 
saline cathartics and sedative remedies. After saline purgation, if 
the skin is hot and the pulse is frequent, tartar emetic may be given 
in small doses as a nauseant sedative ; but it must not be carried to 
the extent of distressing nausea. After this follows the use of vas- 
cular sedatives, such as the tincture of aconite and the tincture of 
veratrum viride, if not contra-indicated by the feebleness of the 
patient with a tendency to depression. 



268 DISEASES OF THE CHEST. 

Sometimes the sulphate of quinine, in a full dose of from twenty 
to twenty-five grains at the onset, or within eight or ten hours, will 
arrest the disease. It may be well to try it, as it can be administered 
with perfect safety. Opium is of great importance also, to relieve 
pain and tranquillize the system. 

Cold or warm applications to the chest may be used according to 
the preferences of the patient. Warm applications act as revulsents ; 
the cold diminishes the determination of blood to the part, and re- 
lieves the pain by obtunding sensibility. Counter-irritants are not 
advisable in that stage. 

The treatment of the second stage aims at the promotion of reso- 
lution of the inflammation, the palliation of the symptoms, and the 
maintenance of the powers of life. 

The tinctures of veratrum viride and aconite may be continued in 
this stage, if there is considerable fever and there is no tendency to 
asthenia ; but the leading measure is to support the system. 

The rational use of veratrum viride, than which there is no better 
drug in Pneumonia, consists in giving five-drop doses hourly till the 
pulse reaches sixty per minute, then just often enough to keep the 
pulse in that neighborhood. 

This course embraces the use of tonics, stimulants, and nutritious 
diet. The use of alcohols is necessary in most cases, and sometimes 
very freely. The diet should consist of milk, farinaceous substances, 
and animal broths. Quinine in tonic doses is the best remedy in 
this stage. 

The preparations of opium are very useful, and only contra-indi- 
cated by the accumulation of mucus in the bronchial tubes. 

Digitalis is useful in five to ten grain doses three or four times a 
day, when it is necessary to increase the heart's action. 

The carbonate of ammonia is necessary in cases of extreme pros- 
tration. 

The external application of the tincture of iodine is the best 
counter-irritant in this stage. 

During the third stage, all those hygienic measures which improve 
the general health are to be pursued. 

Typhoid Lung Fever. — Typhoid Pneumonia. 

This is an inflammation of the lungs, differing from the preceding 
only in the character of the fever attending it, which is of a low, 
typhoid character. The disease, like typhoid fever, is characterized 
by great debility and prostration. 

Symptoms. — These are a combination of the symptoms of pneu- 
monia and of typhoid fever. The disease begins with great weari- 
ness, lassitude, dizziness, pain in the head, back, and limbs. Soon 
there is much difficulty of breathing, tightness across the chest, with 
a dry, short, hacking cough. 



DISEASES OF THE CHEST. 269 

As the disease advances, the active symptoms pass away ; there is 
a dull pain across the chest ; drowsiness is very apt to come on, with 
the various symptoms of sinking peculiar to typhoid fever. The 
skin is harsh and dry, the temperature uneven, the tip and edge of 
the tongue red, and the middle covered with a yellow or brown fur. 
The bowels are tender, swollen, and drum-head like ; while there is 
often a diarrhoea, — the discharges having a dirty-yellow color. 

Treatment. — This should be like the treatment of pneumonia 
and typhoid fever united. 

Great care must be taken not to use reducing remedies. While 
active purging must not be used, yet, if there are symptoms of an 
inactive state of the bowels, podophyllin and leptandrin (34), (39), 
may be employed with advantage. 

When there are symptoms of great depression, use tonics (46), 
(48), (50), (53), (60), (64), (67), (73), taking care to keep the 
cough loose by flaxseed, slippery elm, and marshmallow tea, and by 
some external irritant. 

Broncho-Pneumonia. 

This is an infectious inflammation, characterized by an exudation 
from the blood-vessels, the formation of new connective tissue, and 
the growth of bacteria. The disease involves the walls of the bronchi 
and the air-spaces surrounding the inflamed tubes. It is frequently 
called capillary bronchitis and catarrhal pneumonia. It is the ordi- 
nary pneumonia of children, and is frequently seen in young people. 

It comes on primarily, but is often secondary to measles, whooping- 
cough, etc. 

Symptoms. — In the very young, the only symptoms are fever, 
prostration, and rapid breathing. There is no cough, no physical 
signs, but the disease is, almost always, fatal within a few days' time. 

There is a great difference in the invasion of the disease in dif- 
ferent cases, the severer cases being ushered in by one or more con- 
vulsions, by rapid rise of temperature, vomiting, difficulty in breathing, 
and delirium; the milder cases beginning with lower temperature, 
moderate prostration and shortness of breath. 

The height of the temperature is, as a rule, in proportion to the 
severity of the disease. Temperatures of 105° and over are usually 
fatal. The pulse reaches 150 to 170 in adults, and even higher in 
children, — so high, in fact, that it cannot be taken. The respiration 
varies from 40 to 80. Sleeplessness, restlessness, and even delirium 
are frequently present. The face is flushed, the tongue coated, and 
oftentimes diarrhoea and vomiting occur. Cough is usually present, 
and in the young the sputum is swallowed. The urine is frequently 
albuminous and contains casts. 

Between the second and fifth days the signs of consolidation and 



270 DISEASES OF THE CHEST. 

■r 

pleurisy appear, i. e., dullness on percussion, bronchial breathing and 
bronchophony with crepitant rattles. 

The duration of the disease in children varies : of the fatal cases 
the majority die within the first fortnight. The cases which recover 
vary from one to three weeks, though many persist for six and eight 
weeks. The softening and absorption which occurs in all pneumo- 
nias that recover occupy a much longer period in broncho-pneumo- 
nia than in lobar pneumonia. 

Many cases of broncho-pneumonia are complicated by cerebral 
symptoms of convulsions, delirium, stupor, vomiting, etc., even before 
any marked lesions in the lungs appear; as these subside the lung 
symptoms appear. Many cases are protracted for a long time, and 
though they may terminate favorably at last, yet they are apt to run 
into a chronic hardening of the lung which lasts for years ; or they 
recover with a permanent consolidation of the lung. Some die of 
exhaustion. 

Treatment. — The use of hot fomentations and poultices over the 
chest and the administration of small doses of ipecac and aconite at 
short intervals soothe the bronchitis and pain. 

For the cerebral symptoms, phenacetin and the bromides are very 
useful. Aconite and digitalis are usually employed when the pneu- 
monia stage comes on. As a rule stimulants are not required in 
children, in whom the disease most frequently occurs. 

In convalesence, iron, quinine, cod-liver oil, oxygen and a change 
of air are to be recommended. 

Other Forms of Lung Inflammation. 

Of the various other forms of lung inflammation which occur, 
mention may be made of pneumonia dependent on Heart Disease ; 
Interstitial Pneumonia, or the formation of new connective tissue 
and obliteration of the air-spaces ; Tubercular Pneumonia, which is 
caused by the presence of tubercle bacilli; Acute and Chronic Mi- 
liary Tuberculosis, characterized by the presence of numerous minute 
nodules called miliary tubercles ; Acute and Chronic Tubercular 
Consumption.; Gangrene of the Lung, where a portion of the lung 
has lost its vitality and the germs of putrefaction have entered. 

Asthma. 

Asthma may be defined to be great difficulty of drawing in the 
breath, — coming on suddenly, sometimes gradually, — accompanied 
with a sense of extreme suffocation, and a desire for fresh air ; con- 
tinuing for a longer or shorter period, and then passing away, and 
leaving the patient a period of comparatively easy respiration. 

Symptoms. — There are sometimes no premonitory symptoms, 
the attack coming on suddenly, and without warnings but more fre- 



DISEASES OF THE CHEST. 271 

quently there are, for some days before the onset, loss of appetite, 
flatulence, belching of wind, irritability, languor, chilliness, oppres- 
sion, and drowsiness. The hard breathing generally makes its 
appearance in the night, — quite often at three or four o'clock in 
the morning, when the nervous system is at its lowest ebb. There 
is first a sense of tightness, or stricture, across the chest, which 
seems to expand with difficulty. The patient can no longer remain 
lying down ; he rises up, draws up his knees, and, leaning forward, 
puts his elbows upon them, and his head upon his hands, and then 
struggles hard to draw in his breath ; which, passing in slowly and 
laboriously, produces a loud wheezing sound. Sometimes he feels 
that he must have fresh air, and, rushing to a window, puts his head 
far out, to catch a stirring breeze. The hands and feet are cold, the 
face haggard and distressed, — sometimes a little red and swollen, 
but more generally pale and shrunk, — the body wet with perspira- 
tion, the pulse irregular, feeble, and small, though sometimes not 
disturbed. These symptoms continue for some hours, more or less, 
when the breathing becomes more easy, and there is a little phlegm 
raised, sometimes considerable. This cessation of difficult breathing 
may be complete, or only partial ; and lasts for a longer or shorter 
period, when the attack again recurs. 

Causes. — It is well known that Asthma has its cause mainly in 
the nervous system. The air-tubes are encircled with a series of 
little bundles of fibres, which are, in fact, muscles, and like all other 
muscles have the power of contracting or shortening themselves. 
These muscles, too, like all others, have nerves distributed to 
them ; and when these nerves become diseased or irritable, they will 
become disturbed on certain occasions, and cause these small, circu- 
lar puckering strings to contract and close up. the air-tubes near 
their terminations, very much as the puckeririg-string closes the 
mouth of the work-bag, so that very little air can pass into the air- 
cells, and that little with great difficulty and slowness. When these 
contractions take place, and the air is thus shut off, the result is a fit of 
asthma. This disease may be brought on by any of those states of 
the atmosphere which disturb or irritate the bronchial surfaces, or by 
any of the numerous causes which mysteriously unbalance the 
nervous system. A fit may be brought on by whatever disturbs the 
mind. 

Treatment. — The disease has been regarded as extremely diffi- 
cult of cure. There are certain remedies, however, which have a 
remarkable control over it, and, if skilfully used, will frequently 
bring it to a complete termination, and, even in the worst cases, to a 
state of very great mitigation and improvement. 

Inhalation. — The most important and certain remedy is the use 
of the Alterative Inhalant, described on page 243. I have with this 
article alone effected some surprising cures ; yet it is well to combine 



272 DISEASES OF THE CHEST. 

other treatment with it. I have had several cases of a most distress- 
ing character, — the attacks continuing night and day, — in which 
the inhalation, judiciously administered, has caused the disappearance 
of the complaint within twenty-four hours, and in which no return of 
suffering has occurred for several weeks, and then only in a modified 
form. This remedy should be used four or five times a day. 

Iodide of potassium is a most valuable internal remedy in this 
complaint; indeed, in a certain sense, it is almost a specific. It 
should be used (prescriptions 101, 138, 140, 151) at the same time 
with the inhalation. The following preparation is a very good 
remedy for this disease : Ethereal tincture of lobelia, two ounces ; 
tincture of asafcetida, one ounce ; grindelia, one ounce ; iodide of 
potassium, two ounces ; simple syrup, four ounces. Mix. Dose, 
from a teaspoonful to a tablespoonful, every hour or two. 

Several other remedies are used for asthma, with more or less 
success, such as electro-magnetism, smoking stramonium leaves, 
burning paper dipped in a strong solution of nitrate of potash, and 
inhaling the smoke, etc., — but none of these, have as much value as 
the two remedies first named. 

In as grave a complaint as a severe case of asthma, it is always 
well to seek the aid of a physician. 

Hay- Asthma. — Hay = Fever. 

This is a very troublesome complaint, which seems to combine 
the peculiarities both of asthma and of influenza. Fortunately, it 
attacks but few persons, and those only at particular seasons of the 
year, — namely, while hay is in blossom, and during hay-making. 

Symptoms. — These are a combination of the symptoms of the 
two diseases above named. There is great irritation of the eyes, 
with sneezing, and a free discharge from the nose. There is 
tightness across the chest, difficulty of breathing, and a pricking 
sensation in the throat. These symptoms often appear in great 
severity, making the complaint a really distressing one. 

Cause. — This disorder appears to have but one cause, — namely, 
some sort of emanations from the grasses, flowers, etc., while in 
blossom ; which emanations come in contact with the mucous lining 
of the eyes, nose, and throat, producing very great and teasing irri- 
tation. 

Treatment. — One of the best remedies for this troublesome com- 
plaint is to avoid the cause, by removing, during the flowering and 
haying season, to some large city, or, still better, close down to the 
seashore, where flowers and hay do not grow. 

Of medicines, the tincture of lobelia, taken in moderate doses, is 
a very good remedy. Quinine and iron, given in combination (75), 
are valuable preparations. Strychnine and nux vomica, in connec- 



DISEASES OF THE CHEST. 273 

tion with iron or otherwise (316), (83), (84), (85), (86), (95), are 
very useful. Iodide of potassium (101), (138), (140), is also worth 
a trial. Another very good remedy is the chloride of lime, or the 
chloride of soda, placed in saucers about the sleeping-room. Pieces 
of cotton cloth may also be dipped in one of these solutions, and 
hung about the apartments of the house. The hands and face may 
likewise be washed, once or twice a day, in a weak solution. 

The oxide of zinc and the extract of nux vomica, made into pills, 
two grains of the zinc to half a grain of the extract to each pill, and 
one pill taken morning and evening, should not be forgotten. 

Of late cocaine, painted by means of a camel's hair brush on the 
mucous membrane of the nose, has been used to check a paroxyism 
and mitigate the disease. 

The following formula is the most efficacious of this class of 
remedies and should be painted onto the nasal mucous membrane as 
high uj) as possible ; its use may be repeated several times till the 
membrane becomes numb. 

Cocaine 12 gr. 

Antif ebrin 25 gr. 

Alcohol 1 dr. 

Simple Elixir '. 3 dr. 

Mix and shake before using. 



HEAET DISEASES. 



Life rests upon a tripod, — the brain, the lungs, and the heart. 
These are equally important to its well-being and continuance. 

In substance, the human heart is a bundle of muscles, so put to- 
gether as to bear the greatest possible amount of work. In size, 
shape, and look, it is much like the heart of the hog. I wish it 
never had a likeness to it in its moral nature. 

The heart is enclosed in a case or sac, called the pericardium. It 
lies between the two lungs, a little to the left side of the chest. Its 
point is under the sixth rib on the left side, and its lower surface 
rests on the diaphragm, — a horizontal partition between the chest 
and belly. 

The heart is double. It has four cavities, — two for receiving the 
blood, which are called auricles, and two for driving it out, called 
ventricles. 

The venous, or dark blood, is brought from all parts below, and 
emptied into the right auricle through the ascending vena cava, and 
from all parts from above, and pour into the same cavity through 
the descending vena cava. From this it passes into the right ventri- 
cle, which contracts, and forces it through the pulmonary artery into 
the lungs, where it becomes red, and passes into the left auricle 
through the pulmonary vein, thence into the left ventricle, which 
contracts, and throws it out through the great aorta to all parts of 
the body. Fig. 95 gives a good idea of the circulation through the 
heart and lungs. 

The heart is divided into two sides, which are separated from each 
other by a muscular partition, — each side having an auricle and a 
ventricle. 

The auricles have comparatively thin walls, as they are only used 
for reservoirs. The walls of the ventricles are much thicker, being 
used, — particularly that of the left side, — for forcing the blood 
over a large surface. 

Between the auricle and ventricle on the right side, are three folds 
of triangular membrane, called the tricuspid valves. Between the 
auricle and ventricle on the left side, are three valves, called mitral. 

At the beginning of the pulmonary artery, and the aorta, are three 
half-moon shaped folds of membrane, called semilunar valves. 

274 



HEART DISEASES. 



275 



The office of all these valves is, to close after the blood has gone 
through, and prevent its flowing back while the cavity is being again 
filled. They do the same duty, in fact, as the valves of a pump. 

Through this heart, thus constructed, all the blood in the body, — 
about twenty-eight pounds, — passes once in about one minute and a 
half. This is rapid work; and when we consider that the heart 
works in this way through the whole life, resting not, day or night, 
we cannot wonder that it gets out of order. 




Fig. 95" 



The whole heart is seldom affectefl. 
to disease than the right. 



The left side is more liable 



Impulse of the Heart. 

The ear, when placed over the heart, feels, at each beat, a slight 
shock. This is felt at the same time the first sound is heard. This 
impulse is caused by the apex or point of the heart being thrown up 
against the ribs by the contraction of the ventricles. It is felt best 
between the cartilages of the fifth and sixth ribs on the left side. 



The Sounds of the Heart. 

On applying the ear to the chest just over the heart, two sounds 
are heard. The first one is dull and slightly prolonged ; the second 
is a shorter and smarter sound, having a sort of clack. These occur 
in pretty rapid succession, and then comes a brief interval. And this 
round of action, first a long and dull sound, then a short and smart 
one, and then an interval, — called the heart's rhythm, — is repeated 
continually. If the space of time occupied by the rhythm be divided 



276 HEART DISEASES. 

into five parts, the first sound will take about two parts, the second 
one, and the interval of repose, the remaining two, The first sound 
is heard about the time of the contraction of the ventricles, and is 
therefore called the systolic sound ; the second is synchronous with 
the opening of the ventricles, and is called the diastolic sound. The 
syllables too-to — too-to, very fairly represent the two sounds of the 
heart. These sounds are heard over the largest space in lean 
persons. 

Percussion Sounds. 

If the ends of the fingers be struck upon the chest over the heart, 
a dull sound will be heard over a space from one and a half to two 
inches square, — beginning at the fourth rib on the left side, and ex- 
tending down nearly to the sixth. The dullness is diminished by 
lying upon the back, and increased by leaning forward, and by taking 
a full breath. The deadness of sound is caused by the heart being 
a partially solid body. The lungs which surround it yield a clear 
sound. 

If a solid substance, as large as the heart, were placed on the in- 
side of a drum, against the head, only a dead sound would be ob- 
tained by striking on that spot ; everywhere else, the sound would 
be louder. 

Altered Sounds of the Heart. 

These sounds are changed by disease in a variety of ways, both as 
to their character and duration. One or both sounds may be turned 
into a noise like the blowing of a pair of bellows. This is called the 
bellows sound. When this sound is very harsh, it may become like 
the noise of a rasp, or file, or saw. These altered sounds are all pro- 
duced by an altered condition of the valvular passages through 
which the blood passes. If you build an aqueduct of equal dimen- 
sions throughout, and smooth on the inside, you may send a certain 
volume of water through, at a given speed, without noise. But if 
you make sudden contractions in the aqueduct, or allow large stones 
to project into it, and then attempt to send through the same bod}^ 
of water, at the same rate of speed, you will hear all sorts of noises. 

Enlargement or Hypertrophy of the Ventricles. 

This is simply a thickening, or an increase of bulk, in the walls 
of the ventricles. The muscles composing the walls of one or both 
of these cavities grow thick and large. 

Physical Signs. — Impulse stronger than natural. When consid- 
erable, it is accompanied with a lifting and heaving of the parts. 
Dull sound on percussion over a larger space. First sound of heart 
prolonged; second sound feeble. The interval of silence, shorter 
than natural. In bad cases, the second sound is nearly extinguished. 



HEART DISEASES. 277 

General Symptoms. — Hypertrophy of left ventricle gives a strong, 
prolonged, and tense pulse. Palpitation more constant than in any 
other disease of the heart. In advanced stages, the patient is easily 
ont of breath. There is a rush of blood to the head on making exer- 
tion or stooping, with more or less throbbing and lancinating head- 
aches, which are aggravated by suddenly lying down or rising up. 
There are vertigo, ringing in the ears, sparks of light and other illu- 
sions before the eyes ; also a purplish, violet or livid color upon the 
cheeks, nose, and lips. In many cases there is a dull, severe aching 
pain in the region of the heart, and extending towards the shoulder 
and the inside of the arm. 

When the right ventricle is enlarged, there is a swelling of the ex- 
ternal jugular veins. 

Causes. — The walls of the heart are thickened by overwork, in the 
same way that the blacksmith's arm is made muscular and large. All 
muscles grow in the same way. More action sends more blood to 
them, and this causes an increase of nutrition. 

Whatever interposes an obstacle to the passage of the blood through 
the valvular openings, will cause the ventricles which force it through 
to work harder. Hence, obstructions in the semilunar valves cause 
hypertrophy of the ventricles. 

Any excitement of the mind, or any great exertion, which causes 
the heart to beat harder and faster, if it be often repeated, will induce 
a thickening of the ventricles. 

Treatment. — First, remove, as far as possible, all causes of excite- 
ment which produce palpitation. If the head is much affected, apply 
wet cups to the back of the neck. The same may be applied over 
the heart. This will generally improve the symptoms at once. A 
blister placed over the heart will likewise make a favorable impres- 
sion. 

The meals should be taken at regular intervals, and should be very 
light. The food should be plain and simple, and composed much 
more of vegetable than of animal food. In fact, the diet should be 
so spare as slightly to reduce the strength. 

The patient should be careful never to take violent exercise, or, 
indeed to be in a hurry about anything. In bad cases, walking up 
hill, or against a strong wind, is often out of the question, and must 
in any case be attempted with great caution. Staircases are to be 
shunned as enemies. An attempt to run, even to avoid being left by 
the cars, might, in some cases, prove immediately fatal. Carriage- 
riding is not objectionable. 

The passions must be held in the most thorough subjection. Ex- 
citements of all sorts are dangerous, and must be avoided. 

For the first week or two of treatment, active purgatives will be 
useful. For this purpose, epsom salts and senna will answer a good 
purpose, and should be used so as to procure two or three watery 
stools a day. 



278 HEART DISEASES. 

Iii addition to this, some sedative to lessen the force of the heart's 
action is generally needed, especially when there is considerable 
palpitation. For this purpose, tincture of black cohosh, and tincture 
of scullcap, or the former with tincture of digitalis (285), (94), are 
quite useful. Three to ten drops of tincture of the American helle- 
bore (veratrum viride) will reduce the action of the heart perhaps 
more effectually than any other medicine, for a few days or weeks. 

Dilatation of the Ventricles. 

The several cavities of the heart hold about one and a half ounces 
each. Dilatation is simply an enlargement of these cavities, so that 
they will hold more. And this increase in the size of the cavity in 
simple dilatation is generally at the cost of the walls, which are made 
thinner and weaker, — just as the walls of a bladder are made thinner 
by blowing into it and increasing its internal dimensions. 

Physical Signs. — Impulse more abrupt, and less marked than nat- 
ural. Dull sound on percussion commensurate in extent with the 
dilatation. The first beat of the heart, clearer, louder, and shorter 
than natural, and more nearly resembling the second. 

General Symptoms. — Difficulty of breathing; terrific dreams; 
starting from sleep ; swelling of the feet and legs ; purple, violet, or 
blue color of the cheeks, nose, lips, and especially around the eyes ; 
feeble and oppressed palpitation ; various disturbances in the head ; 
bleeding from the nose, stomach, bowels, and womb ; and frequently 
enlargement of the liver. 

Explanations. — The first sound of the heart is short and not well 
marked, in consequence of the muscular walls of the ventricles in 
this disease being thin and in a weakened condition, so that every 
stroke they make is short, quick, and spasmodic, instead of strong 
and lifting, as in hypertrophy. For the same reason, the impulse is 
a brief blow dealt the walls of the chest, which gives a slight shock, 
but has not power enough to lift the chest up. The blow is quick, 
because the muscle is thin and can contract quicker than a thick one. 

Dilatation, by thinning the walls of the cavities, enfeebles the heart, 
and shows us an obstructed circulation. Accordingly the blood is 
not transmitted by the left ventricle, and being retained in the lungs, 
it causes a crowded state of the vessels, and difficulty of breathing ; 
also congestion of the brain, with terrific dreams, etc. And this en- 
gorgement of the lungs, being propagated backwards to the right 
heart, great veins, and all their ramifications, produces dropsy of the 
feet and legs, discoloration of the face, passive hemorrhages, and con- 
gestion of the brain, liver and membranes. Fig. 95 gives an idea of 
how all this happens. 

Treatment. — As in many other diseases, search out the causes, and 
remove them. If it be obstruction of the circulation in the lungs by 



HEART DISEASES. 279 

bronchitis or other complaint, that needs the first attention. If it be 
caused by violent exercise, by strong emotions of the mind habitually 
indulged, or by drunkenness, or any other irregularity of life, these 
habits must be corrected without delay. 

If it be caused by organic disease of the valves of the heart, relief 
cannot be so readily obtained ; but even in these cases, it is to be 
sought and expected. 

The circulation is to be kept as tranquil as possible by a strictly 
quiet and orderly life, and a plain, moderate, unstimulating diet. In 
this disease, however, it should be more nutritious, and composed to 
a larger extent of meats, than in hypertrophy. 

In some cases the general health and tone of the system will need 
to be improved by bitters (50), (67), (64), (69), (79), mineral acids 
(60), iron (269), (61), and aromatics (115). The compound mix- 
ture of iron is a good preparation when this mineral is called for by 
a low state of the blood. 

The stomach should be kept in the best possible condition, as a 
very small disturbance of it, even from acidity, will set the heart to 
beating very violently. 

If hysterical symptoms are present, the compound galbanum pill, 
and valerian (97), and other nervines will be called for. 

In attacks of great difficulty in breathing, immerse all the extremi- 
ties in warm water, and throw a blanket around the patient to pro- 
mote sweating, — at the same time admitting fresh air to satisfy the 
desire for breath. Give a draught, composed of ether, camphor, 
ammonia, etc. (135). This may be repeated two or three times, at 
intervals of half an hour, or an hour, according to the urgency of the 
case. 

Hypertrophy with Slight Dilatation. 

This is one of the most common complications of heart disease. 
It consists both in a thickening of the walls of the heart, and an en- 
largement of the cavities, — the former being more marked than the 
latter. 

Physical Signs. — Both sounds are louder than in any other dis- 
ease of the heart, and are heard sometimes over the whole chest. 
The impulse is strong and heaving, with an abrupt back-stroke. In 
bad cases, the whole person, and even the bed, is shaken by it. The 
dull sound on percussion covers a large space. 

General Symptoms. — The same as those of the two diseases of 
which it is composed, slightly modified by the action of each upon 
the other. 

Dilatation with Slight Hypertrophy. 

This is an enlargement of the cavities of the heart, with a slight 
thickening of its walls ; the dilatation being the predominant disease, 
or greater than hypertrophy. 



280 HEART DISEASES. 

Physical Signs. — Percussion gives a dull sound in the region of 
the heart, in proportion to its size. The first beat resembles the sec- 
ond. The second beat is louder than natural. 

The impulse is a short, quick stroke, which contrasts strongly with 
the slower and heavier one of hypertrophy and dilatation. 

The general symptoms and the treatment are a modification of 
those of the two disease united in it. It is, however, to be kept in 
mind that the dilatation takes the lead ; and, furnishing the predomi- 
nant symptoms, is specially to be regarded in the treatment. 

Aneurismal Tumors of the Heart. 

When, from some obstruction in the valves, the blood cannot easily 
pass out of an auricle or a ventricle, its inner walls may become 
unable to bear the distending force, and giving way, let the blood 
through against the outer coats, which stretch, and swell out into the 
shape of a tumor, — the inside of the tumor becoming a regular sac. 
Such a state of things constitutes an aneurism of the heart. Of 
course it is a very grave disease. 

Softening of the Heart. 

In this disease the substance of the heart becomes soft, and easily 
broken. It is generally the result of some form of inflammation. 

Physical Signs. — The contractions of the heart being weakened 
by softening, the impulse is reduced in force, and both beats are 
weaker, and often they are intermittent. The first beat becomes 
short and flapping, like the second. 

General Symptoms. — A quick, feeble, small, and faltering pulse, 
great anxiety, and a disposition to faint. General languor ; a sallow, 
bloodless, withered complexion, with a purple, livid tint of the lips 
and cheeks, and frequently, general dropsy, from the inability of the 
heart to propel its contents. 

Treatment. — When accompanied by acute inflammation, softening 
is to be treated on the same principles as inflammation of the heart- 
case. 

If it be a result of chronic inflammation, it calls for iron, bitters, 
nutritious animal food, and good air. 

Induration of the Heart. 

The muscular substance of the heart sometimes undergoes a hard- 
ening process. It is occasionally so much hardened as to sound, 
when struck, like a hollow horn vessel. The disease is rare. 

It increases the heart's impulse, like hypertrophy ; and it requires 
about the same treatment as that disease. 



HEART DISEASES. 281 



Fatty Degeneration of the Heart, 

The heart sometimes becomes overloaded with fat, which is depos- 
ited between the heart-case and the muscular substance, — covering 
the organ all over externally, and in some cases penetrating to some 
depth into its substance. The muscular walls themselves become 
thin and flabby. 

Symptoms. — The sounds of the heart are diminished, — especially 
the first. The pulse is irregular. Pain, and a feeling of oppression 
in the region of the heart, with general signs of retarded circulation, 
such as congestion of the brain and liver. There is occasionally gid- 
diness, loss of memory, and palpitation. 

Treatment. — Exercise, mental excitement, and stimulating drinks 
must be avoided ; and the patient must live for one or two years on 
a very light diet, taking but very little animal food. 

Bony and Cartilaginous Productions in the Heart. 

These productions in the heart are fortunately rare. Yet they 
occur; and the point of the heart, in its whole thickness, is some- 
times changed to cartilage. The ventricles are sometimes so ossified 
as to resemble the bones of the head. 

The symptoms of these degenerations are . obscure ; and as such 
cases are not curable, it is of less consequence that we should be able 
to know their precise nature during the life of the patient. The 
treatment can only afford temporary relief, and should be such as is 
prescribed in other heart-diseases with similar symptoms. 

Shrinking of the Heart. — Atrophy. 

The heart, like any other muscle, is liable to defective nutrition, 
and in consequence of it may become small. It shrinks, in some 
cases, to the size of an infant's heart. 

The complaint is generally caused by whatever reduces the general 
flesh, as consumption, diabetes, chronic dysentery, cancer, and exces- 
sive loss of blood. 

It can hardly be called a disease. Persons who have it are less 
subject to inflammatory diseases than others, though they faint from 
slight causes, and have nervous affections. 

Treatment. — If its causes can be discovered, trea't them; if not 
the treatment should be the same as for dilatation. 

Acute Inflammation of the Heart=Case. — Pericarditis. 

The pericardium, or heart-case, is a membranous sac, in which 
the heart is contained. It is composed of two layers. The outside 



282 HEART DISEASES. 

one is fibrous, dense and white ; the inside one is serous. The serous 
layer forms the lining of the fibrous one, and then is reflected over 
the heart and the roots of the large blood-vessels. 

When the pericardium becomes acutely inflamed, it throws out 
both lymph and serum or water. The lymph often causes the two 
layers of the sac to grow together. 

Physical Signs. — The impulse is strong when the effusion of water 
is small, — feeble and unequal when it is large. Percussion yields a 
dull sound in proportion to the amount of fluid in the sac. 

When listening with the stethoscope, a rough noise is heard, resem- 
bling either the rasping of wood, the grating of a nutmeg, the rustling 
of silk, or the crackling of parchment. Sometimes it is softer, like 
the blowing of a pair of bellows. Occasionally it resembles the 
creaking of a new shoe-sole, or has a low creaking, like the tearing 
of linen cloth. 

When there is effusion, the ordinary beats of the heart sound dull 
and distant. 

General Symptoms. — Acute inflammatory fever, generally pre- 
ceded by chills, with pungent pain in the region of the heart, shooting 
to the left shoulder-blade, shoulder, and upper arm. 

Pain increased by taking a full breath, by stretching the left side, 
by percussion, and by pressure between the ribs over the heart. 
Sometimes the pain is in the epigastrium, or left hypochondrium. 
Inability to lie on the left side. 

Explanation. — The noises mentioned above are produced by the 
rubbing together of opposite surfaces of the heart-case, made rough 
by the exudation of lymph. The rasping is supposed to be caused 
by firm and rugged lymph ; the rustling and creaking, by soft and wet 
lymph; the bellows murmur, by soft and dry lymph; the creaking, 
croaking, and crackling, by dry, tough lymph. These sounds may all 
be imitated by rubbing a damp finger upon the back of the hand, 
while listening with the stethoscope applied to the palm. 

Chronic Inflammation of the Heart -Case. 

When acute pericarditis runs for more than ten days or a fortnight, 
it becomes chronic. It is chronic from the beginning, when it runs a 
slow, insidious course, without marked or violent symptoms. 

The symptoms are much the same in kind with those of the acute 
form, only less in degree. This low grade of the symptoms of the 
disease renders it more obscure than the acute. 

Treatment. — In the acute form of the disease, apply wet cups 
over the region of the heart, or apply from a dozen to forty leeches 
to the same parts. 

At the same time, move the bowels freely by an injection (247), 
or by a purgative pill (31). 



HEART DISEASES. 283 

The strength and amount of the remedies employed in each case 
must be in proportion to the vigor of the patient's constitution. 

It is of great importance that the treatment should be active and 
prompt, and that the disease should be broken down early. 

Diluent, cooling drinks (132), (129), (298), (299), should be al- 
lowed as freely as the patient desires, in order to dilute the blood, 
and render it less stimulating to the heart. 

At the same time, five to fifteen-drop doses of tincture of veratrum 
viride should be given every hour, to bring down the action of the 
heart. Ten-drop doses of tincture of digitalis every four hours are 
good. 

Let the diet be wholly of barley-water, thin gruel, weak tea, or 
arrow-root. 

During recovery, the diet must be spare, and the greatest tranquil- 
lity of mind and body be preserved. 

In the treatment of chronic cases, when the cavity appears to con- 
tain fluid, counter-irritation is suitable. Blisters, croton-oil, the com- 
pound tar-plaster, and especially the tincture of iodine. The diet 
may be a little more nutritious than in the acute form of the disease, 
— embracing light animal food and broths. 

Inflammation of the Heart. — Carditis. 

This is an inflammation of the muscular substance of the heart. 
When existing alone, it is a very rare disease. Being mixed up with 
other forms of heart disease, it does not require any separate account 
of its symptoms or treatment. 

Acute Inflammation of the Lining of the Heart. 

Endocarditis. 

The heart is one of the citadels of life. Disease attacks it on all 
sides. In this complaint, it has entered the fort and taken possession. 
The inflammation is on the lining membrane. 

Physical Signs. — The impulse is violent, abrupt and regular, as 
long as the circulation through the heart is free, but when this is im- 
peded, it is at first a confused tumult (which generally happens when 
a fort is first taken), and gradually sinks to a feeble flutter. 

The dull sound upon percussion covers a space of from three to 
seven square inches. 

The beats of the heart are generally accompanied or marked by a 
bellows murmur, the loudness of which depends on the strength 
of the heart's action. 

General Symptoms. — Inflammatory fever. The action of the 
heart being generally violent and abrupt, the pulse corresponds with 
it, and is strong, full and hard. 



284 HEART DISEASES. 

Explanation. — The bellows sound is supposed to depend on the 
inflamed and swollen condition of the valves. 

The dullness on percussion will be slight when the circulation 
through the heart is free; — more distinct and marked when it is 
obstructed. 

Dr. Hope says the disease may be anticipated, if a person be sud- 
denly attacked with these three signs : namely, fever, violent action 
of the heart, and a murmur which did not exist before. 

This disease, like inflammation of the heart-case, is often produced 
by, and is intimately connected with, acute rheumatism, and is then 
to be treated on same principles as rheumatic disorders. 

Chronic Inflammation of the Heart's Lining. 

Physical Signs. — The impulse more perceptible and diffused than 
natural. 

The dull sound upon percussion covers a space of from four to 
eight square inches. 

There is a sawing, rasping, or riling sound. This sound may cover 
one or both beats of the heart. Sometimes these unnatural sounds 
are double ; in which case, the first is caused by an obstruction to the 
natural flow of the blood forward ; the second, by the regurgitation 
or retrograde flow of the blood from some defect in the valve, — just 
as a pump-valve may get out of order, and allow the water which 
has gone through to flow back. 

Explanation. — A variety of organic changes occur in the valves, 
which give rise to the murmurs. Inflammation of the lining mem- 
brane of the heart reaches the valves, causing puckering, thickening, 
vegetative, cartilaginous, bony and fat-like degenerations, which ob- 
struct the blood in its onward flow, or prevent a closure of the valves, 
and allow it to flow back ; the former causing the first sound, the 
latter the second. If the unnatural noise be synchronous with the 
first beat of the heart, it implies disease in either set of the semilunar 
valves, or an impossibility of closing the auriculo-ventricular open- 
ings ; if it accompany the second beat, it signifies that either set of 
the semilunar valves may be open. 

A murmur attending the first beat of the heart must be caused by 
a current of blood from a ventricle ; one attending a second sound, 
by a like necessity, is produced by a current into a ventricle. 

Treatment. — The same as that for pericarditis. Tt should be 
equally prompt and vigorous. It must not be forgotten that this dis- 
ease leads to various organic diseases of the valves of a very grave 
character, and that such mischiefs can only be escaped by cutting the 
disease short in the very beginning. 



HEART DISEASES. 285 



Disease of the Semilunar Valves. 

The inflammation of the lining of the heart makes sad work with 
the valves. The semilunars are subject to various changes in their 
structure. 

Physical Signs. — Obstructive Murmur. — In disease of the semi- 
lunars, the first beat of the heart is accompanied or obscured either 
by the bellows murmur, or a sawing, rasping, or filing sound. The 
unnatural murmur, whatever it is, appears superficial or near. The 
second beat is natural. 

When the opening into the aorta is contracted, or in any way ob- 
structed by unhealthy growths, so that the blood is subjected to more 
than a natural degree of friction in passing, this sound will be heard. 
It is called obstructive, because it arises from the obstruction of the 
blood in its forward course. 

Regurgitant Murmurs. — First beat of heart natural. Second 
beat accompanied or replaced by bellows murmur. There is some- 
times a musical murmur. 

Explanation. — The regurgitant murmurs arise from the valves 
being too small, or defective in some way, and allowing the blood to 
flow back through the orifice. 

This murmur is loudest opposite the semilunar valves, and is more 
audible above these valves than below them. 

When the aortic valves are contracted or shortened, and the open- 
ings are not guarded by them, so as to prevent the backward passage 
of the blood, there is a double bellows murmur, — one when it is 
driven through the orifice, and another when it flows back. 

Disease of the Mitral Valves. 

Physical Signs. — Obstructive Murmur. — First beat of heart 
natural. Second beat accompanied or replaced by bellows murmur. 

Regurgitant Murmurs. — The first beat of the heart accompanied 
by a loud and rough bellows murmur. This sound is like sawing or 
filing. It is loudest above or below the nipple, between the fourth 
and seventh ribs. There is occasionally a musical murmur. The 
second beat of the heart is natural. Sometimes there is a purring 
tremor. 

General Symptoms of Valvular Disease. — Cough, in many cases 
with watery expectoration ; difficulty of breathing ; frightful dreams 
and starting from sleep ; congestion of the lungs ; expectoration 
stained with dark and grumous blood ; swelling of the jugular veins ; 
a livid look of the face ; a feeling as if a cord were tied tight around 
the lower part of the chest ; general dropsy, of the legs and feet in 



286 HEART DISEASES. 

particular ; passive hemorrhages from the mucous membranes ; en- 
gorgement of the liver and spleen ; congestion of the brain, with feel- 
ings of oppression. When the mitral valve is contracted, admitting 
regurgitation, the pulse is small, weak, irregular and intermittent. 
These are the worst symptoms of an advanced stage. 

Explanations. — The examiner will distinguish the various sounds 
thus: 

The murmurs generated at the origin of the arteries spread their 
sonorous currents upwards along these arteries. 

Those produced in the auricular orifices will be conducted into the 
auricles, and propagated downwards towards the apex of the heart. 

Which Set of Valves. — To learn in which set of valves it origi- 
nates, therefore, find its seat, and trace its direction. 

Finding the murmur to be in the aortic orifice, it is then known to 
be obstructive, if the first sound is morbid, and the second sound natu- 
ral ; and regurgitant, if the first sound is natural, and the second sound 
morbid. 

But if the murmur be in the mitral orifice, it is obstructive when the 
first beat of the heart is natural, and the second beat morbid ; and re- 
gurgitant when the first beat is morbid and the second beat natural. 

The Pitch or Key of a murmur depends on the distance of its seat 
from the ear of the listener, — nearness giving a high, and distance a 
low hey. Thus, a murmur seated in the orifice of the pulmonary 
artery, being nearer the surface, has a higher pitch than any other. 
It is on about the same key with a whispered s, — sometimes a little 
lower, and depending somewhat on the strength of the current of 
blood, a strong current elevating, and a weak current depressing the 
tone. 

The mitral orifice is situated opposite the junction of the cartilage 
of the third rib with the left side of the breast-bone. The aortic 
orifice is about half an inch to the right of this, and the same dis- 
tance lower. It is known by the key being lower, — about like a 
whispered r, which is the ordinary type of the sawing sound. 

Murmurs from pulmonic and aortic regurgitations are about two 
tones lower, in consequence of the currents of the blood being weaker. 
They are like whispering aive by inspiration and if the click of the 
valve be heard, the sound will be changed to paiv. 

Murmurs in the mitral valve, being more deeply seated, are about 
four tones lower, and are like a whispered who. 

The tricuspid murmurs are higher than the mitral, because nearer 
the surface. 

The musical murmur has been compared to whistling, the cooing 
of a dove, and the mewing of a kitten. It generally results from re- 
gurgitation. 

The purring tremor is caused, generally, by regurgitation through 
the mitral valve. 



HEART DISEASES. 287 

Other Symptoms Explained. — The difficulty of breathing, fright- 
ful dreams, congestion of the lungs, hemorrhages, engorgements, etc., 
mentioned above, all proceed from such valvular stiffenings, pucker- 
ings, ossifications, enlargements, and contractions, as occasion a decid- 
edly obstructed circulation. 

The small, weak, irregular, and interrupted pulse, is caused by con- 
traction of the mitral valve, which occasions an insufficient or irregu- 
lar supply of blood to the ventricle, and causes the ventricle, by losing 
the resistance of the valve, to expend its force in a backward as well 
a forward direction, thus sending but little blood into the arteries. 

Treatment. — The tendency of valvular disease is to produce hyper- 
trophy and dilatation. The strong and ceaseless efforts of the ven- 
tricle to drive the blood through ah orifice obstructed by valvular 
disease, will of course make the walls grow thick, which is hypertro- 
phy ; and at the same time, the accumulation of blood which cannot 
be driven forward fast enough, must tend to swell and enlarge the 
cavity, — which is dilatation. 

The great object of treatment, therefore, is to diminish the force 
and activity of the circulation, — to induce the heart to cease striving 
to do what cannot be done. 

To accomplish this, give sedatives (285), (94), (124). The helle- 
bore and cohosh will be found particularly serviceable. 

The tincture of the American hellebore is about the best of 
all. Purgatives may be given according to the strength of the 
patient. 

When there is dropsy, and a scanty secretion of high-colored urine, 
diuretics, or medicines to increase the action of the kidneys, are very 
important. For this purpose, digitalis and acetate of potash (130) 
are excellent. Should this not succeed in reducing the dropsy, an 
active purgative (31) may accompany it. 

Diaphoretics, or medicines which promote perspiration, are also 
useful. This opening of the skin, however, is generally brought 
about by the hellebore, etc. (124), (358). 

The diet should be unstimulating, and yet should be sufficiently 
nourishing to prevent the patient from running too low. Animal 
food of the most digestible kind may be taken once a day ; though 
there are many cases requiring its entire rejection. 

The passions should be kept in the most perfect subjection, and 
the life should be as tranquil is possible. Nothing must be done in a 
hurry. 

Water in the Heart=Case. — Hydropericardium. 

This disease is common as an attendant of general dropsy. 

Physical Signs. — The impulse is undulatory, as if transmitted 
through a fluid, and it is not always of the same strength. 

The dullness extends upward in a conical form, in proportion to 



288 HEART DISEASES. 

the amount of fluid, — sometimes rising as high as the second rib. 
The impulse does not coincide with the first beat of the heart. 

General Symptoms. — The patient has a sensation of the heart 
being in a floating state. The pulse is small, frequent, and intermit- 
tent. 

Explanation. — The reason that the impulse does not occur at 
the same time with the first beat of the heart is, that the apex does 
not i7nmediately strike the walls of the chest, — some time being re- 
quired to push it up through the fluid. 

The beats of the heart sound more distant than natural in conse- 
quence of the organ being pushed away from the walls of the chest 
by the fluid. 

Palpitation. — Nervous Palpitation. — Anaemic 
Palpitation. 

There is a great deal of palpitation of the heart dependent on 
dyspepsia, hypochondria, hysterics, mental agitation, excessive study 
with deficient sleep, venereal excesses, and masturbation. 

Palpitations likewise occur from what is called anosmia, or a low 
and deficient state of the blood. 

Physical Signs. — The impulse is weak, fluttering, or tumultuous, 

— generally increased by trifles. 

The beats of the heart are increased in frequency, and sometimes 
marked by intermission. Now and then they are accompanied by a 
bellows murmur. There are musical murmurs in the jugular veins, 

— loudest a little above the collar-bones. 

General Symptoms. — The complexion is generally pallid and 
bloodless ; the lips and the inside of the mouth partaking of the 
same paleness ; the pulse quick, small, weak, and jerking ; and during 
palpitation it sometimes has a thrill. Slight causes produce breath- 
lessness and faintness. A dislike of animal food, and a fondness for 
acids. The monthly discharge in females is deficient, and the whites 
take its place. Sometimes the menses are too profuse, lasting for 
several days, and consisting only of blood. In this state of things 
there is great feebleness both of mind and body, with rushing noises 
in the ears. 

Explanations. — The murmurs depend on a lack of blood. The 
conditions of their existence are, thinness of blood, a swift and spas- 
modic circulation, and particularly an unfilled condition of the blood- 
vessels. A brook is the more babbling in proportion as its water is 
more shallow. It is a law in physics, that heaviness of freight gives 
steadiness of motion ; and lightness of freight gives unsteady motion. 
The fireman's hose trembles and vibrates when only half full of 
water. In like manner the blood-vessels are agitated when imper- 
fectly filled. 



HEAKT DISEASES. 289 

Treatment: — This is to be governed altogether by the cause of 
the trouble. If it be dyspepsia, hypochondria, hysterics, etc., these 
several diseases require their usual treatment ; when they are cured, 
the palpitation will stop. 

But when it is caused by a low state of the blood, then give for 
several weeks, iron, the compound mixture, and (316), (310). 

The food must likewise be nourishing, — tender meat, beef and 
mutton, with broths, etc. 

Gentle exercise will be required, and much exposure to a bracing 
out-door air. 

Neuralgia of the Heart. — Angina Pectoris. 

This is a strictly nervous disease. It begins with a sensation of 
pain and constriction in the region of the heart. This pain is accom- 
panied with more or less pain and numbness in the left arm. In 
females it is not uncommon for it to be attended by great sensitive- 
ness and pain of the breasts. When the attack is violent, the pain 
in the heart is excruciating, and even terrific. There is attending 
this a feeling of great oppression in the chest, amounting, in the 
worst cases, to a seiise of suffocation. The heart palpitates violently, 
the brain is oppressed, and fainting sometimes occurs. 

The disease is brought on, in nervous subjects, by over-excitement 
of the heart. Walking up hill, against a strong wind, may bring it 
on. If walking at the time of the attack, the patient is compelled to 
stop, and stand still till the pain subsides. 

The disease is often connected with organic changes in the heart's 
structure, such as ossifications and other alterations. 

Treatment. — When the complaint depends on organic disease 
of the heart, the treatment must be directed to the cure of these 
diseases. 

To relieve a severe attack, the patient should be instantly placed 
in a quiet position ; wind in the stomach, if present, should be ex- 
pelled by peppermint or anise water, or ether, or (115), or some other 
aromatic. If there is acidity or sourness of the stomach, it must be 
corrected by a teaspoonful of soda in half a tumbler of water ; and 
if the stomach be full of undigested food, let the patient take a table- 
spoonful of ground mustard, stirred up with a teacupful of warm 
water. This will cause almost instant vomiting. 

These things being done, give some quieting or antispasmodic 
medicines, or one of the following prescriptions : (285), (97), (135), 
(124). Inhale 5 drops of nitrite of amyl on a cloth frequently. 

Great relief is often obtained by sending a current of magnetism 
through the region of the heart, by applying one pole of the machine 
in front, and the other upon the back. 

During the intervals, the general health is to be improved b}^ a 
wholesome, nourishing diet, gentle out-door exercise, and a careful 



290 HEART DISEASES. 

control of all the passions. T ± ^ of a grain of nitro-glycerine every 
hour, while in pain, steadies and slows the heart. 

Polypus of the Heart. 

A portion of the fibrin sometimes separates from the blood in 
the heart and large vessels, and becoming more or less organized, 
forms polypuses, which fill the cavities to which they are attached, 
and seriously obstruct the circulation. 

Physical Signs. — When the pulsations of the heart, previously 
regular, become suddenly anomalous, confused, and obscure, so that 
they cannot be analyzed, we may suspect a polypus. 

General Symptoms. — A sudden and great aggravation of the bad 
breathing, without any visible cause, — the patient being in agony 
from a sense of impending suffocation, and tossing about from side 
to side, struggling for breath. The pulse small, weak, irregular, in- 
termittent, and unequal ; the surface and extremities cold ; the face, 
livid, — to which there is generally added nausea and vomiting. 

Treatment. — When the polypus is once formed, the case is hope- 
less. The treatment, therefore, can only be preventive. 

The chief things to be done are, to keep the patient in a state of 
entire tranquillity, and to bring the circulation to the surface, by keep- 
ing the skin warm, and excited by friction. This will call the blood 
away from the heart and great vessels, and lessen the chances of the 
polypus. 

Displacements of the Heart. 

The heart may be misplaced from birth. I have seen a case in 
which it lay upon the right side, and had always been in that posi- 
tion. Its action was natural. 

A variety of causes may tend to push it out of its place, as water 
in the cavity of the pleura. In such cases, it will return to its place 
when the water is drawn off or absorbed. 



P1.7 




THE INTERNAL ORGANS OF THE HUMAN BODY. 



DISEASES OF THE ABDOMINAL CAVITY. 



Under the above head I shall consider most of the diseases which 
occur in the great cavity below the diaphragm, called the abdomen 
or belly. These affections are quite important, and make up a con- 
siderable part of the ills we suffer from disease. 

Before speaking of these diseases, however, I will call the reader's 
attention to a profile view of the 
relative position of the several or- 
gans lodged in this cavity. 

In Fig. 96, L is the liver, S the 
stomach, C the colon, R the rectum 
B the bladder, P D the pancreas, 
and I the intestines. The double 
lines, folded back upon each other, 
and surrounding most of the or- 
gans, represent the peritoneum, a 
membrane winch lines the great 
cavity of which I am speaking. 

It will be well, too, before pro- 
ceeding further, to make the reader 
acquainted with the names of cer- 
tain regions of the abdomen which 
he will find constantly spoken of 
in medical books. I have not 
used these terms much in my 
book ; but it will be convenient 
to be acquainted with them. Phy- 
sicians who are careless in their 
readings are not always familiar 
with their exact locality. 

In Fig. 97, the abdomen is di- 
vided into nine different regions 

by the drawing of two parallel lines up and down, 2, 2, and 3, 3, 
and two lines across, 4, 4, and 1, 1. This gives three regions above, 
three in the middle, and three below. 

In the upper row, 6 is the epigastrium or epigastric region, in which 
are the left lobe of the liver, and a portion of the stomach ; 5, on the 

291 




292 



DISEASES OF THE ABDOMINAL CAVITY. 




right side, is the right hypochondrium, in which is the right lobe of the 

liver ; and 5, on the left side, is the left 
hypochondrium, which contains the spleen, 
and a portion of the stomach and liver. 

In the middle row, 7 is the umbilical 
region, which contains the small intestines. 
On the right side, 8 is the right lumbar 
region, which holds the right kidney and 
the ascending colon ; and 8, on the left, is 
the left lumbar region, which contains the 
left kidney and the descending colon. 

In the lower row, 9 is the hypogastrium 
or hypogastric region, which contains a 
portion of the small intestines and bladder. 
On the right, 10 is the right iliac fossa, 
containing the coscum or caput coli ; and 
10, on the left, is the left iliac fossa, con- 
taining the sigmoid flexure. 
And now I may as 

well present, in Fig. 98, 

a front view of many of 

the organs, both in the 

chest and abdomen: 1, 1, 

1, 1, are the muscles of 

the chest ; 2, 2, 2, 2, the 

ribs; 3, 3, 3, the upper,] 

middle, and lower lobes! 

of the right lung; 4, 4,1 

the lobes of the left lung;* 

5, the right ventricle offF* 

the heart; 6, the left ven- 
tricle ; 7, the right auricle 

of the heart ; 8, the left 

auricle; 9, the pulmonary 

artery; 10, the aorta; 11, 

the vena cava descendens ; 

12, the windpipe ; 13, 

oesophagus ; 14, 14, 14, 

14, the pleura ; 15, 15, 

15, the diaphragm; 16,16, 
the right and left lobes of 
the liver; 17, the gall- 
bladder ; 18, stomach; 26, 
the spleen ; 19, 19, the 
duodenum ; 20, the as- 
cending colon ; 24, the 
transverse colon; 25, the 
descending colon; 22, 22, 22, 22, the small intestines; 23, 23, the 




Fig 



DISEASES OF THE ABDOMINAL CAVITY. 293 

walls of the belly turned down ; 24, the thoracic duct, opening into 
the left subclavian vein (27). 

Acute Inflammation of the Liver. — Hepatitis. 

The liver is the largest gland in the body. (See Fig. 31.) It lies 
in the right side, and at the top of the great abdominal cavity, di- 
rectly under the midriff, and lapping upon the stomach. Fig. 96 
shows its relative position. Its office was supposed to be to take the 
superabundant carbon out of the blood. This carbon it unites with 
other elements and forms bile, the peculiar bitter substance which is 
poured into the upper bowel, and greatly aids digestion. 

The liver is liable to become inflamed from several causes, such 
as gravel-stones, external violence, suppressed secretions, hot climates, 
inflammation of the duodenum, etc. 

Symptoms. — These are sympathetic fever, with pain, and a sense 
of tension in the right side, inability to lie on the left side, difficulty 
of breathing, a dry cough, vomiting, and hiccup. 

The pain is acute and lancinating generally, though sometimes 
dull and tensive. When sharp, it is like the stitch of pleurisy, and 
it indicates that the peritoneum which covers the liver is inflamed. 
When dull, it is the body of the organ which is suffering. When 
the convex surface of the liver is the seat of the disease, the pain is 
apt to run up to the right collar-bone, and to the top of the right 
shoulder. Breathing, coughing, and lying on the left side, increase 
the pain. A soreness is felt by pressing over the liver. The pulse 
is full, hard, and strong, the bowels are costive, and the stools are 
clay-colored, owing to not being tinged with bile, — this having 
stopped flowing. The tongue is covered with a yellow, dark brown, 
or even black coat, and there is a bitter taste in the mouth. 

Explanation. — The bile, secreted by the liver, is poured into the 
upper bowel, and gives the brown or yellow color to the contents 
of the bowels. When the liver is inflamed, it cannot work, — it se- 
cretes little or no bile, and the discharges from the bowels lose their 
color. The bile is slightly laxative, and when it ceases to flow into 
the bowels, they become bound or costive. When the liver does not 
work, the bile has to be taken out of the blood by the kidneys, and 
the urine becomes of a deep yellow color. Much of it goes out 
through the skin, too, which is likewise yellow, and the sweat be- 
comes so yellow as to stain the linen. 

Treatment. — Flax-seed poultices applied over the liver are very 
good. Purgatives will also need to be used pretty freely at first. 
Those which produce watery stools (31), (247), (34), will be of the 
greatest service. 

After the cups and purgatives have been thoroughly used, blisters 
will be useful, and it will be better to apply several in succession, 



294 DISEASES OF THE ABDOMINAL CAVITY. 

rather than to keep the first one open. Or, in the milder cases, a 
mustard poultice may be applied over tli" whole side, and even along 
the spine. 

Frictions over the stomach and liver with dilute nitro-muriatic 
acid, and a foot-bath of the same, will sometimes do well. The acid 
should be reduced with water to about the strength of sharp vinegar. 
Water a little soured with this same acid makes an excellent drink 
for the patient. 

Perspiration should be induced by the spirit vapor-bath, and kept 
up gently by the tincture of the American hellebore, from three to 
ten drops every hour. Or, the same thing may be done by prescrip- 
tions (126), (358). 

When the urine is small in quantity and red, give some diuretic, 
as infusion of marshmallow-root, pumpkin-seeds, or trailing arbutus. 

The diet should be rice-water, gruel, and toast-water. While 
getting up, it may gradually be improved, and some light tonics 
(49), (58), (64) be added to it. 

Chronic Inflammation of the Liver. — Chronic 

Hepatitis. 

There are few chronic diseases for which the physician is more 
often consulted than this. In the warm climate of the South, in 
the bilious districts of the West, and indeed even in the Middle and 
Eastern States, it meets us continually, and demands our attention. 
That it is difficult to cure must be admitted; but a constant famil- 
iarity with chronic diseases, for several years, has convinced me that 
it is generally curable. 

Symptoms. — A sense of fulness and weight in the right side 
with some enlargement, and shooting pains felt in the same region, 
particularly when it is pressed, with pains in one or both shoulders, 
and under the shoulder-blades ; uncomfortable sensations when lying 
on the left side; yellowness of the skin, eyes, and urine; bowels 
irregular, loose, or costive; appetite disturbed; sometimes a dry, 
hacking cough; shortness of breath; tongue whitish, and brown or 
yellow towards the root; a bitter and bad taste in the mouth in the 
morning. The urine deposits a sediment on standing. There is 
generally a low and desponding state of mind, with irritability and 
peevishness of temper. 

The skin is often covered with yellow spots and with a branny 
substance. The various symptoms of dyspepsia are often present. 
The nervous system is generally much disturbed, and there is a dis- 
inclination to apply the mind. There is frequently a great dread of 
imagined evil, supposed to be impending. 

Treatment. — This does not require to be as active as that for the 
acute form of the disease. 



DISEASES OF THE ABDOMINAL CAVITY. 295 

If there be much tenderness of the liver, begin with mustard 
poultices, and the compound pills of podophyllin, or the compound 
pills of leptandrin, or (36). 

I have abandoned the use of mercury in this disease, as in most 
others ; but if any prefer to use it, the blue pill (52) will be found 
the most useful form. 

The compound tar-plaster placed over the liver, in bad cases, is 
often very serviceable. 

An alterative (138), (146) will be found useful. 

The daily alkaline sponge-bath must on no account be omitted. 
Vigorous friction must follow it. Vigorous constitutions will bear 
the shower-bath; in such cases it may, occasionally, take the place 
of the sponge-bath. 

The diet must be simple, yet nourishing and wholesome, and 
embracing but a small amount of fat, as this is composed largely of 
carbon, and the liver is unable to remove what is already in the blood. 

Especially and above all, out-door exercise must be taken to the 
full amount of the strength, and the thoughts be occupied with 
cheerful subjects. Let the hot sun be avoided, and the summer 
exercise be taken in the cool hours of the day. 

The recovery from this, as from all other chronic diseases, must 
necessarily be slow. 

Congestion of the Liver. 

This is not strictly a disease, but the result of gastro-intestinal 
disorders. There is an enlarged, congested liver, with a sense of 
fulness and weight in the right side under the ribs. 

The application of heat, and even leeches, to the side, and the ad- 
ministration of saline laxatives, afford relief. The diet must be light 
and farinaceous. 

Passive Congestion of the Liver 

Results from mechanical obtruction to the outflow of blood from 
the liver. When this condition has existed some time, there is a 
sense of weight and fullness in the liver region when sitting up or 
lying on the left side. The liver is enlarged and tender; the breath 
is shortened, and pain may be present, extending to the shoulder. 

Jaundice is usually present, but only to a slight degree. When 
the heart is the cause of the obstruction to the outflow of blood, 
there is often present an associated gastro-duodenal catarrh, in which 
case loss of appetite, nausea, vomiting, belching of gas, and pain, 
are also present. In the later stages of a prolonged case, ascites, or 
dropsy of the peritoneal cavity, is present. 

Prognosis. — The outcome of passive congestion of the liver is 
usually grave, since it is the result of some structural disease else- 
where, as of the heart, asthma, chronic pleurisy, tumors, etc. 



296 DISEASES OF THE ABDOMINAL CAVITY. 

Treatment. — The indications for treatment are to strengthen the 
heart with digitalis, strophanthus, etc., increase the strength of the 
patient with strong, stimulating food, and to deplete the portal circu- 
lation by vegetable laxatives like podophyllin, rhubarb, aloes, etc. ; 
the salines also furnish an agreeable method of depletion, as for 
instance, Crab-orchard water, Hunjadi, etc. It occurs usually after 
middle life, and is more common in women than men. It is usually 
secondary to cancer elsewhere, as in the bowels or stomach, rectum 
and womb. The liver is increased in size, and is frequently studded 
with cancerous nodules, which in well-marked cases may be felt 
through the abdominal wall. 

The disease usually gives rise to loss of appetite, nausea, vomiting, 
constipation, emaciation and weakness. Pain over the liver is gen- 
erally present, while jaundice exists in about fifty per cent of cases. 
Dropsy of the bowels exists likewise in about the same proportion of 
cases. Hemorrhages from the nose, stomach and bowels occur in 
the later stages of the disease. The temperature is usually lower 
than normal, and the pulse slow, especially if jaundice be present ; 
the urine is diminished in amount and high colored. The disease 
progressively advances to a fatal termination inside of a year. No 
known treatment is of avail in arresting the terrible malady. 

Cirrhosis of the Liver. 

This is a disease characterized by an excessive increase of the 
fibrous tissue in the liver, whose later function is to contract and 
squeeze out, so to speak, the softer, glandular structure of the liver 
proper, thus causing its atrophy and diminution in size. The dis- 
ease is caused mainly by the introduction into the portal system of 
some irritant like alcohol. It is generally known as the gin-drinker's 
liver, but it does not result especially from gin any more than from 
any other spirit. It is, at all events, essentially a disease due to pro- 
longed though moderate use of spirits of one sort or another, and 
occurs between the ages of thirty and sixty, mostly in men. 

The symptoms of this disease are at first those of gastric and intes- 
tinal disorders due to alcohol, as nausea, flatulence, constipation and 
looseness, etc. 

Dropsy is finally the most pronounced symptom of the disease, but 
hemorrhages from the bowels not infrequently occur. The disten- 
sion of the abdomen by dropsy is sometimes enormous ; finally the 
feet and legs become swollen, emaciation and weakness progress, and 
the patient may finally die in coma or convulsions. The disease, when 
sufficiently advanced to be recognized, is incurable. 

Treatment. — The treatment is to be directed toward the removal 
of all irritating food and alcohol. The diet should consist largely of 
milk; green vegetables and fruit, beans, peas, eggs, lean meat, etc., 
may be taken if well borne. 



DISEASES OF THE ABDOMINAL CAVITY. 297 

The stomach and bowels are to be kept in good condition, the 
dropsy drawn off or removed by means of loose evacuations from the 
bowels. 

Hydrochloric acid in three-drop doses, well diluted, after meals, 
may be of service, while bitter stomach-tonics are to be given before 
eating. 

Acute Inflammation of the Spleen. — Splenitis. 

The spleen is in the upper part of the belly, on the left side, 
opposite the liver. It is subject to acute inflammation, which is 
known by a pain just under the short ribs on the left side, also by 
swelling, soreness to the touch, and by more or less fever. The pain 
often shoots up through the midriff and to the left shoulder. There 
is a short, dry cough ; a feeling of tightness about the heart ; a sick- 
ness at the stomach, and vomiting ; and a discharge frequently of 
black blood from the bowels. The urine is scanty, is passed with 
some difficulty, and is high-colored. 

This disease appears most frequently in hot climates, and is often 
connected with intermittent fevers. 



Chronic Inflammation of the Spleen. 

This prevails most in fever-and-ague districts, and is a frequent 
result of chills and fever. It is generally very stubborn, often lasting 
many years. 

Symptoms. — A feeling of weight, tightness, and sometimes pain 
in the left side, the pain being increased by pressure, or an attempt 
to lie on the left side. The organ sometimes enlarges very much, so 
that it can be felt by the hand. This enlarged mass passes under 
the common name of " ague cake." There are sometimes numbness, 
weakness of the legs, difficulty of breathing, palpitation of the heart, 
inability to exercise much, obstinate constipation, vomiting of food, 
piles, dry skin, tongue coated white or red, low spirits, and occasion- 
ally dropsical affections. 

During the chill in fever and ague, the spleen becomes enormously 
loaded with blood. Surfeited and stretched in this way again and 
again, it is not strange that the organ should become diseased. 

Treatment. — This should be about the same as the treatment for 
acute and chronic inflammation of the liver. 

After the active symptoms of inflammation are subdued, the warm 
bath may be used one or twice a week. 

In the chronic form of the disease, counter-irritation with the 
compound tar-plaster, with mustard poultices, croton-oil, or tincture 
of iodine, will be particularly needed. 

Among medicines, muriate of ammonia (53), has a high reputation. 



298 DISEASES OF THE ABDOMINAL CAVITY. 

To keep the. bowels open, podophyllin, quinine, and mix vomica 
(46), have a fine effect. Iron may be given (73) when the patient 
is bloodless and pale. 

Jaundice. — Icterus. 

The jaundice is a very common disease, and to be known needs 
only to be seen ; but inasmuch as it may be but a symptom rather 
than a disease per se, it behooves one to be careful that some hidden 
disorder be not preying upon the system. Among the more common 
affections which give rise to jaundice are gastro-duodenal catarrh, 
frequently affecting children, obstruction of the gall-ducts by thick 
bile or mucus, or by gall-stones ; cancer, chronic forms of liver com- 
plaints, and some forms of blood diseases. 

Symptoms. — The most prominent symptoms are, yellowness of 
the skin and whites of the eyes, saffron-colored urine, and whitish or 
clay-colored stools. So full is the urine of bile, that a piece of white 
linen dropped into it receives a bright yellow tinge. 

Besides these symptoms, there are impaired appetite, a loathing 
of food, the sense of a load at the pit of the stomach, sourness of 
stomach, sometimes sickness and vomiting, a bitter taste in the mouth, 
disinclination to move about, sleepiness, a dull pain in the right side, 
which is increased by pressure. 

The entire body of a person who has died of jaundice, including 
bones, muscles, and membranes, are found to be full of bile, and col- 
ored yellow. 

Explanation. — The bile flows into the upper bowel, a little below 
the stomach, through a duct or tube about as large as a goose-quill. 
This little tube or vessel receives the bile from a smaller tube, called 
the hepatic duct, and from another which goes to the gall-bladder, 
called the cystic duct. 

These little tubes sometimes get obstructed or plugged up by 
sticky, thickened, or hardened bile, or by gall-stones, formed in the 
liver ; and the bile, finding no outlet through, its natural channels, is 
taken up by the absorbents, distributed over the system, and produces 
the yellowness we witness. When these ducts and the gall-bladder 
are filled and stretched by this thickened and hardened bile, they be- 
come tender and sore. Hence the sore feeling in the side when 
pressure is made. 

There is another explanation of the way in which the yellowness 
of jaundice is produced, and it matters not whether it or the one just 
given be adopted. It is this : The bile is formed by the blood, and 
not by the liver. The office of the liver is to draw or strain off the 
bile from the blood. And when this organ is inflamed, or gets slug- 
gish and will not work, the blood is not relieved of its yellow freight. 
The bile accumulates, and in attempting to escape through other 
channels, it lodges in the various tissues, particularly in the skin. 



DISEASES OF THE ABDOMINAL CAVITY. 299 

Treatment. — An infusion of thoroughwort, drunk freely every 
day, is a valuable remedy. The inner bark of the barberry steeped 
in eider, or this article compounded with others (286), (287), will 
be found excellent. 

The diet should be plain, wholesome, and nourishing, but com- 
posed mostly of vegetable articles, particularly green vegetables and 
berries when they are to be had. 

Cold water should be the principal drink ; or drink and medicine 
may be combined in the shape of three drops of muriatic acid, and 
two drops of nitric acid, dissolved in a tumbler of water slightly 
sweetened. This is generally a pleasant drink, and will assist very 
much in the cure. 

The warm bath once or twice a week, and the alkaline sponge-bath 
every day, with smart friction, must not be omitted. 

When jaundice is caused by the passage of gall-stones through the 
bile-duct, there is sometimes terrible pain and suffering, — the stone, 
occasionally, being as large as a nutmeg, and forcing its way through 
a quill-sized tube. So great is the distress that the patient sometimes 
rolls upon the floor in agony. To alleviate this pain, large doses of 
opium, laudanum, or morphine, are required. A large teaspoonful of 
bicarbonate of soda dissolved in a tumblerful of hot water is an ex- 
cellent remedy if drunk at a single draught. It relieves the acidity 
of the stomach, and acts as a fomentation to the internal seat of the 
pain. Mustard poultices, or warm fomentations, over the seat of the 
pain, are required. The warm bath is excellent. 

The acid bath, made by mixing three parts of muriatic acid with 
two parts of nitric acid, and adding as much of this mixture to water 
as will make it about as sour as weak vinegar, is valuable in jaundice. 
Only a quart of water need be taken ; and the solution should be 
applied with a sponge. It is of the right strength, if it produce a 
slight tingling of the skin. 

Gall=Stones. — Biliary Calculi. 

These are brownish, chocolate-colored concretions which form 
either in the gall-bladder itself, in the duct leading from the gall- 
bladder, or in the common duct which is formed by the ^^ 
union of the gall-duct and the hepatic duct which leads ^jf^ 
from the liver. They are solid, generally have bodies of flJllk 

irregular shape and size, and have facets caused by the y^^yilmlP 
stones being impacted against one another. Fig. 99 'WHB* 
shows their appearance. These concretions are formed FlG - "• 
of inspissated bile and organic salts. When they settle into the ducts 
their natural course is downward through the duct into the bowel, 
where they are naturally carried off with the faeces. Their passage 
through these ducts is accompanied often with extreme pain and 
colic, the pain being the severest of any to which the system is sub- 
jected, and generally requires an opiate. When once an attack of 



300 DISEASES OF THE ABDOMINAL CAVITY. 

gall-stones has occurred, the patient is liable to more, as they seldom 
exist singly in the gall-bladder. These repeated attacks have been 
the subject of a great deal of thought among surgeons. 

Symptoms. — An almost constant uneasiness in the right hypo- 
chondriac region, with spasms of pain, coming on suddenly, and last- 
ing for a time with great severity, and then subsiding. The pain is 
caused by a stone being suddenly forced into the duct and moving 
forward in it, and it subsides when the stone either stops, or gets 
through the duct. When the stone reaches the bowels, it passes off 
with the stools. 

The patient generally has a pale, sallow complexion, a small, feeble 
pulse, and often suffers from nausea and vomiting, and from restless- 
ness and hurried breathing. 

Treatment. — To reduce the spasm, give svapnia powder in full 
doses, or chlorodine. Also, apply mustard over the right hypochon- 
drium and stomach, and follow it with hot fomentations with hops, 
or use wet cups. 

If the stomach is irritable, give the neutralizing mixture until it 
moves the bowels. To relieve the intense pain, morphine should be 
administered, together with hot baths and hot cloths over the abdo- 
men. 

Sweet oil was at one time advocated as a solvent of these bodies, 
but experience has not proven the validity of the claim. Many 
practitioners, however, still insist that oil in large doses hastens the 
passage of the stones. 

To remove the acidity on which the formation of these stones so 
often depends, a neutralizing preparation (338) may be given for a 
long time, the diet, in the mean time, being well regulated. The 
sponge-bath with saleratus and water, should be taken daily, followed 
by brisk rubbing ; and free exercise in the open air should on no 
account be omitted. 

Of late years it is customary to treat this complaint surgically, 
operating directly on the gall-bladder by incising it and removing 
the stones. If the ducts become obstructed, they too are incised and 
the stones dislodged, either by pushing them down into the bowel, 
or otherwise, as may be most convenient. The gall-bladder is either 
sutured to the abdominal wall, and a biliary fistula forms, discharg- 
ing the bile upon the abdominal wall; or it may be drained off into 
a bottle; or, as has been recently advocated, the bladder may be 
sewn up tightly and replaced. Sometimes communication is estab- 
lished between the gall-bladder, or the duct, and the duodenum, by 
means of an ingenious device called " Murphy's Button." This 
button, invented by Dr. Murphy of Chicago, is intended to draw to- 
gether the parts to be connected, retaining them in that position. 
After some days the walls slough away, and the button passes into 
the bowel, and is thus removed from the system. By this means 



DISEASES OF THE ABDOMINAL CAVITY 301 

many stubborn cases of impacted gall-stone have been permanently 
cured. 

Abscess of the gall-bladder, inflammation of the surrounding 
tissue, and even death are not infrequent results of the presence of 
these foreign bodies. 

For preventing the formation of gall-stones, see the articles on 
Biliousness, Diet, etc. 

Acute Inflammation of the Stomach. — Gastritis. 

This is a rare disease. It is generally induced by irritating and 
corrosive substances taken into the stomach. Poisons, as arsenic, 
aquafortis, corrosive sublimate, and the like, are the most common 
causes of it. Blows, sudden stoppage of sweat, and excessive use of 
ardent spirits, may also excite it. 

Symptoms. — It is marked by burning pain in the stomach, thirst, 
restlessness, anxiety, constant vomiting, prostration of strength, a 
quick, hard, and small pulse, incessant retching, a sunken counte- 
nance, hiccough, cold hands and feet, and a damp skin. 

Treatment. — If the inflammation be excited by poison, the reme- 
dies named under antidotes for poisons must be first employed. 

The poison being neutralized or thrown off, the inflammatory con- 
dition must be combatted with the remedies usual for such states. 
Mustard poultices to the feet, along the spine, and particularly over 
the pit of the stomach, will be among the first things to be employed, 
and should be followed by hot fomentations of stramonium leaves or 
hops, — both the fomentations and the poultices to be repeated as 
occasion may require. Dry cupping over the region of the stomach 
is useful. Small and repeated doses of bismuth, or l-grain doses of 
cocaine, are generally very soothing to the stomach, and relieve the 
terrible vomiting. 

Drinks. — Cold water, bread-water, rice-water, arrow-root gruel, 
infusion of slippery-elm bark, and of marshmallow. These should 
be taken in very small quantities, — say a teaspoonful at a time, — 
about twenty drops of tincture of aconite-root being added to a half 
tumblerful. Lumps of ice may be held in the mouth, and occasion- 
ally swallowed. 

Injections. — Emetics and physic are not proper, but injections 
(248), (253), or simply soap-suds, will be required. 

The remedies must be pursued until all tenderness has disappeared 
from the pit of the stomach. 

While the patient is recovering, great care must be taken not to 
overload the stomach with food. Arrow-root, sago, and milk are 
among the first articles to be allowed. After these, will come grad- 
ually beef-tea, chicken-broth, soft-boiled eggs, and beef-steak, until 
the whole diet can be restored. 



302 DISEASES OF THE ABDOMINAL CAVITY. 



Chronic Inflammation of the Stomach. 

This is a much more common disease that the preceding ; indeed 
it is very common. Though it does not put life in immediate danger, 
it perverts the feelings of the stomach, and causes many of the symp- 
toms of indigestion. Dyspepsia, however, is a different complaint, 
and not necessarily connected with inflammation. 

Symptoms. — There is generally pain in the stomach, which is in- 
creased by the presence of food, and by external pressure. The pain 
is sometimes felt only during digestion. The fermentation of the 
food in the stomach generates a gas, which is frequently belched up. 
This is what is meant in common language by having " wind in the 
stomach," and " belching wind." The meals are frequently vomited 
up ; the appetite is tickle, sometimes voracious, and again nearly ab- 
sent ; the thirst is likewise variant ; the tongue is white in the centre, 
and red at the sides and tip, — sometimes smooth and red all over, 
like a slice of raw beef. The urine is scanty and high-colored. 

The disease is very liable, if badly managed, to lead to ulceration 
of the coats of the stomach, and thence to a fatal end ; for an ulcer 
may penetrate the walls of the stomach, and let its contents into the 
abdominal cavity, which would excite an immediately fatal inflam- 
mation. 

Treatment. — If there be much tenderness, we may apply leeches 
over the stomach. With less tenderness, counter-irritation will an- 
swer,« — as blisters, croton-oil, mustard poultices, the compound tar- 
plasters, or dry cups. 

The skin of the whole surface should receive special attention. 
The warm or the cold bath should be used often, according to the 
strength of the patient. When the reaction is good, a cold compress 
bound upon the stomach every night, will do much to bring relief. 

The diet cannot be too carefully managed. While there is consid- 
erable tenderness, the nourishment must be of the most simple and 
unirritating kind, — consisting of little more than the most bland 
nutritive drinks ; and even these should be taken in small quantities 
at a time. Gum arabic water, rice-water, barley-water, arrow-root, 
gruel, tea, and toast without butter, will be amply sufficient to keep 
soul and body together, and will, in two or three weeks, generally 
starve the enemy out of his quarters. After this, a more nourishing 
diet may gradually be resumed. Many of the recent proprietary 
foods serve an admirable purpose in furnishing a large amount of 
nutriment in small bulk, which is easily digested. Among these 
may be mentioned proteinol, in teaspoonful to tablespoonful doses, 
liquid peptonoids, malted milk, koumiss, matzoon, etc. These latter 
are milk preparations with the cooling and refreshing taste of soda. 



DISEASES OF THE ABDOMINAL CAVITY. 303 



Indigestion. — Dyspepsia. 

Dyspepsia is a disease of civilization. Savages know nothing of 
it. It is the costly price we pay for luxuries. All civilized nations 
suffer from it, more or less, but none so much as the people of the 
United States. It is here, in the new world, that the disease has 
become domesticated, and we, as a people, who have threatened to 
monopolize its miseries. 

Few disorders inflict upon their victims greater suffering ; yet it is 
not particularly dangerous, and it is even doubtful whether it tends 
very much to shorten life, unless the length of life be judged to con- 
sist in the sum of happiness enjoyed, — in which case few complaints 
shorten it more. 

Symptoms. — These vary very much in different stages of the dis- 
ease, and in different persons. In general the complaint begins with 
a sense of fullness, tightness, and weight in the stomach, sooner or 
later, after meals, and a changeable, diminished, or lost appetite. 
Occasionally, the appetite is craving, and when, in obedience to its 
promptings, a large meal is taken, there is pain in the stomach, with 
general distress and nervousness, and sometimes vomiting. Flatu- 
lency and acidity are common, with sour and offensive belching of 
wind ; and very often there is a water-brash, or vomiting of a clear, 
glairy fluid when the stomach is empty. Dizziness is a prominent 
symptom. There is a great deal of what patients call an " all-gone " 
feeling at the pit of the stomach, — a weakness so great at that par- 
ticular spot, that it is very hard to sit up straight. There is a bad 
taste in the mouth ; the tongue is covered with a whitish fur ; there 
is headache, heartburn, palpitation at times, high-colored urine, and 
tenderness, now and then, at the pit of the stomach. The bowels 
are generally irregular, sometimes very costive, at other times loose, 
when portions of food are passed off undigested. 

Nervous Complication. — Such are the symptoms in a case of 
simple disorder of the stomach, when no other part of the system is 
materially involved. This is indigestion, well-marked, and distressing 
enough ; but it is only a part of what is understood by a case of 
modern dyspepsia. In this, either the indigestion, in its course, dis- 
turbs and involves the nervous system, or the nerves become them- 
selves disordered, and produce the indigestion. Sometimes one hap- 
pens, sometimes the other, it matters not which ; both are present — 
the affection of the stomach and of the nerves — in a case of thorough 
dyspepsia. To make out a full case, in its tormenting completeness, 
we must add to the above symptoms, great depression of spirits, 
amounting at times to complete hopelessness and despondency ; a 
dread and fear of some impending evil ; a lack of interest in passing 
events ; unwillingness to see company or to move about ; an irritable 
and fretful temper ; a desire to talk of one's troubles, and nothing 



304 DISEASES OF THE ABDOMINAL CAVITY. 

else ; a sallow, haggard, sunken, and sometimes wild expression of 
countenance ; a dry, wrinkled, and harsh skin, with unrefreshing 
sleep, disturbed by all sorts of annoyances and difficulties, such as 
shipwrecks, falls down precipices, and nightmare. 

The man who has all these symptoms, or any considerable portion 
of them, has dyspepsia, and is about as miserable as if all the sorrows 
of life were electrical currents, and were running through him con- 
tinually. 

Causes of Dyspepsia. — To healthy digestion, three conditions are 
especially necessary, — that the food should be well chewed and 
mixed with saliva before it is swallowed ; that the stomach should 
pour out and mix with it the right amount of healthy gastric juice ; 
and that it should be well churned while in the stomach. 

It is well known that the first of these conditions, a thorough chew- 
ing of food, is rare in this country. We eat too fast ; we do not 
masticate our food ; we bolt it whole. 

This is the first cause of dyspepsia, and it is the fruitful mother of 
causes. It furnishes the occasion for eating too much ; for when the 
food is swallowed with such rapidity, the stomach is taken by sur- 
prise, as it were ; it cannot secrete gastric juice fast enough to be 
diffused through the fast-growing mass ; and the appetite does not 
decline until a great deal too much is taken. The coats of the 
stomach, being stretched unnaturally, do not pour out the gastric 
juice at the right time, or as much of it as is wanted, and what there 
is, is altered in quality. 

Moreover, the stomach being overburdened, cannot turn over and 
churn it contents properly. 

To fast eating, we may add, high-seasoned dishes, too stimulating 
for the stomach ; eating between meals, and at unseasonable hours, 
— particularly at bed-time ; excessive use of strong drinks and 
tobacco ; habitually sitting up late at night ; inactive habits of body ; 
and excessive use of the mind. 

No causes of dyspepsia are more active than those which disturb 
and fret the mind. It is surprising how suddenly any mental agita- 
tion will put an end to the appetite, and suspend digestion. And 
when these mental disturbances are protracted, when care becomes a 
daily and hourly companion, dyspepsia is almost sure to show itself. 
Considering tjie numerous causes of unpleasant mental excitement 
which we have in the politics, the business, the ambition, the family 
jars, etc., of this country, it is a wonder that dyspepsia is not even 
more prevalent. It is hard for the sensitive to escape. 

These causes ma}' seem too simple to be the frequent origin of so 
much misery, and yet whole volumes might be written on this one 
subject. One cannot too forcibly nor too frequently remind the 
reader of the importance of these simple and brief remarks. No 
treatment will avail if they are not heeded. 



DISEASES OF THE ABDOMINAL CAVITY. 305 

Urinary Deposits. — Before speaking of the treatment of dyspep- 
sia, it will be proper to take notice of certain deposits in the urine, 
to which persons suffering from this complaint are liable, and the 
discovery of which will, in many cases, indicate the treatment. 

Many dyspeptics have acid urine, which is loaded with crystals of 
oxalate of lime. These persons are much depressed in spirit, and 
look upon the dark side of everything. They are painfully disturbed 
by small annoyances, are irritable in temper, incapable of exerting 
themselves, look with dread upon the future, and generally have the 
dark and dingy look of the face which indicates functional derange- 
ment of the liver. 

The most of these crystals are octahedral in form, and in the field 
of a good microscope are beautiful objects for inspection. (Figs. 100 
and 101.) To obtain them, take a portion of urine passed in the 
morning (urina sanguinis), and let it stand till a deposit takes place. 
Pour off the upper portion of the urine ; put a part of the remainder 
in a watch-glass, and gently heat it over a lamp. The heat will 
cause a deposit of the crystals. 





Fig. 100. Fig. 101. Fig. 102. 

The oxalate of lime is frequently found in urine, the crystals hav- 
ing the form of dumbells. When examined by polarized light, they 
appear beautifully colored and striated. (Fig. 102.) 

The urate of ammonia, and uric acid gravel, are likewise found in 
large quantities in the urine of many dyspeptics. Some are ex- 
hausted by them, and reduced almost to skeletons, and to a wretched 
state of health, — having boils, eruptions, etc. 

To find the urates, put a little of the urine containing the deposit 
in a test-tube, and warm it gently over a lamp. If the deposit readily 
dissolve, it is probably urate of ammonia (Figs. 103 and 104), and 
may then be examined under the microscope, to make the matter 
sure. 

To find uric or lithic acid, let morning urine stand until a solid 
deposit has sunk to the bottom ; then pour off the liquid, and place 
some of the solid portion upon a glass, and examine it with a micro- 
scope, and if this acid be present, its peculiar crystalline forms 
(Fig. 105) will be discovered, either alone, or mixed with urate of 
ammonia. 



306 



DISEASES OF THE ABDOMINAL CAVITY. 



In those cases in which there is a great prostration of the nervous 
system, with a loss of sexual power, bad feelings in the head, perhaps 
pain and weakness across the loins, and a tendency to consumption, 





Fig. 103. 

Fig. 104. 

we may suspect the presence of the triple phosphates in the urine. 
Phosphorus is one of the elements of the brain and nerves, and when 

there is a constant drain of this element 
through the kidneys, the nervous system 
is gradually exhausted. To find the triple 
phosphates, put some morning urine in a 
glass vessel, and let it stand till a sedi- 
ment has gone to the bottom. Put some 
of the sediment in a test-tube, and warm 
it gently over a lamp. If the warmth 
do not dissolve the deposit, add to it a 
little acetic acid ; if the deposit dissolve in 
the acetic acid, it probably consists of earthy 
phosphates. This is then to be exam- 
ined under the microscope to ascertain 
whether it is the phosphate of lime, the 
triple phosphate, or a mixture of both. 

Fig. 106 shows us the prismatic crys- 
tals of the triple phosphate. In a few 
rare cases, these are penniform (Fig. 107). Fig. 108 gives us an- 
other specimen of the crystals of the triple phosphates, as they 




Fig. 105. 





FlU. 106. 



Fig. 107. 




appear under the microscope, mixed with amorphous particles of 
phosphate of lime. If an excess of ammonia be added to the urine, 
the crystals become star-like and foliaceous, as in Fig. 109. 




DISEASES OF THE ABDOMINAL CAVITY. 307 

Treatment of Dyspepsia. — As there are few complaints which 
distress the patient more than dyspepsia, so there are few which give 
the physician more trouble. Generally our 
art has failed upon it because too much has 
been required of us. We have not merely 
been asked to cure the disease, but to do it 
while the patient continues the indulgence 
of his appetite, or his excessive application 
to business or study. It has been expected 
of us, that with medicine we should contra- 
vene the laws of nature, and restore health 
while the causes of the disease are in full ac- 
tivity. 

This complaint is often brought on by 
not keeping the bowels open. To cure it, therefore, one of the first 
things to be done is to remove costiveness and regulate the bowels. 

One of the very best articles I know of to remove constipation is 
Mettauer's Aperient. I have placed it in the department of Phar- 
macy; it ought to be in the United States Dispensatory. Taken 
immediately after meals, in doses of a teaspoonful, it corrects acidity 
of the stomach, it gently opens the bowels, and when its action is 
over, will be found to have diminished the costiveness, rather than 
increased it, as most kinds of physic do. It is excellent in the bil- 
ious forms of dyspepsia, — acting finely upon the liver, — particularly 
if a few drops of aqua regia in water be taken before meals, — the 
aperient being taken after. 

If piles exist, this mixture will be objectionable on account of the 
aloes, and the fluid neutralizing extract may take its place. Sweet 
tincture of rhubarb and soda (37), is sometimes preferable to the 
aperient. 

Several other preparations (38), (289), (39), (290), will be found 
useful to remove costiveness and debility of the stomach. 

For acidity, besides the remedies already mentioned, prepared char- 
coal may be used, in teaspoonful doses, or carbonate of magnesia, or 
fluid magnesia, or trisnitrate of bismuth. A good remedy is pulver- 
ized guaiacum, rhubarb, prepared charcoal, and carbonate of mag- 
nesia, equal parts; also (28), (37), (38), (42). If crystals of oxa- 
late of lime be found in the urine, give a few drops of aqua regia, in 
water, three times a day. 

Hygienic Treatment. — The diet must be managed with great pru- 
dence. Food must be taken in such quantities only as the stomach 
can digest, however small that quantity may be ; and it must be taken 
slowly, and well chewed. No article should be touched, or thought 
of, which disagrees with the stomach. Costiveness may frequently 
be entirely removed by eating no bread except that made from un- 
bolted wheat-flour, commonly called Graham bread (that made from 
Franklin Mills flour), or by making one of the three daily meals of 



308 DISEASES OF THE ABDOMINAL CAVITY. 

boiled cracked wheat, with milk or molasses. If the triple phosphates 
be found in the urine, there is a special reason why the unbolted 
flour, or the cracked wheat should be used. The wheat-grain abounds 
in phosphorus, the largest portion of which is in the bran, and this 
is much needed when the kidneys are robbing the brain of its phos- 
phoric element. 

Not too much Brain=work. — It is important that the brain and 
nervous system should be relieved of the burden of too much work, 
and that the thoughts should be turned into the most agreeable chan- 
nels. If the patient would get well, the disinclination to move about 
and see company must be resisted. In many cases, dyspeptics are 
like sea-sick persons, — feeling as though they would rather go over- 
board than move. In such instances, friends must not be harsh with 
them, and frown upon their listlessness as if it were a fault ; but 
rather treat them affectionately, and beguile them out by all sorts of 
pleasing enticements. Exercise must be had, every day, and be con- 
nected, if possible, with an object, so that it may be performed cheer- 
fully. It is important to engage the mind in the exercise ; and for this 
purpose, some contested game is very useful, as plajdng at billiards, 
rolling nine-pins, pitching quoits, or, where the strength will permit, 
playing ball or riding the bicycle. 

Cheerfulness. — Nothing does more to drive away dyspepsia than a 
cheerful, lively, and even mirthful state of mind. All the nervous 
influences sent from the brain to the stomach should be of the most 
agreeable kind. Some people think it vulgar to laugh. Let such 
stand with long faces in life's shadows, if they choose. As a general 
rule, the best men and women laugh the most. Good, round, hearty, 
side-shaking laughter, is health for everybody ; for the dyspeptic, it 
is life. 

Dyspeptics who have a taste for it, and can endure the expense, 
should travel. A voyage to Europe, and a year spent in seeing the 
wonders of the old world, will generally cure the most stubborn case 
of indigestion. This, however, depends upon circumstances. For 
those having the finer organizations and the higher natures, extensive 
travelling is sometimes indispensable. The narrow circle of thoughts, 
associations and things in their own neighborhood, do not fill the 
compass of their wants ; their many-sided faculties need to be drawn 
on by the large variety to be found only in travel. Their large and 
impressible natures want to be filled full in order to drive out disease, 
and it takes a world, or a considerable part of it, to fill them. The 
dyspepsia of such natures is not comprehended by the multitude, and 
even physicians are often amazed that their narrow prescriptions do 
not reach it. 

Heartburn. — Cardialgia. 

This is a gnawing and burning pain in the stomach, attended by 
disturbed appetite. It is generally caused by great acidit}^ of the 



DISEASES OF THE ABDOMINAL CAVITY. 309 

stomach, and is a symptom of dyspepsia, and often afflicts pregnant 
women. Whenever too much food is taken, it is liable to ferment, 
and become extremely sour, — causing heartburn. In such cases, 
vomiting often occurs ; and what is thrown up is sour, and some- 
times bitter. 

Treatment. — Immediate temporary relief may be obtained by 
swallowing a teaspoonful of soda, magnesia, or chalk, in a tumbler of 
cold or warm water. Fluid magnesia, or lime-water, will answer the 
same purpose. If there is wind in the stomach, as well as acidity, a 
teaspoonful of the aromatic spirit of ammonia, or (135), will often 
still the uneasiness in a moment. 

To cure the complaint, the stomach must be strengthened by the 
remedies directed for dyspepsia. 

Spasm or Cramp in the Stomach. — Gastrodynia. 

Though generally of shorter duration, this is more violent than 
heartburn. It is attended by a sense of fullness, by anxiety, and by 
great restlessness. In females, hysterical symptoms are often coupled 
with it. Great quantities of air or gas are generally expelled, and 
the pain shoots through to the back and shoulders. 

Treatment.— A strong purgative injection (248) will often bring 
immediate relief. The sweet tincture of rhubarb and soda (37), with 
a few drops of tincture of cayenne mixed with it, will often bring 
speedy relief. So will a mustard poultice laid upon the stomach. 
The mustard poultice is a remedy of great excellence, in many cases. 
It deserves to be called the poor man's friend. 

Water-Brash. — Pyrosis. 

This consists in a discharge from the stomach, generally in the 
morning, of a thin, glairy, watery fluid, sometimes insipid, at other 
times sweetish, and at still others sour. A burning heat or pain in 
the stomach attends, and seems to be the immediate cause of the 
discharge. The discharge appears to be the natural mucus of the 
stomach, which is poured out in large quantities in consequence of a 
kind of catarrh of its mucous lining. The amount thrown up varies 
from a spoonful to a pint or more. 

The complaint is caused by a poor, innutritious diet, or by what- 
ever causes the blood to become thin and watery. 

Treatment. — Ten or fifteen drops of water of ammonia, in half a 
tumbler of water, will quiet the distress, and check the discharge. 
The most effectual remedy I am acquainted with for breaking up the 
discharge, is the trisnitrate of bismuth, taken at meal-times, in from 
twenty to thirty-grain doses, three times a day. The compound pow- 
der of kino is a valuable remedy. The compound tincture of senna 
and the tincture of balsam of tolu, in equal parts, and administered 



310 DISEASES OF THE ABDOMINAL CAVITY. 

in tablespoonful doses, are sometimes useful. The tincture of nux 
vomica is a good remedy. 

To restore the blood, some of the various preparations of iron (74), 
(80), (73), (316), will be required. 

The diet should consist of easily-digested, nutritious food, — as 
soups, broths, fresh meat, and unbolted wheat-bread. 

Vomiting. 

This occurs under a great variety of circumstances. It may be 
induced by acidity of the stomach, by irritability of the stomach, by 
distress of mind, by injury of the brain, by offensive odors, and by all 
organic diseases of the stomach. 

Treatment. — Generally, it is cured by treating the disease which 
induces it. But in many cases it persists very obstinately, and may 
become the chief thing to be attended to. In such cases, it may re- 
quire a careful investigation of the cause to check it. But generally 
some aromatic, as ginger, spearmint, peppermint, or spice-tea, will 
put an end to it. Some cordial or stimulant, as brandy, champagne, 
tincture of ginger, paregoric, elixir solutis, or cherry brandy, will 
answer well. Strong coffee, without sugar or milk, will, in some 
cases, act like a charm. If it is dependent on acidity, the remedies 
are given under " dyspepsia." If caused by irritability of stomach, 
a pill of extract of belladonna and ipecac (339) will do well. 

While vomiting, the patient should lie still in bed, and in bad 
cases, a mustard poultice should be placed upon the stomach. 

The vomiting of children may sometimes be stopped by wetting a 
piece of cloth with laudanum, and laying it upon the pit of the 
stomach. 

Seasickness. 

This is the great terror of persons who, for the first time, cross the 
ocean. - It is said that dark-complexioned persons suffer more from 
it than others. 

If it cannot be entirely prevented, it may be mitigated by lying 
flat upon the back. To lie on deck, in the open air, is much better 
than lying in the close air of the cabin or stateroom. A wineglass 
of brandy, or iced champagne, sipped now and then, will relieve the 
sickness very much. For a child, it is sometimes sufficient to wet a 
cloth with mustard, and lay it upon the pit of the stomach. Creo- 
sote, one drop at a dose, made into a pill, is excellent. Ten drops 
of hartshorn, in half a tumbler of water, is good for some. But the 
best known remedy is chloroform, taken in doses of from forty to 
eighty drops, suspended in water by means of a little gum-arabic. 
Bromide of soda in large doses, daily, prevents it, or bromo-caffein 
when it first comes on. Cocaine in one-eighth grain doses every 
twenty minutes is usually very helpful. A spinal ice-bag placed 



DISEASES OF THE ABDOMINAL CAVITY. 311 

opposite the stomach while the sufferer lies upon the back will do 
more toward curing sea-sickness than any other single remedy. 
These bags are about eight inches long, made of thin rubber, and are 
to be filled with small pieces of cracked ice. When the ice melts 
refill the bag. 

Milk Sickness. 

This disease prevails in the West, chiefly in the neighborhood of 
level, heavily-timbered, rather wet oak-land. 

The cattle, horses, and sheep, which range in this land, are fre- 
quently attacked by a disease which the people call the trembles. It 
is supposed to be produced by eating some plant growing upon those 
lands, as cattle which feed in the neighboring regions are free from 
it until they find their way into these low grounds. It has been sug- 
gested that the offending plant may be the poison ivy (rhus toxicoden- 
dron). Be this as it may, the calves, soon after sucking cows which 
have run in these grounds, are seized with trembling, and frequently 
die of the disease. Dogs which lap the milk are affected in a similar 
manner. Children drinking it leave the table and vomit. Upon 
grown persons the effects are more severe, but not so sudden. The 
eating of the beef, mutton, or veal, of affected animals, brings on the 
same disease. 

Symptoms. — The disease sets in with sickness at the stomach, 
which is preceded by general debility, more particularly of the legs. 
There is nausea, vomiting, and the breath is so offensive and peculiar 
that those acquainted with the complaint immediately recognize it 
from this smell. 

These existing for weeks, constitute, in some cases, the whole of 
the symptoms. In other cases they are more severe, being attended 
by chills and flushes, great oppression about the heart, anxiety, deep 
breathing, heat in the stomach compared to fire and boiling water, 
violent retching and vomiting, alarming beatings of the heart, and 
throbbings of the large vessels, and cold extremities, — producing, 
all together, extreme distress. 

In most cases, the vomiting returns every hour or two, attended 
by great burning at the pit of the stomach, the substance thrown up 
having a peculiar bluish-green color, and a sour smell. As soon as 
this discharge takes place, the patient falls back upon the pillow, and 
lies easy until another turn comes round. The tongue is covered 
with a whitish coat, the bowels are obstinately costive, and the pulse 
is small and quick. 

Treatment. — It is believed that the neutralizing mixture, given 
in tablespoonful doses every time the nausea and burning sensation 
are felt, is the most effectual remedy yet used. It relieves the 
acidity, and seems well adapted to allay the irritation. Some anti- 
bilious physic (40) to move the bowels should also be given. 



312 DISEASES OF THE CHEST. 

Besides these remedies, a mustard poultice should be put upon the 
stomach, and hot bricks to the feet, and the patient be kept still for 
some hours. The diet should be very mild, — only toast-water, rice- 
water, or thin gruel. 

Acute Inflammation of the Peritoneum. — Peritonitis. 

This disease affects the extensive membrane which lines the whole 
inside of the belly, an extension of which forms the omentum or 
apron. It is an inflammation to which women are much exposed 
after confinement, and is known, in such cases, as child-bed or puer- 
pral fever. It is common among men also, and is a grave disease. 

The accepted notions of no disease have undergone so much of a 
revolution of late years as those relating to peritonitis. It was formerly 
considered to be generally of spontaneous or idiopathic origin, whereas 
now we know it to be the outcome of some one of several diseases, 
but lately understood, as for instance, appendicitis, septicaemia or 
blood-poisoning, inflammation of the fallopian tubes and ovaries, 
tuberculosis, abscess of gall-bladder, strangulated hernia, etc. 

Symptoms. — Like other forms of fever and inflammation, it is 
preceded by chills, with increased heat of surface, thirst, full, strong, 
and frequent pulse, flushed face, and red eyes, dry tongue with red 
edges, dry skin, restlessness, short, quick breathing, nausea and 
vomiting. 

The pain is increased by the patient sitting or standing up, — the 
bowels being thus pressed against the inflamed membrane. Lying 
upon either side is painful for the same reason. To lie flat upon the 
back, with the feet drawn up, is the only endurable position. The 
patient lies still, for all movements give pain. 

The pain in this disease is generally sharp, cutting, and pricking, 
but is not always equally intense. It is aggravated by the passage 
of wind along the bowel, by which the inflamed membrane is slightly 
stretched. 

When the disease is advancing towards a fatal termination, the 
belly becomes greatly swollen and tense, — having to the hand a 
peculiarly tight, drum-head feeling ; the pulse is rapid and feeble ; 
the countenance is full of anxiety, and is pinched and ghastly ; and 
a cold sweat breaks out. 

Treatment. — Small doses of antimony, lobelia, or ipecac, to pro- 
duce nausea and a moisture upon the skin, are generally among the 
first things given. The tincture of veratrum viride, in five to ten- 
drop doses, repeated every hour, will accomplish the same thing more 
effectually than any other known article. For such purposes, I give 
it the first place among medicines. A large poultice of white bread, 
rye-meal, or flax-seed, may be spread over the belly ; or cloths wet 
with cold water will be still better, if the patient be full-blooded, 
and naturally strong. The bowels should be moved at once by some 



DISEASES OF THE ABDOMINAL CAVITY. 313 

active physic, as butternut, salts, magnesia, castor-oil, or cream of 
tartar (20), (IT), (18), (27), or by podophyllin, etc. (40), (41), (31). 

The two main indications in the treatment of peritonitis after having 
discovered and treated the causes, are the thorough draining of the 
bowels of their watery secretions by some gentle saline which will 
not stir them up ; and secondly to maintain them in a state of quiet and 
rest. The first is met by magnesia in the form of the solution of the 
citrate, say one-half bottle every four hours till copious watery move- 
ments occur. Tins drains the glands and causes a flow of the poi- 
sonous effete material into the bowels and rids the system of so much 
poison. The second indication is met by opium in some of its many 
forms. It is often, however, a serious problem for even the physician 
to decide, and should only be undertaken with his advice. 

The drinks should be lemonade, soda-water, tamarind-water, cur- 
rant-jelly dissolved in water, and preparations (298) and (299). 
Indian-meal gruel, toast-water, barley-gruel, and the like, are the 
only allowable diet. 

Chronic Inflammation of the Peritoneum. 

When the acute inflammation of the peritoneal membrane is not 
successfully treated, it may run on for a time, and then subside into a 
lower grade of inflammation, called chronic, and in this state remain 
for an indefinite time. But it often arises independently of the acute 
disease, and attacks persons of both sexes, and of all classes and ages. 
Scrofulous children have it, and, wasting away under it to mere skel 
etons, are said to have consumption of the bowels. 

Symptoms. — These are sometimes very obscure, and the advances 
of the disease stealthy. At first there may be only a little soreness 
of the belly, so slight as not to be noticed except after hard work, or 
upon some wrenching motion. Generally, there is a sense of fullness 
and tension of the belly, although it may not be increased in size. 
After a time, it enlarges a little, and its tension or tightness increases, 
especially towards evening. By pressing carefully with the hand, a 
deep-feeling tension may be detected, giving to the hand a sensa- 
tion as of a tight bandage underneath, with the skin and integu- 
ments sliding loosely over it. If water has been poured out into the 
abdominal cavity, its fluctuation may be frequently detected by press- 
ing upon one side of the belly with the palm of one hand, and strik- 
ing the other side with the ends of the fingers. 

As the disease goes on, the features become sharp and contracted, 
and the countenance grows pale and sallow. Costiveness comes on, 
sometimes chills and fever, with debility, loss of flesh, cough, difficult 
breathing, hectic, and swelling of the legs. 

Treatment. — Costiveness, if present, may be relieved by Mettauers 
aperient, or the neutralizing mixture, assisted by coarse bread, and 
boiled cracked wheat. 



314 DISEASES OF THE ABDOMINAL CAVITY. 

Daily bathing is especially necessary, particularly the alkaline 
sponge bath, with vigorous friction over the bowels. The warm bath 
once or twice a week will be useful. In some cases, a wet towel 
laid upon the bowels over night, and well covered by flannels, will 
afford relief ; or the compound tar-plaster may occasionally be used. 

If there be dropsy of the belly, iodide of potassium (138) should 
be taken freely, and the skin made sore over the inflamed part, by 
tincture of iodine, well rubbed in, once a day. 

If the patient be pale and bloodless, give iron, quinine, etc. (74) 
(75), and let the diet be nourishing ; and if nervous symptoms be 
connected with the debility and paleness, add some nerve-tonic (93), 
(81), (316). When the disease is known to be the outcome of a 
deposit of tubercles on the peritoneum, it is now customary to open 
the abdomen under antiseptic methods and wash out the cavity. The 
effect of a mild salt-solution and the light and air oftentimes arrests 
the disease. 

Acute Inflammation of the Bowels. — Enteritis. 

By inflammation of the bowels is generally understood an inflamed 
condition of the mucous membrane which lines them ; but this, most 
commonly, is only a part of the disease ; it involves more or less, 
besides this mucous lining, the whole substance of the bowel. After 
an inflammation has existed some time, and even, in severe cases, at the 
start, certain poisonous substances are formed as the result of germ 
invasion, called toxines. These are genuine poisons, and often 
spread rapidly through the walls of the bowels by means of the 
numerous lymphatic vessels to the peritoneum itself, — that delicate 
membrane which we have seen covers all organs within the abdomi- 
nal cavity. When this membrane once becomes poisoned, an acute 
inflammation sets up, which masks all other symptoms, and is indeed a 
veritable blood-poison. We have then to deal with peritonitis. 

Symptoms. — The disease begins with a chill, and with uneasiness 
and slight griping pains, which increase in severity until they are in- 
tense and burning. Pressure aggravates the pain, which is most 
intense about the navel, but extends more or less over the whole 
bowels. 

From the beginning there is sickness at the stomach, and some- 
times vomiting ; there is loss of strength, costiveness, great anxiety, 
thirst, heat and fever, dry, furred, and red tongue, and but little urine, 
with pain in passing it. The matters passed from the bowels are 
dark and fetid ; and the whole belly is tender and sore to the touch. 
The pulse is quick, hard, and small. 

The stomach will be but little affected, comparatively, when the 
disease is at some distance from it in the lower portion of the bowels. 
Indeed, the nearness of the inflammation to the stomach, or its re- 
moteness from it, may be judged pretty correctly by the degree of 



DISEASES OF THE ABDOMINAL CAVITY. 315 

disturbance in that organ. The length of time after drink and medi- 
cines are swallowed, before they are vomited up, is a pretty good 
measure, likewise of the distance of the disease from the stomach. 

How to Discriminate. — This disease is liable to be confounded 
with colic, and with inflammation of the peritoneum. It is important 
to distinguish it from colic, particularly, because the treatment for that 
would aggravate this. In this disease the pain is increased by pres- 
sure ; in colic, it is not, but is rather relieved. In enteritis, the pain 
remits, but never ceases wholly, as it does in colic. In enteritis, 
the knees are drawn up, and the breathing is short ; in colic it some- 
times gives relief to stretch the feet down, and the breathing is not- 
altered. 

To distinguish it from inflammation of the peritoneum, take notice 
that diarrhoea is much more common than in this latter complaint, 
while the pulse is not as quick, nor the pain as severe. 

Treatment. — This should be very much the same as that recom- 
mended for peritonitis. Perhaps in both diseases it might be well 
to begin with covering the belly all over with leeches. 

The tincture of veratrum viride, in full doses, so as to keep up a 
free perspiration, cold compresses, mustard poultices, hot fomentations, 
poultices, blisters, soothing and quieting injections, and demulcent 
drinks, as slippery elm, marshmallow, flax-seed, etc., if judiciously ap- 
plied, will do about all that we have it in our power to accomplish. 

In this disease it is well to inquire if the patient has a hernia, for 
if so, it is liable to become strangulated without his knowledge. A 
strangulation of the gut may be the cause of the disease. When this 
happens, the complaint is very unmanageable. The bowel may pos- 
sibly, in such case, be disentangled by applying a large dry cup ; or, 
what is better, a number of small ones ; but the tenderness of the 
belly makes the use of this remedy difficult. Here again magnesia 
may be of signal benefit unless the movements are already too copious 
and exhausting, in which case disinfectants or astringents must be re- 
sorted to. The possibility of tuberculosis must not be ignored. 

Chronic Inflammation of the Bowels. 

Like other chronic inflammations, this may follow the acute torm, 
but it also results from various other causes, as unripe fruit, taking 
cold, drastic physic, and improper treatment of other diseases. 

Symptoms. — Red end and borders of the tongue, dull pain in 
belly, increased by pressure and rough motion, abdomen either swelled 
or flat, skin dry and husky, feet and hands cold, small frequent pulse, 
thirst, loss of flesh, low spirits, urine scanty and high-colored, and 
dirty, slimy discharges from the bowels, from one to four times a 
day. 

Treatment. — To begin with, blisters, or croton-oil, or mustard 



316 DISEASES OF THE ABDOMINAL CAVITY. 

poultices, or dry cups, if the tenderness is not great, or leeches if it is. 
If the bowels are hot and feverish, bind a cold compress upon the 
belly over night, covering it well with flannel. The warm bath 
should be used twice a week. Salol, ten grains every three hours, 
bismuth and opium, are in this case very valuable. Washing out the 
lower bowel with hot water by means of a syringe often soothes and 
heals. 

The diet must be of the most simple, unirritating kind, beginning 
with a solution of gum-arabic, rice-water, barley-water, arrow-root or 
sago-gruel, and gradually rising, as the symptoms improve, to beef- 
tea, mutton and chicken broth, tender beefsteak, etc. 

When the strength will permit, gentle exercise must be taken in 
the open air, but not on horseback, or in hard, jolting carriages. 

As soon as the inflammation is subdued, some mild laxative (35) 
may be given, in connection with an infusion of wild-cherry bark, 
geranium, and Solomon's seal, equal parts. 

Appendicitis. 

This is one of the so-called modern diseases, — not that it has not 
existed for a long time, but that not till lately has it been recognized 
as a distinct ailment. Formerly it fell under the general category 
of peritonitis or inflammation of the bowels. American physicians 
have done more toward discovering its characteristics than others. 
It is an inflammation of the appendix vermiformis, which is situated 
at the end of the large bowel, in the right flank, close to the junction 
of the colon with the small bowel (see Fig. 60). This organ is a 
small, round, tail-like body, about the size of a slate-pencil, and aver- 
ages some three inches in length. It is hollow, lined with mucous 
membrane, and covered like the bowel proper with a peritoneal mem- 
brane. It secretes mucus. Its use is as yet unknown, being thought 
by many to be a rudimentary organ like the uvula, without function, 
and possibly analogous to the herbivorous stomach. Whenever small 
seeds enter the cavity of this organ (which is in reality a rare occur- 
rence) or whenever, from any cause, a catarrhal inflammation is de- 
veloped in it, the secretion increases, and being confined, aggravates 
the trouble. This catarrhal inflammation is generally mild and the 
trouble often subsides either for good or to start up again sooner or 
later. 

The inflammation may, however, become purulent, the germs pen- 
etrating the walls of the appendix and causing a general inflammation 
of the peritoneal coat of the bowel. In these cases nature fights 
hard to resist the invasion of the germ and throws out a large amount 
of lymph and serum, which, when it hardens, often acts as a barrier 
to the further progress of the peritonitis which has begun about the 
appendix. These cases are characterized by a hard lump in the ap- 
pendicular region, the inside of which contains pus as a rule, which 



DISEASES OF THE ABDOMINAL CAVITY 317 

has escaped from the bursting appendix. Cases of this class are ex- 
tremely dangerous and require the immediate aid of a surgeon, as 
they are bound to give trouble sooner or later, even if the first attack 
does not prove fatal. 

There is still a third class of cases, called fulminating, because 
from the very first they seem to be purulent, and spread rapidly into 
a general peritonitis, death occurring within a few days from the ap- 
pearance of the first symptoms. These cases are the most hopeless 
of all, and must be operated on without the slightest delay, since im- 
mediate evacuation of the pus, before a general infection of the ab- 
dominal cavity supervenes, is the only possible hope of saving the 
patient. 

Symptoms. — The disease, as generally observed, begins with lan- 
guor and pain in the abdomen, with special soreness on the right 
side, oftentimes nausea and vomiting, constipation, a slight rise of 
temperature, and headache. As the disease progresses the tenderness 
amounts to pain, a bunch may be felt by the medical attendant : the 
temperature gets a little higher and symptoms of pus formation set 
in. The case may hang in this initial stage (up to the point of pus 
formation) for several days and finally subside, it being a more or 
less catarrhal inflammation; but when pus has once formed the pa- 
tient cannot escape without an operation for the removal of the of- 
fending body. Many surgeons at the present day even take the 
ground that every inflamed appendix should be removed. 

Treatment. — The medical treatment consists in giving magnesia 
in form of the solution of the citrate, with a light diet, and keeping 
the patient in bed. Poultices may be of some benefit. Opium should 
not be used unless pain is extreme. 

The operation for appendicitis, when performed between the attacks, 
is a comparatively safe one in competent hands ; but it becomes a very 
grave one if pus forms rapidly and invades the general abdominal 
cavity. Between these two classes of cases there are all grades of 
difficulty and danger. 

Cancer of Intestine, 

This disease is much less frequent than cancer of the stomach, 
constituting about five per cent of all cases of cancer. It occurs 
usually about the middle period of life. We are in absolute igno- 
rance of its causation in this region. The rectum is the most favor- 
able part of the bowel for its development, the large intestine next, 
and then the small intestine. 

Symptoms. — Intestinal hemorrhage, pain; emaciation, irregular 
movements of the bowels, pain in the sacral region, radiating to the 
genitals and down the course of the sciatic nerves (in case of rectal 
cancer), are among some of the indefinite symptoms of cancer of the 



318 DISEASES OF THE ABDOMINAL CAVITY. 

bowels. When well marked and when located favorably, a tumor 
may be discovered by palpation, but often this cannot be felt and the 
masses which at first seem to indicate cancer may afterward prove 
to be merely faecal accumulations. When the mass can be felt in 
the rectum the diagnosis becomes clearer. The prognosis of the 
disease is extremely unfavorable. 

Treatment. — As for treatment, only in rare cases is much aid 
ever procured. The formation of an artificial anus in the left flank 
may avert for a while the final end. The injection of the new cancer- 
serum is still of doubtful success. 

Opiates to relieve pain, nourishing food frequently repeated, and 
the use of antiseptic enemas, are, for the most part, the chief meas- 
ures that afford relief. 

Intestinal Obstruction. 

This is a mechanical interference with the movements of the fae- 
ces, and is caused either by intussusception or invagination, con- 
striction, twists, stricture or hernia. These conditions are frequently 
produced by irregular movements of the bowels as a whole, and by 
irregular movements in various parts of the same, there being an 
increased peristalsis in one part and constipation in an adjacent part. 
Many cases of intussuception occur at the ileo-caecal valve, the small 
bowel entering the large bowel and being driven downward. The 
circulation of the bowels is naturally interfered with, and intense 
congestion occurs, with swelling and final obstruction of the calibre 
of the gut. Pain becomes paroxysmal and peritonitis ensues. Pain 
increases, with vomiting and the discharge of mucoid stools ; finally 
the patient dies of exhaustion. 

Constriction of the bowel forms the larger proportion of cases and 
is not infrequently caused by fibrous bands which are the result of 
inflammation. Strangulation may be produced by a loop being held 
down by such bands or by being twisted about it. Intestinal ob- 
struction, ulceration, and even perforation are common results. 

A twist or volvulus is also a cause of obstruction, though less com- 
mon than the two causes just mentioned, and occurs generally near 
the sigmoid flexure. 

Stricture of the bowel usually occurs at the sigmoid flexure, or in 
the rectum, and is not usually complete, some small amount of faecal 
matter still escaping. Tumors, like cancer, not infrequently cause 
stricture by their compression. 

Functional obstruction occurs chiefly in hysterical females, but also 
in disease of the brain and spinal cord, as well as from peritonitis 
and blows on the abdomen. It is the result of a paralysis of the 
bowel. 

Impaction of fasces is still another frequent cause of obstruction. 
The contents of the bowels, especially in the rectum, become hard, 



DISEASES OF THE ABDOMINAL CAVITY. 319 

blocking the passage till quite a perceptible bunch may be felt ex- 
ternally. The channel is not always blocked completely. Gall-stones 
may become impacted near the ileo-csecal valve in their passage 
downward, and form the starting point of the fsecal accumulation. 
These various causes produce either acute or chronic obstruction. 

Symptoms. — In the acute variety, pain, vomiting and constipa- 
tion are the prominent symptoms. There are at first some digestional 
disturbances, with moderate pain. Afterwards the pain becomes 
severe, even intense, and is usually located near the seat of the ob- 
struction. It is at first colicky and intermittent, but finally becomes 
continuous and severe over the whole abdomen. Vomiting sets in, 
first of food, then later of bile, and finally stercoraceous if the ob- 
struction becomes complete. Vomiting occurs whether the obstruc- 
tion is in the large or small bowel. Before the close of the scene 
this vomiting assumes a ricewater-like character, perhaps attended 
with hiccough. 

There is an absence of the passage of wind, although at first some 
small amount of fsecal matter may pass. In intussusception there 
are usually bloody discharges in addition to constipation. The ab- 
domen of course soon becomes tympanitic or swollen, and sounds of 
water and gas may be heard very distinctly. 

The general symptoms are those of a very grave disease, — restless- 
ness, cold extremities, pinched features, and cold, clammy skin. The 
pulse is small, the temperature generally subnormal, tongue dry, and 
thirst very pronounced. 

In the event of chronic obstruction, all these symptoms appear very 
much more gradually. Pain is less severe, vomiting often absent till 
the obstruction becomes complete. The fsecal matter may often be 
several feet long before the obstruction becomes severe. Long-stand- 
ing constipation which does not respond to proper laxatives should 
arouse suspicion. The stools themselves are often ribbon-like in 
shape and very small, not infrequently resembling the fseces of sheep. 

The prognosis of obstruction of the bowels is usually very grave, 
and the duration of life varies from a few hours to ten or twelve days. 
The higher up the obstruction, the worse the prognosis. Simple 
fsecal impaction perhaps offers the most hope ; next those cases 
amenable to surgical interference, 

Treatment. — Opium to relieve pain and to stop the exaggerated 
peristaltic movement in parts of the bowel above the obstruction is 
surely indicated ; it also relieves the vomiting. Continued, large 
enemas of suds and oil, and even the addition of turpentine, should be 
resorted to at once as soon as the trouble has been made out. These 
are best given with the hips elevated, and should consist of four to 
six quarts of water ; they are to be given slowly and without much 
force. Oftentimes an ansesthetic is needed. 

If the obstruction is from fsecal impaction, small, repeated doses 



320 DISEASES OF THE ABDOMINAL CAVITY. 

of some saline should be used ; say two ounces of the solution of the 
citrate of magnesia every two hours. Castor-oil in teaspoonful doses 
hourly till movement occurs is also good. But if the obstruction is 
from intussusception, twist, stricture, etc., all laxatives must be 
strictly interdicted. Finally, these simple means failing and the case 
be suspected to be due to impaction by foreign bodies, fibrous bands, 
etc., the abdomen must be opened and the seat of the obstruction 
found and if possible removed. The operation in this class of cases 
is not attended with a great percentage of recoveries, and yet the 
fatal termination is much surer if left alone ; in many cases it is 
brilliantly successful. 

External methods of treatment by hot fomentations of turpentine, 
and even of massage, often add greatly to a favorable termination. 

The diet must be very light and nutritious, and in case of vomiting 
must be given by the rectum. After the obstruction has been re- 
lieved, one must be very careful about the diet and see that the bow- 
els are open daily. 

Wind Colic. — Flatulent Colic. — Interalgia. 

This is a severe and distressing pain in the bowels, — sometimes a 
stoppage, and a swelling about the pit of the stomach and the navel. 
What children call belly-ache is a mild form of it. The wind passing 
from one portion of the bowel to another causes a rumbling noise. 
The pain is not increased by pressure ; and this distinguishes it from 
the pain of inflammation. It moves about, too, from place to place, 
and is much relieved by the escape of wind up or down. 

The complaint may be caused by a weakness in the digestive or- 
gans, by eating indigestible food or unripe fruit, by costiveness, and 
by taking cold. Some persons always have the colic excited by eat- 
ing certain kinds of fruit. 

Treatment. — When the complaint is caused by an indigestible sub- 
stance taken into the stomach, the offending matter should be thrown 
off by an emetic as soon as possible. If this does not bring relief, 
let it be followed by a dose of salts, salts and senna, compound infu- 
sion of senna, elixir salutis, elixir pro., or sweet tincture of rhubarb. 
If there is no sickness of the stomach, a little essence of peppermint 
or spearmint in hot water, or brandy, gin, or whisky, in hot water, 
may prove sufficient to expel the wind, and relieve the pain. Ginger 
and hot water does well with some. If there be costiveness, and the 
pain is obstinate, let the bowels be unloaded by a stimulating injec- 
tion (248), (249), (250). Inject one dram of. ether in a little starch- 
water into the bowels, and relief will often be instant. It can be 
repeated every half-hour. The injection of a table-spoonful of tur- 
pentine in suds can also be tried and repeated every two hours. 



DISEASES OF THE ABDOMINAL CAVITY. 321 



Air=Swellings. — Tympanites. 

It is quite common for persons in delicate health — particularly 
females — to have their stomach and bowels swell up, sometimes 
slowly, sometimes suddenly, so that they cannot bring their clothes 
together. They do not know what to make of it; it sometimes 
alarms them ; and they ask their medical adviser what it means. 

These swellings may occur from an accumulation of air within 
the bowels, and also within the abdominal cavity. This latter gives 
the belly a peculiarly hard feel, like the head of a drum, and when it 
is pressed upon with the finger no indentation remains. It usually 
is the result of a weakened sympathetic nervous system, brought 
about by some one of the many abdominal diseases. 

Treatment. — If the air be in the intestinal tube, a stimulating in- 
jection may bring away the wind. It may be composed of one pint 
of infusion of peppermint, one gill of tincture of prickly-ash berries, 
half a gill of tincture of castor, and a teaspoonful of ginger. The 
bowels of the patient should be rubbed for a long time ; and in all 
forms of the complaint, it would be well to do this every day. Some- 
times the wind may be drawn off by inserting into the rectum a long 
rubber tube. Treatment often resolves itself into a cure of some 
existing uterine or ovarian disease and the various phases of peri- 
tonitis, in which latter case there is fever and other well marked 
symptoms. 

The best constitutional remedies are tonics, — iron, quinine, mineral 
acids, and bitters, (48), (bh), (59), (60), (62), (63), (64), (71), 
(73). 

Exercise in the open air, and a careful regulation of the diet, will 
do much towards removing these troubles. Costiveness must be care- 
fully guarded against. 

Bilious Colic. 

This is a dangerous disease. There is pain of a griping, twisting, 
tearing kind, — what the ancients called atrocious pain. It is chiefly 
about the navel, but sometimes tortures the whole belly. It comes 
and goes in paroxysms. Sometimes the abdomen is drawn in, at 
other times it is swelled out, and stretched like a drum-head. At 
first the pain is relieved by pressure ; after a time the belly is tender to 
the touch. There is thirst and heat, and a discharge of bilious mat- 
ter from the stomach. In the worst cases, the pulse is small, the face 
pale, the features shrunk, and the whole body covered with cold 
sweat. While the head is hot the feet are cold. In advanced stages 
of the disease, the action of the bowels is sometimes reversed, and 
the fecal matter forced up through the mouth, owing to impaction of 
faeces or other obstructions of the bowel. 



322 DISEASES OF THE ABDOMINAL CAVITY. 

Causes. — Costiveness, irritating substances in the bowels, thick, 
vitiated bile, long exposure to cold, torpidity of the liver and skin, 
great unnatural heat, with dampness, obstructed gall-duct, etc. 

These attacks are usually the result of indigestion in the upper 
bowel, near the bile-ducts, creating a thick mucus which obstructs 
the passage of bile from the ducts into the bowels. A regulation of 
the duct, small doses of podophyllin or the acids, with daily doses of 
some mild bilious laxative, will prevent their return. Crab-orchard 
water^ sal-muscatelle, and other simple medicines answer every pur- 
pose. 

Treatment. — Administer an active purgative injection immediately 
(251), (252). Internally, dioscorin, camphor, etc. (340), every fifteen 
minutes until relief is obtained, at the same time covering the whole 
belly with a large mustard-poultice. A strong decoction of the wild- 
yam root, drunk freely, is a medicine of some value, — so is a decoc- 
tion of sculleap and high-cranberry bark, equal parts. This latter 
article is excellent in spasmodic affections, on which account it has 
gained the name of cramp-bark. The sickness at the stomach may 
frequently be allayed by effervescing drafts, to which twenty-five or 
thirty drops of lavender are added. Croton-oil, given in one-drop 
doses, done up with crumb of bread, will sometimes succeed well as 
a purgative medicine ; or castor-oil and spirits of turpentine, equal 
parts, in two great spoonful doses, may be tried before the croton 
oil. 

The warm bath is worth remembering, and trying, too, if the 
means are at hand. Hot fomentations of the bowels with a decoc- 
tion of poppy-leaves, stramonium-leaves, hops, wormwood, boneset, 
or peppermint leaves, should not be overlooked. Bottles filled with 
hot water, or hot bricks rolled in flannel, should be placed at the back 
and feet to promote perspiration. 

Persons subject to this complaint may derive advantage from one 
pill composed of extract of high-cranberry bark, etc. (100), taken after 
each meal for some months. At the same time a reasonable amount 
of exercise should be taken out of doors, and a sponge bath, with 
friction, be employed daily. Care should be taken not to be often 
exposed to the hot sun. 

Painters' Colic. — Colica Pictorum. 

This form of colic is caused by the slow introduction of lead into 
the system, — generally the carbonate of lead. It passes under the 
different English names of painters' colic, Devonshire colic, and dry 
belly-ache. The first of these is the name by which it is most com- 
monly known, from its frequent occurrence among painters, who use 
white lead (carbonate of lead) a great deal in the preparation of their 
colors. 

Symptoms. — The disease generally comes on in a very gradual 



DISEASES OF THE ABDOMINAL CAVITY. 323 

way. At first, the appetite is impaired, there is a slight nausea, 
belching of wind, languor, very obstinate costiveness, transient pains, 
with a feeling of weight and tightness in the belly, and a disinclina- 
tion to make any exertion. 

By degrees, the pain in the bowels, and particularly about the na- 
vel, becomes more severe, and has a twisting character. The belly 
becomes hard, drawn in, and a little tender to pressure, and the stom- 
ach very irritable. The pain occasionally slacks off a little ; but 
never, even in mild cases, entirely stops, as in other kinds of colic. 

In some severe cases, the pain runs up to the chest, and down the 
arms ; also down to the bladder, causing the urine to be passed with 
pain and difficulty, and giving a sense of weight and beaiing down 
in the lower belly. During the severest pains, the countenance is 
pale, contracted, and full of suffering ; cold sweats break out upon 
the face and limbs, and anxiety and agitation seize the patient. 

When the disease is not seasonably removed, it degenerates into 
the chronic form, the mental and physical energies become torpid, 
the circulation in the small vessels inactive, the skin dry, harsh, shriv- 
elled, pale, sallow, or of a leaden hue, the temper irritable, despond- 
ing and gloomy, and the body wasted. Besides all this, the muscles 
which lift up the lower arm become palsied, so that, when the arms 
are raised, the hands hang down in a helpless condition. In some 
cases, there is a blue line along the edges of the gums. 

Treatment. — For relieving the pain and opening the bowels, the 
treatment should be very much the same as that for bilious colic. 
There is one article, however, which is thought to have some special 
influence in curing this disease, after it has become chronic ; it is 
alum. Fifteen grains of alum, two of aloes, two of jalap, and four 
of ipecac powder, may be mixed, and taken for a dose two or three 
times a day. If the muscles of the arm be palsied, one thirtieth of 
a grain of strychnine may be added to the above. The aromatic sul- 
phuric acid, taken as a drink, fifteen drops to the tumblerful of water, 
is always worthy of trial. 

The use of the electromagnetic machine maybe tried for the palsy; 
or a splint applied to the arm and hand, with vigorous friction once or 
twice a day, will sometimes do much for recovering the use of the 
muscles. 

But the best remedy for the palsied muscles is iodide of potassium 
(146), taken freely. The sulphuret of potassa, one ounce dissolved 
in a quart of water, and taken in teaspoonful doses, three times a day, 
is also worth a trial. The affected arm should be soaked an hour, 
once or twice a day, in the same amount of this latter salt, dissolved 
in a gallon of water. 

Means of Prevention. — The numerous persons who work in lead 
should comb their hair with a fine comb, wash their hands and face, 
and rinse their mouth several times a day, and also wash the whole 



324 DISEASES OF THE ABDOMINAL CAVITY. 

person with soap once or twice a week, and with clear water, or sal- 
eratus and water, once a day. Their working clothes should be of a 
kind to admit of being washed once or twice a week, and they should 
be put off for others when out of the workshop. A paper cap should 
be worn while at work. The food of the workmen should not be ex- 
posed to the vapors or floating particles of lead, and consequently 
should not be carried into the shop ; and when much of the poison is 
floating in the air of the workroom, it is a good plan to wear a mask 
to prevent its being drawn with the breath into the throat and lungs. 
It has been said that those who eat freely of fat meats, butter, and 
other oily substances, are not attacked by the disease, though exposed 
to the poison. I know not what protection this can give, unless the 
skin is in this way kept more oily, which prevents the absorption of 
the poison. This would seem to afford a hint in favor of anointing 
the whole person once or twice a week with sweet-oil. 

Costiveness. — Constipation. 

Few disorders are more common than costiveness. By this term 
I mean a sluggish state of the bowels, which causes them to retain 
the faeces longer than is warranted by health, hi this complaint, the 
discharges from the bowels are not always less frequent than they 
should be, but they are less in quantity, are compacted and hard, and 
are passed by hard straining, and sometimes with considerable pain. 

Symptoms. — Headache, dizziness, feverishness, bad feelings in the 
head not easily described, loss of appetite, sometimes nausea, but 
little desire to go to stool, a weight and heaviness about the lower 
part of the belly, and a sense of confinement over the whole body. 

Causes. — Sedentary habits, particularly when connected with close 
application of the mind ; astringent articles of medicine ; stimulating 
diet, composed chiefly of animal food ; various diseases, particularly 
those of a nervous character, and especially, a neglect to evacuate 
the bowels at proper periods. All these causes tend to weaken the 
bowels, and gradually to arrest that peculiar undulatory movement, 
or worm-like action, called the peristaltic motion of the bowels. It 
is this continual contraction of the muscular fibres of the intestines 
from above downward, which pushes the contents steadily along; and 
whatever weakens the force of this vermicular play of the intestinal 
walls, brings on constipation. 

Treatment. — One of the first things to be done is to establish the 
habit of attempting to evacuate the bowels at a particular hour every 
day. The best time for most persons is soon after breakfast in the 
morning. Whether successful or not, the attempt to procure an evac- 
uation should on no account be omitted. This regularity will often 
do much to break up the costive habit. 

Diet To this should be added a careful regulation of the diet. 






DISEASES OF THE ABDOMINAL CAVITY. 325 

The quantity of food taken should be no greater than can be easily 
digested. Full meals which distend the stomach and cause it to press 
upon the bowels embarrass their movements. Bread made from fine 
wheat flour is an abomination in this disorder. Eat only that from 
unbolted flour. Cracked or rolled wheat, prepared as directed among 
dietetic preparations, is excellent for the cure of costiveness. Fresh 
vegetables, as peas, beans, potatoes, squashes, and ripe fruits, in their 
season, are all wholesome, and help to relieve costiveness. But rich 
pies, puddings, cakes, doughnuts, and all that sort of trash, increase 
the disorder. 

Water Injections, etc. — One of the best remedies is water, cold 
or tepid, according to the condition of the patient, injected into the 
bowels with the fountain syringe. Syringes for this purpose may be 
obtained in any drug-store, and one should be in every family. 
Water used externally, in the form of the sponge-bath, is also useful. 

Medicines. — All the above measures having failed to give relief, 
take Mettauer's aperient, or the neutralizing mixture. If these fail, 
podophyllin, etc. (36), may have a trial. A cold decoction of thorough- 
wort, drunk daily, sometimes has an excellent effect. It must be re- 
membered that medicines may make matters worse, and they should 
be used cautiously. Cascara Sagrada taken in small, repeated doses, 
say, half a grain once, twice or more times daily till the bowels move, 
for some weeks, then gradually decreased, often yields excellent re- 
sults. A glass of some aperient like Hunyadi Janos water, one-third 
glass with one-half glass of plain water on rising, will then take the 
place of the cascara ; and finally a glass of plain water will accom- 
plish all that previously required the use of the cascara. Daily knead- 
ing of the bowels, following the course of the large bowel, will add 
greatly to break up the sluggishness of the muscular atony of the 
bowel-walls. 

Piles. — Hemorrhoids. 

There are few complaints more common than the piles, and 
scarcely any which cause more trouble and misery. They consist in 
a fullness of blood, and languid circulation in the lower portion of the 
lower bowel or rectum. In consequence of this congestion, either the 
veins of the gut become enlarged or varicose, or the blood gets infil- 
trated into the cells beneath the mucous membrane, and collects, so 
as to form bloody tumors. 

These tumors, which are seldom absent, are the leading features of 
the piles. They sometimes appear externally, around the anus ; this 
is external piles. At other times they are within the bowel ; the com- 
plaint is then called internal piles. They are called bleeding piles 
when blood is discharged, and blind piles when it is not. 

Symptoms. — Usually there is a sense of weight and weakness in 
the lower part of the back and lions, with a painful itching about the 



,/ 



326 DISEASES OF THE ABDOMINAL CAVITY. 

anus. On going to stool, there is a burning, cutting pain experienced, 
which is followed by bearing down and tenesmus. If it be bleeding 
piles, the little tumors will bleed at every motion of the bowels. 
There are frequently disagreeable sensations in the head, general las- 
situde, an irritable state of mind, and a sense of fullness and anxiety 
in the stomach. The pains experienced range all the way from the 
slightest twinges up to the most terrible sufferings, which appear like 
tearing the body asunder. 

Causes. — Everything that irritates the lower bowel, and causes a 
determination of blood to the part. All drastic physic has this effect, 

— particularly aloes, which acts especially upon the rectum. Habit- 
ual costiveness, straining at stools, riding much on horseback, sitting 
a great deal, tight-lacing, high-seasoned food, and stimulation gener- 
ally, lifting and carrying heavy weights, and indurations of the liver, 
as well as a bilious indigestion. 

Females during pregnancy are much affected with piles, which are 
induced by the costiveness so peculiar to their condition, and by the 
pressure of the enlarged womb upon the veins of the pelvis. 

Treatment. — This should be medicinal and dietetic. 

Great care must be observed not to push medication too far. Ac- 
tive purging will do great mischief. Yet costiveness must in some 
way be corrected. For this purprse, no remedy that I have ever 
tried has done better in this complaint than an electuary composed 
of confection of senna, flowers of sulphur and cream of tartar (6), 
taken in doses just sufficient to procure one natural motion of the 
bowels each day. Pills made of extract of thoroughwort are said to 
do well. If the liver be in a congested state, take some of the arti- 
cles recommended in the chronic inflammation of that organ. 

For the local treatment, nothing is better than two ounces of lard 
and one dram of the flowers of sulphur mixed, and rubbed between 
two plates of lead until they are well blackened. This ointment is 
not only soothing but curative, both in the bleeding and blind piles. 
An ointment of almost equal excellence may be made from one hand- 
ful each of witch-hazel bark, white-oak bark, and sweet-apple tree 
bark, boiled together in one pint of water down to one-third of a pint. 
Then strain, and add two ounces of lard and simmer away the water, 

— stirring continually before and after removing from the fire, till it 
cools. Witch-hazel suppositories are excellent, as is also an oint- 
ment composed of 1 ounce stramonium ointment, 6 grains pulverized 
opium, and 5 grains tannin. 

If there is much inflammation and distress, an emollient and 
soothing poultice should be applied, composed of slippery-elm 
bark and stramonium or poke leaves. Steaming the parts is some- 
times useful, by sitting over a hot decoction of hops, stramonium, 
and poke. 

Piles may often be cured by the use of the domestic syringe. Daily 



DISEASES OF THE ABDOMINAL CAVITY. 327 

injections of cool or cold water will do much to strengthen the bowel, 
and restore the dilated veins to their natural condition. 

The food should be of a laxative nature, corn-bread, rye-pudding, 
bread of unbolted wheat flour, mealy potatoes, ripe fruit, pudding 
and milk, buckwheat cakes, broths, and a little tender meat once a 
day. 

When the piles are very painful an ointment of cocaine, ten 
grains, vaseline, one-half ounce, smeared well over them, is exceed- 
ingly grateful. Five-grain iodoform suppositories are very effective 
in reducing piles ; its odor, however, is quite objectionable to many. 
Surgical treatment is often the only resource left for their cure. 

Looseness of the Bowels. — Diarrhoea. 

Looseness, or relax of the bowels, is manifested by frequent, copi- 
ous, and thin or unusually liquid discharges. The excessive dis- 
charge may be caused either by irritating and unwholesome food, by 
inflammation and ulceration of some portion of the bowels, or by de- 
bility. 

Symptoms. — Rumbling noise in the bowels, with more or less 
weight and bearing down and uneasiness in the lower part of the 
bowels. This pressing down and uneasiness are relieved as soon as 
the evacuation takes place, but returns when another is near at hand. 
Griping is generally present, the strength is reduced, and the skin is 
pale, dry, and, after a time, sallow. 

Treatment: — When the complaint is caused by irritating food, it 
will generally stup as soon as the offending substance is removed, and 
not much medicine will be required. 

To neutralize any acidity, to remove wind, allay irritation, and 
strengthen the stomach, the compound syrup of rhubarb and potassa 
is well adapted, given in teaspoonful doses, every hour, till it oper- 
ates. A little paragoric added to it occasionally, or essence of pep- 
permint, or spearmint, may aid its good effects. 

If nausea and vomiting are present, put a mustard poultice of one- 
third strength upon the stomach, and give one-tenth grain of cocaine in 
a teaspoonful of water every fifteen minutes. If there is much grip- 
ing, give an injection (248), with twenty drops of camphor in it. 
A common diarrhoea may generally be arrested at once by prescrip- 
tions 159 or 162, in teaspoonful doses, after each discharge. 

When there is inflammation and ulceration of the bowel, the treat- 
ment must be similar to that for dysentery, — fomentations exter- 
nally, and the occasional use of starch injections, mild cathartics (9), 
(10), and poultices externally. 

Chronic Diarrhoea. 

The acute form of diarrhoea, not being properly managed, often 
runs on, and becomes chronic, and is at times exceedingly difficult 
to cure. 



328 DISEASES OF THE ABDOMINAL CAVITY. 

Symptoms. — Frequent discharges, generally with some pain and 
griping, restlessness, thirst, poor appetite, debility, loss of flesh, dry, 
rough, and somewhat sallow skin, and tongue dry and dark-colored. 
The food often passes through the bowels pretty much in the condi- 
tion in which it was swallowed. The liver is generally out of order, 
and the bowels are frequently afflicted with a low grade of inflam- 
mation. 

Treatment. — In this form of the disease, astringents and tonics 
will generally be required. Sometimes a teaspoonful of brandy, in a 
little sweetened water, or in clear water, several times a day, will 
effect a cure. Good cherry brandy is a valuable remedy ; so is black- 
berry brandy. Many of the worst cases have been cured by taking 
no nourishment, for a long time, except milk, with a little lime-water 
in it. 

When the liver is involved in the complaint, as evinced by light- 
colored stools, leptandrin, geranium, etc. (341), may be given with 
advantage. 

In some instances, when there is considerable debility, pills of 
quinine, catechu, etc. (342), will do well. 

A sponge-bath must be taken daily, and the skin be well rubbed 
after it. 

Cholera Morbus. 

The above name is given to a disease common in warm weather, 
and characterized by sudden attacks of bilious vomiting and purging, 
with severe pain in the belly, jcramps, and general fever and subse- 
quent prostration. The great amount of bile secreted and discharged 
has given it the name cholera, from cholos, bile. 

Symptoms. — The disease begins by sickness and distress at the 
stomach, which is succeeded by violent gripings, with vomiting of 
thin, dirty-yellowish, whitish, or greenish fluid, with discharges from 
the bowels similar to that vomited. The nausea and distress, with 
some few exceptions, continue between the vomiting and purging, 
and the pain, at times, is intense. The pulse is rapid, soon becoming 
small and feeble, the tongue dry, the urine high-colored, and there is 
much thirst, though no drink can be retained on the stomach. It is 
to be distinguished from diarrhoea by the bilious discharges. 

Treatment. — Apply a large mustard poultice over the stomach and 
liver, and give tablespoonful doses of compound powder of rhubarb 
and potassa, every half hour, until the vomiting and nausea are 
checked, adding to each dose five to ten drops of camphor, if neces- 
sary. Perhaps it would generally be best, however, to give liberal 
draughts of warm water, at first, or flax-seed tea, that all the solid 
contents of the stomach and bowels may be washed out. 

A teaspoonful of laudanum in a wine-glass of flax-seed tea, given 
as an injection, every two hours, will sometimes do excellently well ; 



DISEASES OF THE ABDOMINAL CAVITY. 329 

or a tea made of chamomile flowers, or Colombo, and made sour by a 
few drops of nitric or sulphuric acid, and given internally, will some- 
times succeed better than most other things. One grain of svapnia 
and thirty grains of bicarbonate of soda dissolved in an ounce of sweet 
tincture of rhubarb, and given in teaspoonful doses, every half hour 
will often have a fine effect. The prescription 162 is also valuable. 
Hot-water bags should be applied to the feet, and warm flannels, 
or other kinds of dry heat, to the whole body. 

Asiatic Cholera. 

Besides the above name, this fearfnl disease has been called epi- 
demic cholera, malignant cholera, spasmodic cholera, and cholera 
asphyxia. It first attracted notice in Bengal in 1817, whence it 
spread westward through Europe, and in 1832 it reached Quebec, on 
this continent. It has since then visited Asia and Europe several 
times with great severity, and has even been present on our shores. 
But at the present day the strict vigilance of sanitary boards has 
done much to prevent its spread and mitigate its terrors. Through 
the investigations of Koch and others it is now known to be propa- 
gated by a microbe, called the comma bacillus, and the efforts of 
investigators is now being directed to the discovery of an agent that 
will destroy this germ and thus control the disease. 

Symptoms. — -First Stage. — The first, premonitory stage, is 
marked by derangement of the digestive organs, rumbling in the 
bowels, pain in the loins or knees, twitching of the calves of the legs, 
impaired appetite, thirst, and especially, a slight diarrhoea ; and these 
symptoms continue from a few hours to several days. I should add 
to these symptoms what is said to have been recently discovered, 
namely, that for several days before the attack, the pulse is down to 
forty or fifty beats in a minute. This, if it prove to be reliable, is a 
very valuable symptom. 

Second Stage. — This stage is marked by vomiting and purging a 
thin, colorless fluid, looking almost exactly like rice-water; by severe 
cramps in the calves of the legs, which soon attack the bowels and 
stomach. These cramps are excessively painful, and draw the mus- 
cles into knots. The tongue is pale and moist; the pulse feeble, 
though sometimes full and firm ; the breathing hurried, with distress 
about the heart ; great thirst ; a feeling of internal warmth, and the 
secretion of urine entirely stopped. 

These thin, colorless discharges by vomiting and purging, are the 
serum or watery portion of the blood, which oozes through the sides 
of the blood-vessels, and runs off rapidly, leaving the crassamentum, 
or red, solid part of the blood, stranded upon the inner surfaces of the 
arteries and veins. When so much of this is discharged that the 
blood cannot circulate freely, the patient sinks into the 



330 DISEASES OF THE ABDOMINAL CAVITY. 

Third Stage, which is characterized by great prostration ; pulse 
hardly perceptible ; skin cold and clammy; face blue or purple, and 
eyes much sunken ; hands dark -colored and sodden, looking like a 
washerwoman's ; breathing short and laborious; a sense of great heat 
in the stomach ; and intense thirst. Recoveries from this stage sel- 
dom take place. 

Treatment. — In the first stage, the diarrhoea should receive the 
most prompt attention. From five to ten drops of laudanum, re- 
peated a few times, every three hours, will generally put a stop to it. 
Catechu (162) is also a suitable remedy. The compound syrup of 
rhubarb and potassa, with some other articles (343), in tablespoonful 
doses, every hour, till it operates gently, is worth a trial. The diet 
should of course be very carefully regulated at such a time, though 
not particularly changed, except to leave off any indigestible article 
which is known to be injurious, and to be made a little more sparing 
than in time of perfect health. 

When the second stage has set in, or the stage of vomiting, purg- 
ing, and cramps, the treatment must be energetic. The sinking pow- 
ers must be sustained by chloroform, opium, and ammonia (119), or 
by camphor, opium, and cayenne (344), giving one pill every hour. 
Brandy may also be given freely. 

The warmth of the surface must be promoted by all possible means, 
hot bricks and bottles, tincture of cayenne, friction, etc. 

In the third stage, the remedies recommended above are to be pur- 
sued with increased energy, particularly the stimulants, and the efforts 
to promote the warmth of the surface. 

Dysentery. — Bloody Flux. — Colitis. 

This is an inflammation of the mucous membrane lining the lower 
or large bowels. The small bowels begin at the stomach, and are 
eight or ten yards long ; being largest near the stomach, and dimin- 
ishing in size as they approach their termination in the caecum. The 
lower or large bowels are two or three times as large as the small 
ones, and from their junction with the latter, they extend about six 
feet to the outlet, or anus. The large bowels are composed of the 
caecum, the colon, and the rectum. The rectum is about one foot in 
length. 

In most cases of dysentery, the rectum, and about half the adjoin- 
ing portion of the colon, experience the chief force of the inflamma- 
tion. Sometimes the whole of the colon and caecum are affected. 
Sometimes the mucous membrane lining these is ulcerated, and, be- 
coming wholly disorganized, passes off in shreds. 

Symptoms. — The disease comes on with loss of appetite, costive- 
ness, lassitude, shivering, heat of skin, and quick pulse. These are 
followed by griping pains in the bowels, and a constant desire to pass 



DISEASES OF THE ABDOMINAL CAVITY. 331 

their contents. In general the passages are small, composed of mucus 
mixed with blood. These passages are attended and followed by 
severe gripings and inclination to strain, learnedly called tormina, and 
tenesmus. They are sometimes, in the early stages, attended by nau- 
sea and vomiting. The natural feces, which do not pass off much, 
are small in quantity, and formed into round, campact balls, or irreg- 
ular, hardened lumps. This tenesmus, or great desire to strain, will 
continue, perhaps increase, for several days — the discharges being 
mostly blood in some cases, and chiefly mucus in others. Having 
generally but little odor at first, these discharges become, as the dis- 
ease advances, exceedingly offensive. 

Causes. — Dysentery is very frequently caused by sudden changes 
from hot to cold, by which sweating is suddenly checked, and the 
blood repelled from the surface. Hot climates, and dry, hot weather 
are predisposing causes. All green, unripe, and unwholesome food, 
and indigestible food of every sort, may induce it. 

Treatment. — In mild cases give a tablespoonf ul of castor-oil and 
two teaspoonfuls of paregoric, mixed, once a day. Sometimes, in 
place of the above, a dose of rochelle powder, dissolved in water, and 
eleven or twelve drops of camphor, may be taken. A moderate quan- 
tity of flax-seed or slippery-elm tea, may be taken as a drink, and the 
bowels be well emptied by an injection of starch. 

When there is much pain in the bowels a mustard poultice laid 
upon them will have a good effect. The starch injections should, in 
such case, have half a teaspoonful of laudanum mixed with it. The 
compound syrup of rhubarb and pdtassa will often act favorably, 
given in tablespoonful doses. 

If there is reason to suppose the liver is affected, give podophyllin, 
etc. (46). 

The patient should not be allowed to sit up, and must be kept very 
still, and be allowed only a very scant diet, as flour porridge, well 
boiled, rice water, etc. 

Chronic Dysentery. 

When dysentery " runs on " for some time, it is liable to become 
chronic. 

Symptoms. — Looseness of bowels, — the discharges being un- 
healthy, more or less bloody, attended by bearing down, or a desire 
to strain, and being in number from two to forty a day. There is 
great debility, the pulse is weak and quick, the tongue slightly furred, 
the appetite lost, the face pale and sallow, the skin dry and parched. 
Sometimes the relax alternates with costiveness. 

Treatment. — In this form of the complaint, astringents will be 
necessary (159), (161), (162), (345), (346), (347). 

Injections may be used, if necessary, composed of nitrate of sil- 



332 DISEASES OF THE ABDOMINAL CAVITY. 

ver, fifteen grains to the ounce of water, or an infusion of golden seal, 
with a little tincture of prickly-ash berries added to it. 

The diet must be very light, easy of digestion, and nutritious. In 
some cases, it should be composed chiefly of wheat porridge, or boiled 
milk and boiled rice. In other cases, a little tender beef-steak should 
be taken once a day. 

Worms. — Vermes. 

The intestinal canal is subject to various disturbances from the 
presence of worms. Of these troublesome tenants, there are three 
principal varieties. 

The Ascaris, or phi-worm, called also maw or thread worm, is a 
small, white, thread-like worm from half an inch to an inch in length. 
These worms live, in great number, in the rectum, where they excite 
great irritation and itching. 

The Lumbricus, or ascaris lumbricoides, is a round worm, about an 
eighth of an inch in thickness, and from an eighth to a quarter of a 
yard in length. Its color varies from a milky whiteness to a deep 
red. It generally occupies the small bowels. 

The Tenia Solanum, or tape-worm, is a flat worm, with four suck- 
ers at the head, is from a few feet to some hundreds in length, and 
full of joints. It dwells in the small bowels, and feeds on the chyle 
as it comes along, before it is absorbed by the lacteals. In this way, 
it robs the body of nourishment, and produces great loss of flesh, and 
an enormous appetite. 

Symptoms. — In the grown person the symptoms of worms are 
quite obscure, except an intolerable itching within the anus, which 
generally indicates pin-worms. 

In children worms are indicated by paleness, itching of the nose, 
grinding of the teeth and starting in sleep, irregular appetite, bad 
breath, swelled upper lip, picking of the nose, hard swelled belly, and 
one cheek constantly flushed. 

Treatment. — For expelling worms various articles have been used. 
Among these spirits of turpentine (155) has a high reputation. The 
following preparation does well : Spirits of turpentine, half an ounce ; 
essence of anise, half an ounce ; castor-oil, one ounce ; worm-seed 
oil, one ounce. Mix. The dose for a child one or two years old is 
ten to twenty drops, every two or three hours. In two or three days, 
a brisk physic should be given. The worm-powder is quite success- 
ful. 

One of the most popular remedies is the pink-root. It should be 
united with a purgative. The following is a good preparation: Pink- 
root and senna, each half an ounce ; bitartrate of potassa, one dram ; 
pulverized jalap, half a dram ; cardamom seeds, half a dram ; extract 
of liquorice, two drams. Mix, and add half a pint of boiling water. 
Let the whole steep an hour. Give a tablespoonful or two, occasion- 
ally, till the worms are expelled. - 



DISEASES OF THE ABDOMINAL CAVITY. 



333 



An injection composed of quassia (66), or aloes (22), or of simple 
sweet-oil, is very effectual *in removing pin-worms from the lower 
bowel. So is an injection composed of the red iodide of mercury, 
one grain; iodide of potassium, half a grain; and two pints of 
water. 

Most of the above preparations are thought to be successful in ex- 
pelling all kinds of worms ; but for the tape-worm, no other remedy 
has yet shown itself as effectual as pumpkirirseeds. The seeds should 
be well bruised, and steeped in water. This should be drunk freely 
for several days, if need be. It is believed to be a sure remedy, even 
in cases of several years' standing. 

In all cases of worms, the diet should be carefully chosen, and be 
connected with proper exercise, pure air, frequent bathing, and all 
those measures which tend to improve the general health. 

After the expulsion of the worms, tonics should always be taken 
to strengthen the bowels, that the same evil may not return. 

Acute Inflammation of the Kidneys, — Nephritis. 

Before speaking of this disease, I wish to give the reader a general 
idea of a kidney, and shall do so by the use of two cuts. 

Fig. 110 presents the external surface of the right kidney, with its 
renal capsule mounted on top ; t, being its upper edge ; /, \ superior 
and inferior branches of the emulgent artery ; e, d, e, three branches 
of the emulgent vein ; a, the pelvis of the ureter ; 5, the ureter. 

Fig. Ill is the same kidney laid open ; 1, being the super-renal 
capsule ; 2, the vascular portion ; 3, 3, the tubercular portion, consisting 





Fig. 110. 



Fig. 111. 



of cones ; 4, 4, two of the calices receiving the apex of their corres- 
ponding cones ; 5, 5, 5, the three infundibula ; 6, the pelvis ; and 7, 
the ureter. 

The kidneys are glands, and their office is to draw or strain off 



334 DISEASES OF THE ABDOMINAL CAVITY. 

from the body those effete or worn-out particles, or products of decay 
which contain nitrogen, while the liver takes away those carbonaceous 
matters which have no nitrogen. These useless substances which go 
out through the kidneys are generally in the form of urea. In carry- 
ing off these matters, the kidneys may have more to do than properly 
belongs to them ; and may be so stimulated, or irritated, or injured 
in some way, as to become inflamed. . 

Symptoms — Like most other inflammatory diseases, it begins with 
cold chills and rigors, especially in the back and loins, followed by 
fever and pain. The pain frequently extends to the bladder, the loins, 
and the thighs, and is of a severe, lancinating kind. — though some- 
times obtuse. Pressure, motion, straining, or taking a full breath, add 
to its pungency. The urine is scanty, high-colored, sometimes bloody, 
and can only be passed drop by drop. In the loins there is a sense 
of heat, gnawing, and constriction ; the bowels are either constipated, 
or relaxed by diarrhoea. A numbness of the thigh, and drawing up 
of the testicle on the affected side, are marked and peculiar symptoms. 
In some cases, there are nausea, vomiting, oppression of the stomach, 
faintness, hiccough, drum-head distention, and rumbling of the bowels. 
The skin is hot and dry, the pulse hard and frequent. 

Causes The use of cantharides, oil of turpentine, and other di- 
uretics, taking cold, violent exercise, mechanical injuries, the transla- 
tion of rheumatism or gout, the striking in of skin eruptions, and 
gravelly formations in the kidneys or ureters. 

Distinctions This disease is to be distinguished from colic by 

the pain being increased hj pressure, and by the frequent but difficult 
discharge of red urine ; from lumbago, from its being confined fre- 
quently to one side, and also by the urinary troubles, and by the 
nausea and vomiting; and from all other diseases, by the numbness 
>f the thigh, and the drawing up of the testicles. 

Terminations of the Disease It runs a rapid course, and may 

terminate by resolution, or by suppuration. When the latter happens, 
it is indicated by the decline of the more violent symptoms, a throb- 
bing and a sense of weight, with chills, followed by flushes of heat, 
and sweating. The matter formed, generally small in quantity, may 
pass into the cavity of the kidney, and thence through the bladder to 
a natural outlet with the urine. 

Treatment Either put the feet into a hot mustard-bath, or put 

mustard drafts upon them. At the same time apply a large mustard 
poultice upon the small of the back, and follow it up with hot fomen- 
tations of stramonium leaves and hops, or stramonium and wormwood 
or tansy. 

Let perspiration be induced as soon as possible by five to ten- 
drop doses of tincture of veratrum viride, repeated every hour, or by 
teaspoonful doses of the compound tincture of Virginia snake-root, 
given every half hour. 



DISEASES OF THE ABDOMINAL CAVITY. 335 

If costiveness exist, the bowels must be opened by epsom salts, 
cream of tartar, or salts of tartar ; or by copious injections of warm 
water, containing a few drops of the tincture of arnica-leaves. Such 
injections not only unload the bowels, but act as a local bath, by lying 
in the bowel near the inflamed kidneys. 

The drinks must be mucilaginous and diuretic. The marshmal- 
low root and peach-leaves, slippery-elm bark, flax-seed, mullein, elder 
blows, hair-cap moss, and cleavers, are all valuable. If the disease is 
caused by gravel, twenty drops of liquor potassse, largely diluted 
with flax-seed and upland-cranberry tea, and taken freely as a drink, 
is excellent. We recommend Poland water in large quantities. 

Chronic Inflammation of the Kidneys. 

This is frequently the result of the acute form of the disease, but is 
also produced by injuries and other causes. 

Symptoms A weakness in the small of the back, and a dull, 

heavy pain in the kidneys. The urine is passed often and in small 
quantities. It is alkaline — sometimes white and milky — and has 
in it deposits of phosphate of lime, and triple phosphates. 

Treatment. — Infusions of pipsissewa, uva ursi, trailing arbutus, 
wild carrot, queen of the meadow, buchu-leaves, or foxglove are use- 
ful diuretics, and may be taken with advantage. 

The bowels must be kept open with some gentle physic (18), if 
they are costive ; and the alkaline sponge bath, with friction, be used 
daily. 

An eruption may be brought out upon the small of the back by 
rubbing on a few drops of croton-oil ; or, if the patient prefer it, a 
mustard poultice may be applied two or three times a week. 

The food should be nutritious, and easily digested, and a little ex- 
ercise be taken daily in the open air. 

Acute Inflammation of the Bladder. — Cystitis. 

This disease affects the lining membrane of the bladder, — some- 
times its muscular substance. It may attack the upper portion, the 
middle, or the neck of this organ. It runs a rapid course. 

Symptoms. — Burning, piercing, and throbbing pain in the region 
of the bladder. The pain extends to the perineum, and in some 
cases, to the testicles and thighs, and is much increased by pressure. 
The perineum, the space between the fundament and testicles, feels 
sore to the touch. The desire to pass urine is incessant, but the 
effort to do so is mainly ineffectual. The water passes off drop by 
drop, with great pain, or is entirely stopped, causing enlargement 
of the bladder, and great distress. Mucus from the inflamed lining 
of the bladder passes off with the water. Nausea, vomiting, and 



336 DISEASES OF THE ABDOMINAL CAVITY. 

great anxiety are common. The bowels are bound, and when the 
disease is on the side next the lower bowel, there is a desire to empty 
the bowels ; and if the inflammation be in the neck, there is great 
pain in the perineum, and frequently an entire retention of the water. 
The pulse is full, hard, and frequent, the skin hot and dry, the thirst 
urgent, and the patient restless and dejected. 

Causes. — This disease may be produced by taking cantharides and 
turpentine ; by irritating substances forced into the bladder with a 
syringe, or by pushing bougies or catheters into it ; by gravel-stones 
in the bladder ; by retained urine ; by external injuries ; by gonor- 
rhoea ; and by cold applied to the feet, or to the lower portion of the 
abdomen. 

Treatment. — If the urine be retained, it is of the utmost impor- 
tance that it be earty drawn off with the catheter, lest a distention of 
the bladder bring on mortification. Great care is required not to pro- 
duce irritation by any roughness in introducing the instrument. 

Leeches should be applied upon the lower part of the bowels, the 
perineum, and around the anus. When these are removed, warm 
poultices should be applied. Cold compresses will often do as well. 
The bowels must be opened with epsom salts. Injections of warm 
water, with a few drops of tincture of arnica-leaves, will act finely as 
a local bath, — the water being retained as long as possible. 

The tincture of veratrum viride will be required in five to ten-drop 
doses, or the compound tincture of Virginia snake-root, to induce 
perspiration. Ex. jaborandi may sometimes be used for the same 
purpose. 

Drinks must be taken very sparingly. A small amount of cold in- 
fusion of slippery-elm bark, or marshmallow and peach-leaves, or 
cleavers. This mucilaginous drink must be the beginning and the 
end of the diet during the active stage of the disease. Alkalis are 
exceedingly useful in allaying the pain and smarting of urination, 
perhaps the best remedy being liq. potass, citratis, in tablespoonful doses 
every two hours. Suppositories of opium and belladonna in one-fourth 
grain doses by the rectum every two to four hours allay the frequent 
urination and pain and quiet the spasm of the neck of the bladder. 

Chronic Inflammation of the Bladder.— Cystirrhcea. 

This is much more common than the active form of the disease. 
It often arises from the same causes which produce acute inflamma- 
tion of the bladder. 

It often passes under the title of "catarrh of the bladder." It is 
a chronic inflammation of the mucous lining of that organ, and is a 
very common and troublesome affection among old people. 

Symptoms. — Slight lancinating pains, with a feeling of heat in the 
region of the bladder, and a sense of weight and tenderness in the 



DISEASES OF THE ABDOMINAL CAVITY. 337 

perineum ; frequent and tormenting desire to pass water, with occa- 
sional spasmodic action of the bladder. The urine is loaded with 
tenacious mucus, just as the expectoration has large quantities of 
mucus in it when there is inflammation of the membrane lining the 
windpipe and bronchial tubes. When the water has stood a while, 
this mucus settles at the bottom of the vessel, leaving the fluid clear 
above. Great quantities of this are sometimes passed, — amounting 
even to pints in a day. The triple phosphates of magnesia and am- 
monia are often found in the water. 

Frequently there are derangements of the appetite and digestive 
functions, a white or brown fur upon the tongue, a harsh, dry skin, 
with thirst and general debility, — especially in the back and loins. 
Sometimes there is a little fever. 

Treatment. — To reduce the inflammation, apply leeches, or mus- 
tard, or croton-oil, or a cold compress every night. 

As a diuretic, give an infusion of buchu, uva ursi, trailing arbutus, 
queen of the meadow, etc. Tincture of veratrum viride and sweet 
spirits of nitre (125) is a good remedy. The compound infusion of 
trailing arbutus is well recommended. So is the compound balsam 
of sulphur. An infusion of the pods of beans has been well spoken 
of. 

An injection into the bladder, once a day, of a tepid infusion of 
golden-seal root, with much care, may be of great service ; or an 
infusion of equal parts of golden-seal, witch-hazel, and stramonium. 
It may be done with a gum-elastic catheter and a small syringe. 

The bowels must be kept open with the neutralizing mixture, or 
some other mild physic ; and the skin bathed with saleratus and 
water once a day, and rubbed well with a coarse towel. 

Should there be any scrofulous, or gouty, or rheumatic condition of 
the system, the remedies for those complaints may be used in addition 
to the above. 

Disease of the Supra=Renal Capsules. 

The supra-renal capsules are small bodies situated above the kid- 
neys. (Fig. Ill, 1.) Their office is not well understood. It has 
been found of late that they are subject to a disorder having peculiar 
symptoms. This is a comparatively new disease. 

Symptoms The most marked symptom is a peculiar change in 

the color of the skin, called " bronzing." This bronzing process be- 
gins in patches on those parts exposed to the sun, and to friction, 
as the neck, the backs of the hands, the fronts of the thighs, and the 
arms. These patches look, in color, like spots upon a bronze statue, 
deprived of their gloss. 

Another marked symptom is a general debility, which comes on 
without any apparent cause, — there being, generally, no evidence of 
organic disease, and no loss of flesh, — and is attended with faint- 



338 DISEASES OF THE ABDOMINAL CAVITY. 

ings, loss of energy both of body and mind, a peculiar flabbiness of 
flesh, and an early death, apparently from sheer weakness. 

The blood becomes depraved, and loses its coloring matter, as 
shown by the paleness of the skin where there is no bronzing. 

The pulse is generally very soft and compressible. The stomach is 
irritable, the appetite is gone ; there is nausea and sometimes vomiting, 
with pain and a sense of sinking at the pit of the stomach. Fre- 
quently there is costiveness, sometimes diarrhoea, and pains in the 
back and loins. In some cases there are epileptic fits, failure of 
memory, change of temper, or a numbness of the fingers, legs, etc. 

Treatment. — Tins disease is a peculiarly fatal one. As no mode 
of treatment has yet proved successful, it is well to observe caution 
in prescribing. 

The treatment prescribed for chronic inflammation of the kidneys, 
would perhaps be as safe as any that could at present be proposed. 

Bright's Disease of the Kidneys. — Albuminuria. 

This peculiar disease was first explained to the profession in 1837, 
by Dr. Bright, of England, whose name it took. It consists of a dis- 
order of the kidneys, — probably a congestion and an obstructed cir- 
culation in them, from which arise two most important effects ; first, 
albumen, an essential alimentary constituent of the blood, is secreted 
and passed off, in larger or smaller quantities, in the urine ; and sec- 
ondly, urea, the worn-out matters of the blood which the kidneys are 
made expressly to carry off, is permitted to remain. If the urine of 
a person having Bright's disease be examined, therefore, albumen, 
which should not be there, will be found, and urea, a natural constitu- 
ent, will be absent. The presence of albumen, however, while ab- 
normal, is not necessarily indicative of Bright's disease, as it may 
proceed from indigestion and blood disorders. 

Method of Examination To discover albumen in urine suspected 

to contain it, place a little in a test tube, and boil it over a spirit- 
lamp. If albumen be present only in minute quantity, it may cause 
only a delicate opalescence ; if in larger quan- 
tity, it may separate in curdy flakes, and fall to 
the bottom as a more or less abundant white 
precipitate. If very abundant, the liquid may 
become nearly solid. 

The albumen is the same as the white of an 
egg, and the boiling has the same effect in 
whitening and hardening it, as upon that sub- 
stance. 

FlQ * 112 - Albumen is sometimes found in the urine in 

a coagulated state, and having the shape of tubes or worms (Fig. 
112). This is quite common in Bright's disease. The deposit seems 
to be made up of fibrous casts of the uriniferous tubes of the kid- 
neys. 




mm 



DISEASES OF THE ABDOMINAL CAVITY. 339 

Symptoms. — The two unnatural conditions mentioned above 
give rise to the symptoms of Bright's disease. One of them, how- 
ever, is itself the most constant and characteristic symptom of the 
disease, namely, the presence of albumen. This, too, being one of 
the nutritive constituents of the blood, its abstraction thins the 
serous portion of the blood, and causes it to filter out of its vessels 
into the cells, — causing dropsy of the cells, usually called cellular 
dropsy, or anasarca. This general dropsy begins frequently in the 
face, and spreads rapidly over the whole body and limbs. In addi- 
tion to this, there are pains in the back and loins, a gradual failing of 
strength, and a derangement of digestion. The skin becomes dry, 
with a pale and bloodless appearance, and there are frequently thirst, 
nausea and vomiting. The urine frequently has fat, blood, epithelial 
scales, mucus, blood-discs, fibrous casts of the uriniferous tubes, and 
saline sediments ; and is generally lighter by weight than in health, 
and less in quantity, and is apt to be red, brown, or dingy in color. 

The retention of urea in the blood acts as a poison, and causes, 
toward the latter end of the disease, when accumulated in large quan- 
tity, drowsiness, convulsions, and apoplexy. 

A frequent desire to make water, with a shifting back and forth 
of the bowels between costiveness and diarrhsea, are common symp- 
toms. 

Treatment. — The results of treatment in this disease are often un- 
satisfactory. Yet if taken in season, investigated with proper care, 
and treated with due diligence, much may be done for its cure. It is 
one of those harassing complaints, which physicians in family prac- 
tice seldom have the patience to investigate and manage with suffi- 
cient care. 

Let the healthy and active condition of all the vessels of the skin 
be the first object aimed at. This will relieve the laboring and falter- 
ing kidneys of a portion of their burden. The alkaline sponge-bath 
with vigorous friction every day will secure this object. 

In the next place, the skin being put in a working condition, should 
be made to work by some internal diaphoretic, — as the tincture of 
veratrum viride, in doses of from five to ten drops, or the compound 
tincture of Virginia snake-root, in teaspoonful doses. 

The kidneys may be still further relieved, especially when there is 
considerable tenderness and other signs of inflammation, by cupping, 
leeching, mustard-poultices and croton-oil. 

The bowels should be regulated by some gentle physic, as cream of 
tarter dissolved in flax-seed tea, rochelle powders, epsom salts, etc. In 
some cases, podophyllin and leptandrin (40), or the compound 
powder of jalap (41 ) , are useful. 

When there is dropsy of the cells, elaterium may be used as physic 
(31), or the kidneys may be jogged by digitalis (130), (129), its effects 
being carefully watched. Cider, freely drunk, has been found useful 
in some cases. 



340 



DISEASES OF THE ABDOMINAL CAVITY. 



To restore the blood, iron (73), (93), (74), (75), (72), (71) is 
the essential article. When there is considerable debility, some of 
the vegetable bitters, as quinine, quassia, gentian, Colombo, etc., may 
be used daily. 

Coffee, and all indigestible articles of food, as rich pastries, new 
bread, high-seasoned meat, and fats, must be avoided, — in a word, 
nothing must be taken, either in kind or quantity, which the stomach 
cannot easily digest. 

Diabetes. 

This disease is a kind of diarrhoea of the kidneys. The amount 
of urine secreted and discharged is large, sometimes enormous in 
quantity, amounting even to several gallons in twenty-four hours. 
Everything taken into the stomach seems to run off by the kidneys. 
The food and drink being mostly converted into urine, do but little 
good. The kidneys having got into an exalted state of action, do 
too much, — just as the mucous membrane of the air-tubes does in 
bronchitis. 

Nature of the Urine. — Not only is there too much urine discharged, 
but, instead of being lighter than healthy urine, as in Bright's disease, 
it is heavier, and instead of holding albumen in solution, it contains 
grape-sugar. 

To Detect Sugar. — Put a little of the suspected urine in a test- 
tube ; add to it a drop or two of solution of sulphate of copper, which 
will give the fluid a pale-blue tint. Now add liquor potassa in 
excess : if sugar be present, this will throw down a pale-blue precipi- 
tate (hydrated oxide of copper), which will immediately re-dissolve, 
forming a purplish-blue liquid. Boil this over a lamp; if there be 
sugar, a reddish or yellowish-brown precipitate (sub-oxide of copper) 
will be thrown down ; if no sugar, a black precipitate (common oxide 
of copper) will fall to the bottom. 

Another Test. — Place a little urine in a test-tube; add to it half 
its volume of liquid potassa, and boil five minutes. If there be sugar 
present, the liquid will take a brownish or bistre tint. 

G-roivth of Torula as a Test. — Place a portion of saccharine urine 
in a warm place, and a scum will soon rise, as 
if a little flour had been dusted on it. This, 
when examined under the microscope, proves to 
be minute oval bodies. These expand and dilate 
the vesicle containing them into the form of a 
tube. They still continue to enlarge, and pro- 
ject from the parent bladder, like buds. The 
whole then resembles a jointed fungoid growth 
(Fig. 113), which finally breaks up, and falls to 
the bottom, as a copious deposit of oval vesicles 
or spores. 




Fig. 113. 



DISEASES OF THE ABDOMINAL CAVITY. 



341 



Other Symptoms. — Great thirst, craving appetite, dry skin, a 
sense of weight and uneasiness in the stomach after eating, dry and 
parched mouth, white and foul or clean and red tongue, wasting of 
flesh, languor and aversion to exercise, debility, pain and weakness 
in the loins, costiveness, loss of the sexual feeling, and cold feet. 
As the disease draws towards a fatal end, the gums become spongy, 
the breath fetid, sometimes smelling like urine. 

Treatment. — The skin should have about the same treatment as 
that recommended in Bright's disease. Also, the same counter-irrita- 
tion over the kidneys. The bowels must be kept open by some 
gentle physic (13), (12), (15). 

Tonics. — These will be required to restore the tone of the system, 
particularly iron, — same preparations as recommended in Bright's 
disease. 

Astringents to check the flow of urine will be needed. Alum, in 
three-grain doses, three times a day, or sugar of lead, or white vitriol, 
or clear opium, will be serviceable. Creosote, in one or two-drop 
doses, and tincture of cantharides, have each cured cases. 

One scruple of Peruvian bark, one scruple of wild-cranberry leaves, 
powdered, and half a grain of opium, mixed and taken three times a 
day, is a good remedy. 

All articles which contain sugar and starch must be forbidden in 
the diet. Bread and potatoes contain a large amount of starch ; and 
beets, parsnips, and some other vegetables, have sugar. It is best 
to confine the patient almost entirely to tender, fresh meats ; and the 
drink, notwithstanding the great thirst, must be restricted to a very 
small quantity. Saccharin should be used to sweeten drinks instead 
of sugar. 

Bleeding from the Kidneys, etc. — Hematuria. 

By this I mean a discharge of blood from the urinary passage. It 
may come from the kidneys, the ureters, the bladder, or the urethra. 

Symptoms. — The passage of the blood is preceded by pain in the 
region of the bladder or kidneys, and accom- 
panied by faintness. There is generally heat 
and distress in the loins, and tenderness upon 
pressure in the region of the bladder or kid- 
neys, according to the place from which the 
blood comes. 

It is sometimes difficult to decide whether 
the coloring matter in the urine is really blood. 
In such cases, the microscope will generally 
detect the blood corpuscles, if present. They 
commonly appear as in Fig. 114, having a yellow color, and being 
pretty uniform in size. 




Fig. 114. 



342 DISEASES OF THE ABDOMINAL CAVITY. 

Treatment. — This must of course vary according to the nature of 
the case, and the immediate cause producing it. Where active bleed- 
ing exists, the patient must have absolute rest in bed, with applica- 
tions of cold to the hips and loins. If the patient be strong and full 
of blood, wet cups or leeches may be applied over the kidneys, or the 
bladder. In such cases, too, the bowels must be freely moved with 
some preparation of salts (14), (18), (20), (25). 

Sugar of lead is a valuable remedy; but it should be given in large 
doses for a short time, rather than in small doses for a long time. It 
is best taken in form of solution (348), two great spoonfuls every 
two hours, until five or six doses are taken. 

But the best remedy is gallic acid. It seems to have extraordinary 
power in this complaint. It should be given in five-grain doses, 
mixed with a teaspoonful of mucilage of gum-arabic, and ten drops 
of tincture of henbane. 

Suppression of Urine. — Ischuria Renalis. 

This disease is, in one respect, just the opposite of diabetes. 
While immense quantities of urine are secreted in that, none is se- 
creted in this. In that, the kidneys do too much ; in this, they do 
nothing. 

This complaint is sometimes called paralysis of the kidneys. It 
usually occurs in old persons, and those inclined to corpulency. 

Symptoms. — The patient makes no water; and if the catheter be 
applied, none will be found in the bladder. The patient feels unwell, 
restless, anxious, with a slight pain in the loins and bowels, perhaps ; 
but on the whole not illness enough to give any very good account 
of it. After a little time, nausea comes on, and perhaps vomiting, 
and soon drowsiness, wanderings of mind, incoherent talk,' hiccough, 
stupefaction, and death. These head symptoms are caused by the 
shutting up, in the kidneys, the natural outlet of urea, of an excre- 
mentitious matter, which acts as a poison to the nervous system. 
Before death, the perspiration has a strong smell of urine. 

Treatment. — The cause of this complaint not being known, the 
treatment must necessarily be a little uncertain. We cannot go 
amiss, however, in placing the patient immediately in a warm bath 
for fifteen or twenty minutes. Then apply wet cups over the kidneys, 
and follow these either by mustard poultices or by hot fomentations. 

Let the bowels be opened by the compound powder of jalap, or by 
elaterium (31). Epsom salts or cream of tartar might in some cases 
be substituted for the above. A stimulating injection is also desira- 
ble (246). 

Diuretics, as sweet spirits of nitre, digitalis, queen of the meadow 
and peach-leaves, equal parts, and marshmallow, are of course called 
for. 



DISEASES OF THE ABDOMINAL CAVITY. 343 

Much of the poisonous matter retained may be got out through the 
skin, by a free use of the compound tincture of Virginia snake-root 
or tincture of veratrum viride in full doses. 

Although the symptoms, in the earlier stages of this complaint, 
may not attract much attention, or be thought worthy of notice, yet 
the treatment should be prompt and energetic, as a fatal termination 
is sometimes reached in the brief space of forty-eight hours. 

Retention of Urine. 

This disorder is often confounded with suppression of the urine, 
but it is different in every respect. In suppression, the urine is not 
formed by the kidneys ; in retention, it is formed, and, in some cases, 
poured into the bladder, but is retained on account of some inability 
to pass it. 

Ischuria. — This is one of the forms of retention. In this com- 
plaint, the urine has passed from the kidneys to the bladder, but from 
some cause, generally palsy of the muscles of the bladder, it cannot 
be passed off. In this case, there is no pain, but the stream of water 
flows off with slower and slower pace, — the patient having to make 
tiresome efforts with the abdominal muscles to get the bladder 
emptied. As the quantity discharged diminishes, the desire to uri- 
nate grows more urgent. Pressure just above the pubes gives pain, 
and the bladder feels under the hand like a large, hard tumor. 

Dysuria. — In this form of the complaint, the water is passed to 
some extent, but with pain and heat along the water-pipe. This is 
generally caused by some inflammation along the urethra. 

Strangury. — In this the water is only passed drop by drop, and 
with great burning, scalding, and tenesmus in the neck of the bladder. 
When there is considerable inflammation, the skin becomes hot, the 
pulse hard and quick, and the tongue covered with a white fur. 

Causes. — These several forms of the complaint are caused by palsy 
of the bladder, gonorrhoea, inflammation in the neck of the bladder 
or the water-pipe, mechanical injuries of the bladder in child-bearing 
or otherwise, by tumors pressing upon it, by irritation from gravel or 
stone within its cavity, by stricture or partial closing up of the ure- 
thra, by disease of the prostate gland, by taking spirits of turpentine 
or cantharides, or by the absorption of this latter article when used 
as a blister. 

Treatment. — It is obviously necessary in this complaint, that 
treatment, in order to be of any avail, should be prompt ; for when 
the retention is complete, the bladder will burst in from two to five 
days, and cause the death of the patient. 

The treatment must vary according to the cause of the retention. 

If it be caused by palsy of the bladder, the common flexible cathe- 



344 DISEASES OF THE ABDOMINAL CAVITY. 

ter must be used daily until the muscular fibres recover their lost 
power. When much irritation is caused by introducing it, it is better 
not to withdraw it, but to close its external orifice with a small plug, 
which the patient can remove as often as necessary to let off the 
urine. To remove the paralysis, the electro-magnetic machine is 
worth a trial, the current being passed through the bladder. At 
the same time let the patient take strychnia (85), (86), (83), (95). 
Cantharides, in the form of tincture, or in connection with strychnia 
(291), is often used. 

If the retention is caused by inflammation of the neck of the blad- 
der, leeches should be applied to the perineum, and three or four drops 
of croton-oil may be rubbed on just above the pubes to bring out an 
eruption. Warm fomentations will also be serviceable, and warm 
hip-baths. Cooling diuretics, as infusions of marshmallow, cleavers, 
pumpkin-seeds, buchu, sweet spirits of nitre, etc , must not be omitted. 

Inability to Hold the Urine. — Enuresis. 

This complaint, generally called incontinence of the urine, is quite 
common among children. In some cases the child has no ability to 
hold its water at any time ; but generally it is only passed off invol- 
untarily at night while in bed. In adult life it is less frequently met 
with, except among the old. 

Causes. — Irritation of the roots of the spinal nerves which go to 
the bladder, mechanical injuries of the bladder, palsy of the bladder, 
particularly in old people, debility of the neck of the bladder, a gen- 
eral weakness of the nervous system, worms in the bowels, piles, 
whites, gravel or stones in the bladder, long prepuce in boys, etc. 

Treatment. — As a general rule, the change of constitution which 
occurs at puberty cures this complaint. But as this does not always 
happen, it is important that parents do everything in their power to 
break it up early, lest it become an affliction for life. 

Children who suffer from this disorder are apt to drink largely. 
This habit should be restrained. But little drink should be allowed, 
whatever the desire for it. Care should be taken that the child make 
water before going to bed, — also that it be aroused at a late hour for 
the same purpose, and that the foot of the bed be elevated so as to 
draw the urine away from the neck of the bladder. 

The skin should be washed all over, every day, with cool or cold 
water, and vigorously rubbed with a coarse towel. This will cause 
the excess of fluids to pass off through the skin, and lessen the action 
of the kidneys. 

In some instances children urinate in bed through carelessness, 
being half conscious of what is occurring, but not caring enough to 
rouse themselves. In such cases, they are often cured by some de- 
cided correction, — the impending act of passing water connecting 



DISEASES OF THE ABDOMINAL CAVITY. 345 

itself in their mind with the correction, and recalling them instantly 
to full consciousness. Of course this mode of relief should be resorted 
to with great judgment and caution. 

When the complaint proceeds from debility or relaxation of the 
neck of the bladder, the compound infusion of trailing arbutus and 
the isinglass custard found among dietetic preparations, may be used 
freely. The tincture of cantharides, from ten to forty drops to chil- 
dren, may be given, and increased gradually to a hundred, or until 
slight difficulty is felt in passing the water. Then stop, and give 
the articles mentioned above. Spirits of turpentine is useful to some 
extent, given also in small doses, and continued for some time. 

If the disorder be caused by irritation of the spinal nerves, cold 
water douched upon the back, or croton-oil rubbed along the spine, 
or a warm stimulating or irritating plaster upon the lower part of the 
back, will be required. The electro-magnetic machine may do well 
in some cases. Tincture of belladonna, given just as tincture of can- 
tharides above, afternoon and at bedtime, gives best results usually. 
Belladonna after a while troubles the eyes and must be stopped. 

Urinary Deposits. — Gravel. — Stone. 

Unnatural deposits in urine are to be regarded simply as evi- 
dences of changes which disease is making in the body. As such 
they are valuable, — more valuable, in many cases, than any or all 
other symptoms we can study, and most valuable from the ease with 
which they may be investigated. Yet but very few physicians, com- 
paratively, pay any special attention to them, or make any effort to 
acquire the small amount of knowledge needed for their detection. 

Sources of the Urine. — The urinary secretion has three sources. 
The largest bulk of it comes from the superabundance of drink taken 
into the stomach. This is shown from the free flow of pale urine 
after taking copious drafts of water or other fluids. Such quantities 
of water as are often drunk, would embarrass the functions of animal 
life, were it not pumped off by the kidneys. 

A second source of supply for the urinary secretion is to be found 
in the elements of imperfectly digested food, and also some abnormal 
elements arising from incomplete assimilation. Oxalic acid is a 
specimen of the latter, being sometimes largely excreted, in dyspep- 
sia, soon after a meal. 

The third source of urine is found in those old and worn-out atoms 
of the system, which can serve no further useful purpose in the ani- 
mal economy, and which cannot be got rid of by the lungs or skin. 
It is only, however, one portion of the dead tissue, namely, that which 
is rich in nitrogen, which goes out through the renal strainer ; an- 
other portion, which has a preponderance of inflammable elements — 
carbon, hydrogen, and perhaps sulphur — takes the outward channel 
through the liver, as bile. 



346 



DISEASES OF THE ABDOMINAL CAVITY. 



u 



Characteristics of Urine. — Healthy urine has a light amber color, 
is transparent, and lias different degrees of density, its specific gravity 
varying from 1.003 to 1.030. It has an aromatic, violet-like smell, 
and a bitter, disagreeble taste, like salts. 

That which is passed a little time after drinking largely, is pale, 
and has a low specific gravity, varying from 1.003 to 1.009, and is 
called urina potus. That passed soon after the digestion of a full 
meal, is called urina cliyli, or urina eibi ; it has a specific gravity f rom 
1.020 to 1.030. That which is secreted from the blood, and is passed 
before eating or drinking in the morning, is called urina sanguinis; 
and has a specific gravity of from 1.015 to 1.025. This is the best 
specimen of the average density and nature of healthy urine. 

Healthy urine contains urea, uric acid, sulphuric acid, phosphoric 
acid, lime, magnesia, phosphate of soda, etc. It is only when these 
are discovered in excess, that they indicate disease. 

Examination of Urine. — Let a piece of blue litmus-paper be first 
dipped in the urine ; if it be acid, the color of the paper will be 
changed to red, or reddish-brown. Should the blue color remain un- 
changed, then use •yellow turmeric or reddened litmus paper; 
if the urine is alkaline, the turmeric will become brown, and 
the reddened litmus will be changed to blue. If the color in 
both cases remains unaltered, the urine is neutral; that is, 
neither acid nor alkaline. 

This being done, let the specific gravity be taken. This is 
easily done by the urinometer (Fig. 115). This instrument 
is known also by the names hydrometer, and gravimeter. It 
is generally made of glass. When placed in distilled water, 
it will sink to a certain point; and as all bodies immersed in 
fluid displace a bulk equal to themselves, it follows that in 
a fluid denser than water, the instrument will not sink so 
deep. The space above the large bulb is marked off into de- 
grees corresponding to different densities. When this instru- 
ment is immersed in urine, and has come to rest, the number on the 
graduated scale, which stands at the surface of the liquid, when 
added to 1.000, will represent the specific gravity of the fluid. If, for 
example, the surface of the liquid corresponds with 9 on the scale, 
the specific gravity of the urine will be 1.009 ; if at 25, it will be 
1.025. 

By attending to the specific gravity of the urine, the physician may 
often gain important information respecting his patient, as it may be 
made to show him how much solid matter is daily carried out of the 
body through the kidneys. This, at the bed-side, may often give 
useful hints in regard to treatment. 

The following table, constructed by Dr. Golding Bird, shows at a 
glance the amount of solid matter in 1000 grains of urine of different 
densities : — 




Fig. 115. 



DISEASES OF THE ABDOMINAL CAVITY. 



347 



Specific 
Gravity. 


Solids. 


Water. 


Specific 
Gravity. 


Solids. 


Water. 


Specific 
Gravity- 


Solids. 


Water. 


Specific 
Gravity. 


Solids. 


Water. 


1001 


2.33 


997.67 


1011 


25.63 


974.37 


1021 


48.93 


951.07 


1031 


72.23 


927.77 


1002 


4.66 


995.34 


1012 


27.96 


972.04 


1022 


51.26 948.74 


1032 


74.56 


925.44 


1003 


6.99 


993.01 


1013 


30.29 


969.71 


1023 


53.59 


946.41 


1033 


76.89 


923.11 


1004 


9.32 


990.68 


1014 


32.62 


967.38 


1024 


55.92 


944.18 


1034 


79.22 


920.78 


1005 


11.65 


998.35 


1015 


34.95 


965.05 


1025 


58.25 


941.75 


1035 


81.55 


918.45 


1006 


13.98 


986.02 


1016 


37.23 


962.72 


1026 


60.50 


939.42 


1035 


83.88 


916.12 


1007 


16.31 


683.69 


1017 


39.61 


960.39 


1027 


62.91 


937.09 


1037 


86.21 


913.79 


1008 


18.64 


981.36 


1018 


41.94 


958.06 


1028 


65.24 


934.76 


1038 


88.54 


911.46 


1009 


20.97 


979.03 


1019 


44.27 


955.73 


1029 


67.57 


932.43 


1039 


91.87 


909.13 


1010 


23.30 


976.70 


1020 


46.60 


953.40 


1030 


69.90 


930.40 


1040 


93.20 


906.80 



The mode of using the above table is this. Having learned the 
density of the urine passed in twenty-four hours by means of the 
urinometer (Fig. 115), a glance at the table will show the proportion 
of solid matter and water in 1000 grains of the urine. Then, by 
weighing the whole quantity of urine passed in twenty-four hours, 
the weight of solids drained off by the kidneys may be determined 
by the simple rule of proportion. 

Symptoms of Gravel. — A sudden attack of pain in the region of 
the kidneys, so acute and severe, frequently, as to cause fainting and 
even convulsions. The pain runs down to the groin and thigh, caus- 
ing a numbness on the affected side, and a drawing up of the testicle. 
The pain is excessive at times, and then remits. Finally it stops 
suddenly. 

Leading from the kidneys to the bladder are two small tubes about 
the size of a goose-quill, called ureters, — being the appointed chan- 
nels of the urine. The pain, of which I have spoken, is caused, gen- 
erally, by the passage of a stone along one of these small tubes. If 
the stone happen to be a- little too large for the tube, or uneven or 
ragged upon its surface so as to bruise and tear the delicate lining 
of the ureter, severe pain is the result. The pain is intense when the 
stone moves along ; remits when it stops ; and suddenly ceases alto- 
gether, when it gets through, and drops into the bladder. 

Sometimes there is no pain, the gravel being so fine as to pass 
through the ureters very easily. It then passes through the urethra 
also, and is found as a sediment of the urine at the bottom of the 
vessel. 

These urinary deposits are various, and quite unlike each other in 
kind. They indicate different states of health, and require to be 
spoken of separately. 

Uric-Acid Gravel. 

This form of deposit passes indifferently under the name of uric 
acid gravel, or lithic acid gravel. The person who is in the habit of 
passing this kind of deposit largely, is said to have the lithic or uric 
acid diathesis or condition. 

The urine of persons in this state lets fall, after it has stood awhile, 



348 



DISEASES OF THE ABDOMINAL CAVITY. 



a reddish sediment, like brickdust. This consists chiefly of urate of 
ammonia (Figs. 116 and 117), tinged with certain coloring matters. 
This coloring substance may be more or less abundant, and give to 
the deposit various shades, as dirty-white, yellow, pink, and red. The 





Fig. 116. 



Fig. 117. 



pure uric acid sometimes appears as fine sand, or large crystals (Fig. 

118). The urine is of a dark copper-color, about like brown sherry, 

and is more scanty than in health. It is 
also highly acid, giving to litmus paper 
a deeper shade of red. 

Persons who pass this kind of gravel 
largely are apt to be troubled with in- 
flammatory complaints; with acidity of 
the stomach and heartburn ; and some 
of them with gout and rheumatism. 

Placed under a blowpipe, uric acid is 
decomposed, and gives out an odor like 
that of burnt feathers, combined with 
the oil of bitter almonds. It is dissolved 
by liquor potassa, from which muriatic 
and nitric acids precipitate it ; and by 
sulphuric acid, from which it is precipi- 
tated by water. Acetic, nitric, and mu- 
riatic acids, alcohol, ether, and water, do 
not dissolve it. 




Fig. 118. 



Causes. — Uric acid is the form in which nitrogen and the effete 
compounds which contain it are got out of the body. It is the result 
of the decomposition of the tissues of the body. Its gravelly particles 
are the sands of life daily washed out of us, — reminding us always 
that we are wasting away. Whatever causes the body to waste 
rapidly, produces it in excess. We find it, therefore, in the urine of 
those who suffer from gout, rheumatism, dyspepsia, fevers, debility of 
the genital organs, straining of the loins, etc., which produce loss 
of flesh. 

Treatment. — The remedies for this uric-acid gravel are the alka- 
lies, bicarbonate of potash, bicarbonate of soda and magnesia. The 



DISEASES OF THE ABDOMINAL CAVITY. 349 

first named is generally the best. It may be used in the form of the 
neutralizing extract, — especially if there be costiveness. If the bowels 
do not need physic, let the potash be taken in the shape of lye made 
from hard- wood ashes (300). Fluid magnesia is an excellent remedy; 
so is liquor potassa, taken in twenty or thirty-drop doses. The urine 
must be watched, and these remedies discontinued when it becomes 
alkaline. Black coffee drunk freely every day is an excellent remedy. 

At the same time the stomach should be supported by some bitter 
tonic, as the infusion of quassia, gentian, columbo, Peruvian bark, etc. 

Iron is, in many cases, not to be overlooked. If the patient be 
pale and bloodless, some of the preparations of this metal will be 
needed (61), (73), (74). 

Acid must be carefully avoided, both in food and drink. 

The diet must be plain, digestible and nourishing, and quite mod- 
erate in amount. The quality is of less consequence than the quan- 
tity. 

Exercise is of great consequence, and must be regular, and, if pos- 
sible, in the open air. 

The skin must receive daily attention in the shape of an alkaline 
sponge-bath, with friction. This will throw upon the skin much of 
the labor done by the kidneys. Poland Spring water used in large 
quantities is good. 

Phosphatic Deposits. 

These deposits are indicated by a state of the urine just the oppo- 
site of that which contains the uric-acid gravel. They are contained 
in urine which is either alkaline when passed, or becomes so very soon 
by standing. 

As the urine cools, a white sand falls to the bottom, and frequently 
a film forms upon the surface of the water. Looking at this film in 
different lights, you may see in it the several colors of the rainbow. 
Skim off this pellicle, place it upon paper, and let it dry ; and you 
may then see the little shining crystals. This urine quickly grows 
putrid and offensive. Sometimes it smells strongly of ammonia. 
The more phosphates it contains, the sooner it becomes alkaline. 

These deposits are generally the triple phosphates. Healthy urine 
contains the phosphate of magnesia in a state of solution. Under 
some circumstances, the urea of the urine is decomposed in the kid- 
neys, and ammonia is disengaged. This combines with the phosphate 
of magnesia, and forms the triple salt of the phosphate of ammonia 
and magnesia, which is not soluble. 

Symptoms. — A sallow complexion, a languid, spiritless state of 
mind, and an exhausted, debilitated condition of body. The urine is 
pale, rather copious, slightly turbid, has a low specific gravity, and 
smells unhealthy, having sometimes the faint odor of weak broth. 
There is generally derangement of the digestive organs, windy stom- 
ach and bowels, nausea, constipation, or diarrhoea, stools of various 



ooO ' DISEASES OF THE ABDOMINAL CAVITY. 

colors, and sometimes, in diarrhoea, resembling yeast, and an aching 
pain and weakness in the loins. 

Causes. — These deposits are produced by great debility of the 
constitution, by injuries of the spine, dyspepsia, defective assimila- 
tion of food, bad diet, irritation of the neck of the bladder, and or- 
ganic disease of the kidneys. But they are caused more especially 
by whatever wears and exhausts the nervous system, as heavy cares, de- 
pression of spirits, sedentary habits, great mental exertions, mastur- 
bation, and venereal excesses. 

Treatment. — These deposits being connected with great debility, 
care must be taken not to make the matter worse by taking active 
purgatives, by extreme fasting, or by any means which will increase 
the weakness. 

On the contrary, the strength must be supported by all the means 
that can be commanded. With this view, the citrate of iron (75) 
may be taken. Arsenic combined with iron (80), to allay irritability, 
and impart strength at the same time, may be used. The valerianate 
of iron (93) is excellent for the same purpose. 

Connected with a state of urine just the opposite to that which 
holds the uric-acid deposits, this form of gravel calls for the opposite 
remedies. Instead of the alkalies, the acids are wanted. The nitric 
and muriatic acids, with a vegetable tonic (76), may be used. Borax 
is spoken of in high terms, and is thought by some to have great 
power in turning alkaline urine acid. The compound balsam of sul- 
phur is highly spoken of, and the compound infusion of trailing arbu- 
tus is also mentioned with approbation. 

It is all-important to throw off care, and to give the mind a chance 
to rise up with all the elasticity it has. To bring this about, journeys 
and amusements are useful. The society of lively, laughing, witty 
friends will do a great deal to give the spirits a rebound, and the 
whole health an upward movement. Such persons are a blessing to 
the world ; and he who reckons a few of them among his friends will 
live the longer for it. 

The skin should have the benefit of the daily tonic effect of a 
sponge-bath, with water at first tepid, and afterwards cool ; and exer- 
cise, out of doors, should be habitual, and connected, as much as pos- 
sible, with objects of pleasure. 

The drinking of hard water is highly injurious ; and if none other 
can be had, it should be distilled, and then spread out to the atmos- 
phere, in shallow vessels, that it may recover its pleasant taste by 
reabsorbing air and carbonic acid. 

Oxalic Deposits. 

Oxalate of lime a\ the urine is the cause of this kind of gravel. 
It appears in the form of dumb-bells, and octahedral crystals. (Figs. 
119, 120, and 121.) 



DISEASES OF THE ABDOMINAL CAVITY. 



351 



The urine has a specific gravity of 1.015 to 1.025, and is generally 
of a dark amber-color, and clear and bright ; it is generally acid, 






Fig. 119. 



Fig. 120. 



Fig. 121. 




Fig. 122. 



though occasionally alkaline or neutral. Urea is generally found in 

it, and epithelial cells (Fig. 122). Unlike the 

uric and phosphatic urines, it is quite free 

from sediments, except, as often happens, there 

is a large amount of urea in it, in connection 

with the oxalate of lime. 

When the urate of ammonia is combined with 
the oxalate of lime, it often happens that the 
latter has to be dissolved with a little liquor 
potassa, before the former can be seen with the 
microscope. 

Symptoms. — Great depression of spirits, excitable state of the ner- 
vous system, painful susceptibility to external impressions, dyspeptic 
symptoms, and disturbances of the liver, a fear and dread of consump- 
tion, emaciation, inability to make exertion, — the" smallest exertion 
causing fatigue ; in men, a deficient sexual power, a pain and weight 
across the loins, and some irritability of the bladder. 

Causes. — These deposits are supposed to result, like most other 
derangements connected with loss of flesh, in too great a degree of 
oxidation. Vegetables produce oxalic acid by just the opposite pro- 
cess, namely, deoxidation. 

Whatever depresses the vital powers, may generate this deposit, 
as mental depression, overwork of the brain, burdensome cares, idle- 
ness of mind or body, masturbation, debaucheries, intemperance, vene- 
real excesses, and injuries of the spine. 

This deposit may also be produced by certain articles of diet, which 
contain the oxalic acid. Among these may be named the rhubarb 
plant, which in summer is largely used for tarts ; and sorrel. 

Treatment. — The treatment for these deposits should be very 
much like that for the phosphatic. The stomach and liver should 
receive some special attention. A pill of leptandrin, podophyllin, 
etc. (39), may be used with advantage. The preparation of nitric 
and hydrochloric acids (76) must generally be taken for some time. 
In cases of great irritability, the sulphate of zinc (82) does well. 



352 DISEASES OF THE ABDOMINAL CAVITY. 

The diet should be plain, digestible, and nourishing, — all articles 
containing oxalic acid being rejected, as the rhubarb plant, sorrel, 
tomatoes, onions, etc. 

For the rest, follow the directions for the treatment of phosphatic 
deposits. 

Urate of Ammonia Deposits. 

The urine which contains these deposits is generally pale, and of 
low specific gravity, about 1.012. It becomes opaque on cooling, 
from the deposition of a nearly white urate of ammonia. Instead of 
falling down readily, this forms ropy masses in the fluid, and looks 
like mucus or pus, or something between the two. Its real nature is 
discovered by applying a little heat, which quickly dissipates it. 

Microscopic Character. — Place a drop of this turbid urine be- 
tween two slips of glass, and examine it closely with a microscope ; 
you will see myriads of minute globules adhering together in linear 
masses. Now place a drop of the turbid urine in a watch-glass, and 
gently warm it ; as soon as it has become clear, add a drop of hydro- 
chloric acid to it, and when it is cold, examine it with the microscope. 
The muddiness will be gone, and you will now see lozenges, or thick 
cohering prisms of uric acid (Fig. 123). The explanation of this is, 
that the hydrochloric acid combines with the ammonia, forming muri- 
ate of ammonia in solution, and liberating the uric-acid crystals. 





Fig. 123. Fig. 124. 

Urate of soda (Fig. 124) is sometimes found in urine, which has 
similar chemical reactions with urate of ammonia. 

Causes. — These deposits are generally produced by some over- 
eating, or derangement of the skin. 

The treatment is the same as that for uric-acid gravel. 

Hippuric Acid Deposits. 

These deposits appear in the healthy urine of the cow and the 
horse ; and also in that of human beings, but in such small quanti- 
ties as to be scarcely appreciable. 

They sometimes, however, appear in unhealthy proportions : but 
they never show themselves as a sediment, until after the addition 



DISEASES OF THE ABDOMINAL CAVITY. 



353 




Fig. 125. 



Cause. 



of a stronger acid. The urine containing them is generally slightly 
acid or neutral, — sometimes alkaline, — having a low specific gravity, 
from 1.006 to 1.008. The triple phosphates 
are often found in it. 

To detect these deposits, fill a large watch- 
glass with urine, and evaporate it over a lamp 
to a few drops. Then add to it about half 
its bulk of hydrochloric acid, and set it aside. 
The addition of the acid produces a bright 
piak color, and an odor like new hay. After 
a few hours, if the hippuric acid be present, its 
peculiar crystals will be seen. (Fig. 125.) 

In man, this deposit is supposed to depend on the 
absence of food having a good share of nitrogen. The urine of 
vegetable-eaters contains it in largest quantities. 

Treatment. — The only treatment required is a diet composed in 
good proportion of animal food, a proper attention to the skin by 
bathing, etc., and when debility exists, tonic medicines, as iron and 
bitters, with out-door exercise enough to keep the muscles in working 
order. 

Cystine Deposits. 

These do not occur in healthy urine, and rarely as an element in 
diseased action. They contain twenty-six per cent of sulphur. 

Urine which contains cystine is of a pale yellow color, and has a 
low specific gravity. It frequently has an oily appearance, and its 
smell is peculiar, resembling that of sweet brier. Sometimes its odor 
is fetid, like putrid cabbage. On being kept for a short time, it has 
its surface covered with a pellicle which looks oily, and consists of a 
mixture of crystals of cystine and the phosphate of ammonia and 
magnesia. 

The cystine deposit appears to be diffused through the urine, which 
is always turbid when boiled. It is a white or fawn-colored powder, 
and falls to the bottom as a sediment. It undergoes no change by 
warming the urine, and this distinguishes it from white urate of 
ammonia. It is not soluble in diluted hydrochloric or strong acetic 
acid, which distinguishes it again from the earthy phosphates. 

To test this deposit, add liquor ammonia to a portion of it, and 
shake them. If the deposit be cystine, it will dissolve readily. Allow 
a few drops of the solution to evaporate on a slip of glass, and the 
six-sided tablets of cystine will remain, which may be examined under 
the microscope. (Fig. 126.) 

It is to be remembered that occasionally the chloride of sodium or 
common salt crystallizes in octahedral forms (Fig. 127), which, in 
some positions, may look very much like cystine. The ready solu- 
bility of the chloride in water, and the absence of all color when they 
are examined by polarized light, will prevent mistaking these crystals 



354 DISEASES OF THE ABDOMINAL CAVITY. 

for cystine. If urine containing common salt be quickly evaporated 
on a slip of glass, and be then examined, instead of the octahedrons, 
we find crosslets and daggers. (Fig. 128.) 





Fig. 126. Fig. 127. Fig. 128. 

Causes. — An excess of sulphur in the tissues, a scrofulous consti- 
tution, and hereditary predisposition, with defective oxidation, and 
torpidity of the liver. It is often found in the urine of girls who 
have the green sickness. 

Treatment. — The great object is to improve the general health, 
which is to be done by attending to the skin, and the administration 
of iron and bitters, and also alteratives. The syrup of iodide of iron 
is a valuable remedy. Podophyllin and leptandrin (34) are wanted 
to regulate the liver. The nitro-muriatic acid (76) should be tried. 

The daily sponge-bath, and daily exercise, as in most chronic com- 
plaints, must on no account be neglected.- 

Stone. — Calculus. 

It often happens that the proper treatment for removing urinary 
deposits is not adopted in season. In such cases, gravelly particles, 
finding a lodgment for a time, in the kidneys or bladder, are apt to 
draw other particles to themselves, which become fastened to them, 
and form a layer quite around them. Over this, other layers form in 
succession, until a stone is produced so large that it cannot pass off. 
These grow to various sizes, — being sometimes so large as to fill the 
bladder. 

Uric-Acid Calculus. — The most common of these formations is the 
uric-acid calculus. It is generally smooth or slightly tuberculated on 
the surface, and varies in color from a pale yellowish-fawn to a red- 
dish-brown. When sawn through the centre, its layers will be found 
tolerably regular, but of different thickness. (Fig. 129.) 

To test it, place a small fragment upon platinum foil under the 
blow-pipe. If uric acid, it blackens, and gives out an odor like burnt 
feathers mixed with the oil of bitter almonds. 

Mixed Calculus. — These calculi are frequently composed of two 
or more different kinds of matter arranged in irregular layers. Fig. 
130 is a mixed calculus, — the dark layers being oxalate of lime, the 
light ones uric acid. 



DISEASES OF THE ABDOMINAL CAVITY. 



355 



In testing such, fragments of each ingredient should be separately 
examined. 

Urate of Ammonia Calculus. — We occasionally meet with a cal- 
culus composed of the urate of ammonia. These calculi, when found, 
are generally small in size, smooth or slightly tuberculated upon the 
surface (Fig. 131), and of a pale slate or clay color. When heated 
before the blowpipe, it gradually disappears. 





Fig. 129. 



KlG. 130. 



Fig. 131. 



Phosphate of Lime Calculus. — This has a smooth polished sur- 
face, and quite regular layers, which separate easily when the calculus 
is cut asunder. It has a pale fawn or stone color. (Fig. 132.) 

It chars before the blowpipe, and gradually becomes white as the 
carbon burns away. Diluted nitric or hydrochloric acid dissolves it 
without effervescence. 

Oxalate of Lime Calculus. — This is frequently met with uncom- 
bined with others, but more generally its nucleus is uric acid or urate 
of lime. It commonly has a brown, dark-olive, or dirty-purple color. 
Its surface is irregular and somewhat rough. It looks like the fruit 
of the mulberry, and is known as the mulberry calculus. (Fig. 133.) 

It dissolves, without effervescence, in diluted nitric or hydrochloric 
acid. When thus dissolved, the addition of a little ammonia will 
cause it to fall to the bottom as a white precipitate. 






Fig. 132. 



Fig. 133. 



Fig. 134. 



Fusible Calculus. — This is a mixture of phosphate of lime and the 
phosphate of ammonia and magnesia. It is the most common of 
all the calculi, except the uric acid. It has an oval, irregular form 
(Fig. 134), and is white, soft, and friable, like chalk. Sometimes it 
is hard. * 

It may be known by the readiness with which it melts down before 
the blowpipe, without being consumed. 

Causes. — The causes of the different kinds of gravel have been 
already explained. Generally stones of the bladder are formed in the 



356 DISEASES OF THE ABDOMINAL CAVITY. 

kidney, and descending through the ureters into the bladder, are pre- 
vented from passing out through the water-pipe by an enlarged pros- 
tate gland. Remaining in the bladder, they soon get encrusted over 
by other matters in the urine, and grow by accretion to be stones. 

Symptoms. — When a stone in the bladder reaches a certain size, 
especially if it is rough, it always produces suffering. A dull, annoy- 
ing pain is felt at the end of the penis. The desire to make water is 
frequent, and there is a sense of weight in the perineum. Sometimes 
the stream of urine is suddenly stopped by the stone falling on the 
orifice of the urethra. As the bladder becomes nearly emptied, it 
embraces the stone, and the pain is increased. Jolting in a carriage 
causes great pain. Mucus passes off with the urine, and sometimes 
blood. After a time, the appetite fails, hectic sets in, albumen ap- 
pears in the urine, and the patient sinks under inflammation of the 
bladder. 

These symptoms being found in diseases of the kidneys and blad- 
der, no one is authorized to pronounce upon the existence of stone, 
until the stone has been touched by a metallic sound introduced into 
the bladder. 

Treatment. — The only effectual treatment is a choice between 
three operations, — lithotrity, lithotomy, litholopaxy. 

The first consists in introducing an instrument, a kind of forceps, 
into the bladder, through the urethra, taking hold of the stone, and 
crushing it. The preparatory treatment consists in correcting the 
unhealthy state of the urine, and the frequent introduction of bougies 
or sounds to enlarge the water-pipe for the easy entrance of the 
crushing forceps. The after treatment consists in diluent drinks to 
increase the urine, injections of warm water to wash out the frag- 
ments, with hip-baths, soothing injections, and leeches or cupping 
upon the perineum. 

Lithotomy consists in making an incision into the bladder through 
the perineum, and taking out the stone or stones whole. 

Litholopaxy consists in crushing the stone in situ by means of the 
lithotrite and syphoning out the debris. 

Dropsy of the Belly. — Ascites. 

This is a collection of water in the cavity of the belly ; sometimes 
the fluid is outside of the peritoneum, and next to the muscles. 

Symptoms. — An enlargement 01 the belly, with a sense of disten- 
tion and weight, — particularly on the side on which the patient lies. 
When the collection of water is large, the breathing becomes short 
and difficult, and the swelling is uniform over the whole abdomen. 

In some instances the fluctuation of the water may be distinctly 
heard when the patient moves about, — just as we may hear the 
water in a half-filled barrel when it is rolled over. This sound of 
the fluid, when heard, distinguishes the complaint from pregnancy, 



DISEASES OF THE ABDOMINAL CAVITY. 357 

and from the drum-head state of the bowels. This fluctuation may 
sometimes be produced by pressing upon one side of the belly while 
the patient is standing or sitting, and striking the other side with the 
ends of the fingers of the other hand. 

In some cases, there is loss of appetite, dry skin, costiveness, scanty 
urine, oppression of the chest, cough, colic pains, and variable pulse. 

Causes. — A frequent cause of this complaint is chronic inflamma- 
tion of the serous membrane which lines the abdomen, — I mean the 
peritoneum. It may also be produced by scarlet fever, fever and 
ague, disease of the heart, particularly dilation of the right cavities, 
and diseases of the liver, particularly the shrivelled, hobnail condition 
of the liver, — in short, whatever causes a pressure upon the portal 
veins, and obstructs the venous blood returning from the intestines. 

Treatment. — The remedies for this disease are mainly diuretics 
and purgatives. The bowels may sometimes be reduced in a few 
days from an enormous size, by medicines which excite the action of 
the kidneys. Digitalis combined with acetate of potash, etc. (130), 
forms an excellent preparation. The patient should have as a con- 
stant drink, a strong infusion made from two parts of hair-cap moss, 
and one each of juniper berries and dwarf-elder bark ; also an infu- 
sion of queen of the meadow. 

The purgatives used in this complaint are those which produce 
watery stools. One of the best of these is elaterium. It will some- 
times carry off the water with great rapidity ; combined with some 
active cathartics (31), it will have all its good effects without the 
griping it is apt to occasion alone. 

Cream of tartar, taken in large doses, every day, will sometimes do 
well. Epsom salts produces watery stools, and is a good remedy. 

For promoting absorption of the fluid, the iodide of potassium, 
taken in from three to ten-grain doses, three times a day, is a valua- 
ble medicine in many cases. The compound infusion of parsley is 
said to be still better. 

The skin must receive careful attention. The alkaline sponge 
bath, with friction, will increase the transpiration of fluid through 
that organ. Exercise does much to keep up an active circulation, 
and to lessen dropsical effusions. 

The strictest temperance, both in eating and drinking, must be 
observed. A light and nourishing diet, with water, tea, and the 
diuretics named above for drinks ; beyond these the patient must 
not go. 

A kneading and shampooing of the bowels once a day has an 
excellent effect ; it gives activity to the circulation in obstructed 
veins. A bandage tied close around the bowels, and tightened as 
the water diminishes, has an effect upon the sluggish vessels similar 
to that of the laced stocking in varicose veins of the legs. It lessens 
the liability of a return of the complaint. 



358 DISEASES OF THE ABDOMINAL CAVITY. 



Dropsy of the Cells. — General Dropsy. — Anasarca. 

Just under the skin is a membrane composed chiefly of cells, 
called the cellular membrane. When a considerable part or the 
whole of these cells are filled with a watery fluid, we call the com- 
plaint anasarca, or cell-dropsy. If, besides this, there is a collection 
of water in the large cavities, we give it the name of general dropsy. 

Symptoms. — The disease generally begins with a swelling around 
the ankle and leg, which is more visible at night after standing and 
walking, and is less perceptible in the morning in consequence of 
the horizontal position of the night. To the touch of another person, 
dropsical feet and legs feel a little colder than natural ; and when 
hard pressed with the finger, a pit will be sunk in the flesh, which 
remains some time before it fills up. As the disease advances, the 
skin of the legs becomes smooth, shining, and sometimes even cracks 
open to let out the water. The limbs, and indeed the whole person, 
become stiff, heavy, and clumsy. 

As the disease advances, and ascends to the belly and chest, there 
is shortness of breath, a sense of suffocation on moving or lying 
down, a tightness and distress across the epigastrium, thirst, dryness 
of skin, wakefulness, loss of appetite, scanty and deep-colored urine, 
and a slow fever. 

Cause. — General dropsy is caused by whatever weakens the gen- 
eral system, and by such circumstances as obstruct the circulation in 
the veins. The most frequent causes, therefore, are certain diseases 
of the heart and kidneys. 

Explanation. — Modern physiology has demonstrated that the veins 
do a certain part of the work of absorption. The serous membranes 
which line the larger cavities of the body exhale watery fluid enough, 
and no more than enough, to keep them moist, and cause the organs 
within to play smoothly upon their surface. If the fluid were not 
taken away as fast as it is poured out, the cavity, being a shut sac, 
would become full, and we should have dropsy. It is the office of 
the veins to absorb this fluid and convey it away in the general cur- 
rent of the blood. 

This is the method of their doing it : The walls of the veins are 
so constructed as to permit watery fluids to pass through them, either 
in or out. When they are comparatively empty, or only moderately 
full, fluids on the outside pass in, and mingle with the contents. 
This is called endosmosis. When they are very full, the watery 
portion of the blood will filter through, and pass out. This is called 
exosmosis. 

Now, if the reader will think a little, he will easily see that if the 
veins are barely full enough not to allow any fluid to pass in, the 
natural exhalations of the shut sacs would bring on dropsy ; but if 



DISEASES OF THE ABDOMINAL CAVITY. 359 

the veins are so full as to cause water to floiv out, then the dropsical 
accumulation will be still more rapid. 

Such being the office arid nature of the veins, the reader may 
learn how disease of the right side of the heart will cause dropsy. 
When the right ventricle is so dilated and weakened that it cannot 
send the blood forward to the lungs, of course the veins which bring 
it to the right side of the heart, will become full, and greatly distended. 
Exosmosis will then occur; the watery portion of the blood will 
begin to run out, either into the large cavities, or into the cells, and 
dropsy, either general or local, will be the result. 

Treatment. — This must be goverened very much by the cause of 
the disease. 

In dropsy from disease of the heart, we may use diuretics and 
such other methods as are recommended for dropsy of the belly. 
If the urine is strongly acid, depositing the brick-dust sediment, 
the alkaline diuretics will be the best, as the acetate and bicarbon- 
ate of potash combined, and dissolved in water. The bitartrate of 
potassa, to act upon the bowels, is a proper remedy. If the disease 
arise from general debility, the following powder will be useful: 
digitalin, three grains ; cinchonia, half a dram ; phosphate of iron, 
half a dram ; and white sugar, one dram. Mix, and triturate ; divide 
into sixteen powders, and give one, in pumpkin-seed tea, four times 
a day. 









VENEREAL OR SEXUAL DISEASES. 



Of all the diseases to which flesh is heir, none bring so much 
misery, moral and physical, as those called sexual or venereal. To 
the physician, they are the source of the greatest anxiety and per- 
plexity. They bring him into possession of the most delicate secrets, 
— secrets which involve the peace of families and neighborhoods, — 
secrets which his honor as a man, and his truth as a physician, compel 
him to lock fast in his own breast, and hold sacredly apart even from 
his nearest companions, — secrets which, if revealed would fill domes- 
tic circles with unutterable bitterness and heartburnings, and whole 
neighborhoods with scandal and immorality. These secrets are often 
a burden to him. They are in his breast like undigested food in the 
stomach, — disturbing the whole nature. 

The patient, if a man of sensibility, suffers even more, of course, 
than his physician. In many cases, he is a man of virtuous inten- 
tions, and perhaps of religious habits, who has fallen in a moment of 
temptation ; and he fears that the effect of his sin will spread itself 
through his whole system, and extend to the end of life ; or, still 
worse, that having poisoned the fountain of his life, it will go down 
as a heritage of misery to his offspring ; or, what he would deprecate 
as almost equally calamitous, that the partner of his bosom may be- 
come the innocent partaker of his disease. 

In this state of apprehension, he turns to his physician, not merely 
to keep his secret, but to cure his disease. How great a pity that, in 
such circumstances, he does not always fly immediately to an honor- 
able physician, instead of seeking the advice, as many do, of those 
miserable quacks, who lure him to their dens only to get Ins money, 
having no intention or ability to cure his complaint. 

These diseases are divided into two great branches, characterized, 
in part, by different symptoms, and generally held to be entirely dif- 
ferent complaints. The first to come under consideration is 

Pox. — Syphilis. 

This disease had a very early origin. It was known among the 
Jews, as we learn very clearly from the fifteenth chapter of Leviticus. 
Dr. Adam Clarke's Commentary upon this chapter, at least, makes it 
apparent. David, the king of Israel, has unconsciously left on record, 
in the thirty-eighth Psalm, a most graphic description of Tertiary 

360 




P1.5. 




Q 




VENEREAL OR SEXUAL DISEASES. 361 

Syphilis, experienced in his own person. Dr. Clarke says : " It is 
most likely the Psalm was written in reference to some severe afflic- 
tion that David had, after his illicit commerce with Bathsheba ; but 
of what nature, we are left to conjecture from the third, fifth, and 
seventh verses." The Psalm is dated not quite a year after the act 
alluded to, — about the right time for the terrible symptoms David 
describes to make their appearance. 

The term syphilis is from a Greek word signifying filthy. There 
is one unvarying sign of this disease, — the existence of an ulcer or 
ulcers, usually upon the genital organs. The French call this ulcer a 
chancre. The common name is simply venereal sore, or ulcer. A 
pimple first appears ; on the summit of this a pustule forms ; then the 
rupture of the top of this brings to view the ulcer or sore. This ulcer 
is shallow, more or less circular or oval in form, bounded by a perpen- 
dicular and slightly jagged border, and furnished with a smooth, yel- 
low base, moistened by an unhealthy secretion. The skin around the 
sore is a little thickened and inflamed. This is a simple venereal 
ulcer. It generally lasts about five weeks, and then heals. 

But it is not always thus simple. It may be an inflammatory 
chancre, attended by excessive inflammation. It may be what is 
called a sloughing chancre, characterized by the perishing and falling 
off of large parts of flesh. It may be gangrenous, or marked by a ten- 
dency to mortification. It may be phagedenic, or eating, — being dis- 
tinguished by a rapid loss of substance, or eating away of flesh. Or, 
finally, it may be indurated, — being noted for the peculiar hardness 
of the base, and of the flesh immediately around it. 

A venereal sore is the result of impure connection with a person 
having the syphilitic disease. The poisonous secretion of a sore, 
applied to the skin of a healthy person, produces inoculation, and a 
new sore upon the previously healthy person is the result. This 
chancre appears in a few days after coition, — a certain time being 
required for it to produce its effect, as in the application of vaccine 
matter to the arm. 

Bubo. — The next symptom in the order of occurrence, which fre- 
quently follows the ulcer, is the bubo. It is named from a Greek 
word which means groin, from its usually appearing in that part. 
It is a painful swelling of the inguinal gland in the groin, and is 
caused by the absorption of virus or poisonous matter from the 
chancre. This gland is one of the lymphatics, a class of vessels as 
numerous, all over the system, as the veins and arteries. They are 
likewise called absorbents. Those that originate from the private 
parts absorb the poison from a venereal sore, and convey it to the 
glands in the groin, which being poisoned by it, inflame and swell. 

The bubo generally appears in from one to two weeks from the 
appearance of the ulcer. It is usually upon the same side which the 
chancre occupies upon the penis. When the bubo advances to sup- 
puration, and becomes an open sore, it is then a glandular chancre. 



362 VENEREAL OR SEXUAL DISEASES. 

Vegetations. — These are peculiar growths appearing upon differ- 
ent parts of the skin, which resemble certain vegetables. They are 
found most frequently, in the male, on the head of the penis, and on 
the membrane lining the foreskin. In the female, they are found at 
the entrance to the vagina, and not infrequently in the vagina itself. 
They sometimes appear on the neck of the uterus. 

Primary Disease. — Thus far, the diseases noticed are what are 
Called primary. If properly treated, and cured in season, the consti- 
tution is not infected, and no subsequent troubles appear. But a 
result so fortunate as this is not common. Generally, the treatment 
is either too long delayed, or is too brief and superficial. The poison 
is, in consequence, absorbed into the circulation; the whole con- 
stitution becomes infected ; the fluids and solids are so acted on and 
altered, in fact, that a special constitution is created. For this reason 
the affections of the skin, the mucous membranes, the bones, etc., 
which follow, are called 

Constitutional. — These constitutional diseases never appear im- 
mediately, as the result of an impure connection, but only after those 
affections already noticed. The primary diseases are local ; the con- 
stitutional affections are general. 

The first thing which strikes the eye in these constitutional com- 
plaints is the color and appearance they give the skin. It has a red- 
dish, coppery tinge, and a peculiarly dirty appearance. 

The order in which the several parts are affected, are, first, the skin 
and mucous membranes ; second, the hard substance surrounding the 
bones, called periosteum, the tendons, and the bones themselves. 
Those affections which appear upon the skin and mucous membrane 
are usually called secondary, because they are the second to appear ; 
while those affecting the bones, etc., are denominated tertiary, be- 
cause, in the order of their appearance, they are in the third class. 

Eruptions of the Skin, and Ulcers. — Of the constitutional erup- 
tions, there is a great variety, — so great that I cannot, in small space, 
give a minute description of them. The breast and arms are not 
infrequently the first to be affected. Attending these eruptions there 
is little uneasiness, and no pain ; though there is sometimes a slight 
itching. The first breaking out is usually of a copper color, some- 
what paler than it subsequently is. The eruption is often in the 
form of blotches, elevated only a very little above the skin. They 
are composed of small pustules, with a little fluid in them, which 
soon dries away, and the whole may be rubbed off like bran. This 
may leave the skin looking tolerably sound, and inspire the belief 
that no further mischief is to be experienced. No hope can be more 
delusive. Parts afflicted with this complaint show no tendency to heal. 
The first crop of pimples is soon followed by a second, which pro- 
duces a thicker crust, and yields a larger amount of bran. This 
rubbed off, small ulcers appear underneath. 



VENEREAL OR SEXUAL DISEASES. 



363 



Vesicular Uruptions. — There is another syphilitic affection of the 
skin, which appears in the shape of vesicles, like small-pox. These 
dry and leave a scab. 

Scaly Eruptions There is still another affection, which is in 

the form of scales, and one scale will be piled upon another. It 
begins with an eruption of copper-colored blotches, which become 
covered with scales ; these are succeeded by scabs, and when these 
fall off, shallow ulcers are left with copper-colored edges. (Fig. 
135.) This is a stubborn form. 




Fig. 135. 

Tubercular Eruptions In another variety of the disease, broad, 

red, copper-colored tubercles, or hard elevations appear, most com- 
monly about the sides of the nose, or on the cheeks. Gradually they 
suppurate, and are succeeded by deep ulcers, terminating in scars. 
This is an unfavorable form of the disease, and usually appears some 
considerable time after the primary symptoms, in persons whose con- 
stitution has been shattered. Plate V. 

This rather belongs to the tertiary form of the disease ; and in addi- 
tion to the above, patches of unhealthy inflammation are apt to form 
on the tongue, and after a time break, disclosing ragged, orange- 
colored ulcers. Plate VI. Fig. 2. 

Many other forms of eruption exist ; but in a popular work like 
this, it would be useless to make the nice distinctions which their 
description would require. 

Some of the worst forms of the secondary affections are found 
upon the mucous membrane of the mouth and throat. These corres- 
pond, in number and size, with the affections of the skin. They 
affect the lips, the internal sides of the cheeks, the tongue, the tonsils, 
the pharynx, the soft palate, the nasal cavities, etc. They are terribly 
destructive in their effects, forming gaping ulcers, and eating deeply 
into the parts. They often make shocking work in the whole mouth 
and throat; and, when attended with considerable inflammation, 
make it almost impossible to swallow anything, or even to open the 
mouth. I have often seen breaches through the palatine arch (Plate 
VI, Fig. 1), and even the whole arch destroyed (Plate VI, Fig. 2). 
Persons have often died from starvation, — not being able to swallow. 
The ulcers sometimes take hold of the tonsils, and "dig them out as 
if it were done with a punch." 

These ulcerations affect the mucous membranes of the genital 
organs. In the female, they often affect the vagina and the neck 
of the womb, and thus may exist for a long time, as the cause 



364 VENEREAL OR SEXUAL DISEASES. 

of whites, without being suspected as such. They affect also 
the mucous lining of the fundament and the large bowel. They 
sometimes exist in the ear, and more often in the eye. This latter 
affection passes under the name of syphilitic iritis. In Plate V. 
the artist has well represented this form of constitutional disease in 
the eye. 

The disorder having, by frightful ulcers, run riot upon the delicate 
structures of the skin and mucous membranes, advances boldly on- 
wards, attacking the muscles, the tendons, the hard covering of the 
bones and the solid bones themselves. No part of the human frame- 

— not even the skeleton — can escape this devouring complaint. 
The bones of the nose and face are generally the first to be attacked. 
These perish slowly, — falling away piece by piece, — the nose, in 
the mean time, sinking down nearer to a level with the cheeks. 
From these parts the disease may spread to the bones of the whole 
system. 

These affections of the bones are attended by pains of almost 
every kind and degree. These pains are sometimes fixed in one 
place ; at other times wandering, the whole skeleton being painful. 
In these latter cases, they seem to the sufferer to reach the very mar- 
row. Sometimes when the pain is fixed in one place, the feeling is 
such as might be supposed to be experienced if the bone were being 
bored. These pains are most terrible during the night. 

Upon those parts where the skin is near the bone, as the forehead, 
or shin, syphilitic nodes or tumors often appear, which are hard, like 
cancerous tumors. Besides the above, there are the loss of the hair 
(alopecia), blindness, deafness, and various other mischiefs, resulting 
from syphilis, which need not be described. 

Is the Constitutional Disease Communicable ? — Many believe, 

— even among those who are eminent in the profession — that the 
constitutional forms of the disease are not communicable. A few 
years ago, indeed, this latter opinion was generally received. It is 
now quite extensively doubted, or rather disbelieved. Facts are con- 
stantly occurring under the eye of unprejudiced physicians, which 
make it very evident that the constitutional disease may be commu- 
nicated from one person to another. 

The Disease Hereditary It is no small amount of suffering, 

bodily and mental, which the individuals endure who contract this 
disease. But the inflictions visited upon them, severe as they are, 
are small compared with the aggregate of ills entailed by it upon 
the long line of their posterity. Whether it be the man or the 
woman whom the sphilitic virus has inoculated, if it be allowed to 
be absorbed, so as to affect the constitution, it Avill be very likely to 
be sent down to the children, and children's children. The divine 
law which links the sins of the father with the sufferings of even the 
third and fourth generation, is nowhere more painfully illustrated 



VENEREAL OR SEXUAL DISEASES. 365 

than iii the scourging descent, through many generations, of this ter- 
rible disease. It may be passed down to posterity by either of the 
parents ; but if both be diseased, the transmission will be more cer- 
tain. If the mother be infected, she will infect the child while car- 
rying it. If the father's constitution be poisoned, the child will 
receive the infection from him, through the semen, and will be 
likely, while in the womb, to infect the mother. I recollect but one 
author of note (Ramsbotham) who has mentioned this mode of in- 
fection. I have myself seen two cases of it. 

This constitutional disease, whether it exist in the mother, or be 
communicated to the child, and thence to her, by an infected father, 
is a frequent cause of abortion. Throughout nature, blight is the re- 
sult of a diseased parentage. Mature fruit is seldom obtained from 
infected seed. 

Is the Constitutional Disease Curable ? — No question connected 
with the complaint possesses a greater interest than this. None is 
pressed more earnestly upon the physician. In a certain sense the 
disease is curable. Its outward manifestation may be wholly re- 
pressed. The health of the person suffering from it maybe restored, 
and become, in an important sense, good. But this cure is never 
brought about by nature ; it may be, and is often effected by medicine, 
I have never failed to effect such a cure in any case which has come 
under my treatment. Such results may properly, in general terms, 
be called cured. 

Yet there is a sense in which a cure never occurs. It is a well- 
attested fact, that a system once thoroughly pervaded by the poison 
is never completely purged of it. It may be shorn of all its active 
malignancies ; but it has too intimately permeated the tissues and 
solid bones to be wholly expelled. Pursue it as we will with the 
remedial forces of our art, it still takes refuge in the most subtle pro- 
cesses of animal life, — still infects the currents of being, and finds 
expression in the scrofula, in the lupus, and in the scaly affections of 
other generations. Dr. Erasmus Wilson, the great authority in skin 
diseases, says : " I feel convinced that a considerable proportion of 
those diseases which pass under the name of scrofula are the produce 
of the syphilitic poison, — are, in fact, not scrofulous, but syphilitic." 
Astruc thought the same, and suggested, what is doubtless true, that 
the transmission of syphilis must occur through several generations 
before it becomes scrofula. Bierchn, Camper, Stoll, Portal, Huf eland, 
and Alibert, have all advocated the same opinion. 

This is doubtless right, though there are many authorities on the 
other side. He must be a poor observer who cannot discover a prob- 
able filial relationship of scrofula to syphilis. 

A variety of facts, admitted by the whole profession, go far towards 
demonstrating this relationship. Scrofula is always hereditary. It 
is a disease of the parent, imparted to the offspring. But there is 
scarcely any disease so certainly sent down to posterity as syphilis. 



366 VENEREAL OR SEXUAL DISEASES. 

Scrofula is like syphilis in many of its characteristics. It is like it 
in its power of propagating itself from parent to child. It is like it in 
affecting nearly all the children of diseased parents. It is like it in 
the variety of the structures it attacks,' — affecting the skin, the 
mucous membranes, the bones, etc. Like syphilis it produces hard 
tumors, ulcers of the skin, abscesses, and decaying of the bones. 
And finally, the great remedy for tertiary syphilis, iodide of potas- 
sium, is likewise the great remedy for scrofula ; and, indeed, almost 
every remedy which acts favorably upon one, is found useful for the 
other. This could hardly occur were not the diseases identical in 
nature. 

We can scarcely be surprised that a disease so widely diffused as 
scrofula should be the product of syphilis, when we reflect how fright- 
fully prevalent were the causes of this latter affection during the 
earlier and the middle ages of the world. 

To pass over the records of earlier times, with merely mentioning 
Abraham, and Lot, and Jacob, and Reuben, and Samson, and David, 
and Solomon, and numerous females, of whom some singular things 
are written in the older scriptures, and omitting all . mention of the 
incredible and almost universal debauchery and prostitution of 
Greece, and Rome, and Persia, and Media, and Egypt, I may say that 
Europe, in the middle ages, was well-nigh converted into a vast brothel. 

Foremost in the race of profligacy were those in authority, kings, 
and emperors. The licentiousness of Childeric knew no bounds. He 
carried off and violated the wives and daughters of his vassals, with- 
out regard to any right, human or divine. His successors were gen- 
erally a race of lecherous men, who spread debauchery on every hand. 
The French monarchs, from Pepin and Charlemagne, were a race of 
debauchees. Their courts were national brothels, in which the finest 
women in the land were trained in the arts of seduction and lust. 
Francis I, in 1515, endeavored to invest prostitution with elegance 
and chivalry, and even to ennoble it, by abandoning the public 
women of the palace to his subaltern officers, and substituting for 
them ladies of noble blood. In this movement, the nobles and the 
officers gave the king their support. 

' ' ' They are all gone aside ; they are altogether become 

filthy; there is none that doeth good, no, not one." 

Brantome justifies Francis in his selection of girls of noble blood, 
on the ground that " they could not communicate the venereal dis- 
ease to the noblemen of the courts, like the common prostitutes." 
But the king, who was previously diseased, infected them; and these 
noble women, so called, passing from the arms of the prince to those 
of the courtiers, presented to them the fatal infection received from 
the king. 

The way in which Francis himself was infected illustrates, in a 
most shocking manner, the morals of the times. His illicit loves with 



VENEREAL OR SEXUAL DISEASES. 367 

the Belle Ferroniere were not concealed from her husband, who, 
though obliged outwardly to regard the dalliance of his wife with 
the monarch as an honor, was inwardly indignant, and determined 
to become infected himself, and thus disease his wife, and revenge 
himself upon the king. This plan was suggested to him by a noble 
who had another motive, namely, that of punishing Francis for some 
personal spite. " How," said the husband, when the suggestion was 
made, " shall I give this disease to my wife, when we are both 
sound ? " " Go visit an infected girl," said the noble, " and to ren- 
der the matter certain, as I am infected, I will see your unfaithful 
wife." The result was such as the husband desired; and in 1547, 
Francis I, the gay and chivalric monarch, perished of the most foul 
and loathsome of all diseases. 

Debauchery did not die with him. It was cherished by his succes- 
sor, Charles IX, and his mother, Catherine de Medicis, and his grand- 
son, Henry III. The reigns of Henry IV, Louis XIII, Louis XIY, 
the Regency, and of Louis XV, were stained by the same licentious- 
ness and disregard of public decency, until the whirlwind of the revo- 
lution came to purify the moral atmosphere. 

The reader will now, I think, be in no mood to wonder that the 
men and women, and many of royal progeny, whether the dishonored 
occupants of thrones, or the more private recipients of the public 
bounty, are a scrofulous and degenerating race. Nor need it be 
much wondered at, that so large a portion of men and women every- 
where have more or less scrofula in their frames. Happy are those 
who can find no trace of this complaint in their constitution ! They 
should rise up and call their virtuous progenitors blessed. They 
should especially thank God that they have sprung from the loins of 
a race more noble and kingly in the eyes of Heaven than all the 
royal lines of the world. 

Treatment of Syphilis. — In the treatment of this disease, the first 
thing which requires attention is the pimple, pustule, or sore. This 
must be instantly touched with caustic. There should be no delay, 
for if the sore be not syphilitic, the caustic will do no harm ; and if 
it be, the most terrible results may be averted. The general belief is 
that poison remains in the sore for a time before it is absorbed into 
the constitution. It is of the utmost importance that it be destroyed 
before the absorption takes place. 

The caustics used are nitrate of silver (stick nitrate), nitric acid, 
chloride of zinc, potassa with lime, caustic potassa, and the painless 
caustic. 

The nitrate of silver is much used, but the best surgeons now re- 
gard it as useless. It does not prevent the absorption of the poison. 
The caustic potassa, the potassa with lime, and the painless caustic, 
are the sure remedies, — that is, if applied in season. But they must 
be employed with caution. It will not do to trust them in bungling 
hands. A little vinegar and Avater must be immediately used to neu- 



368 VENEREAL OR SEXUAL DISEASES. 

tralize the caustic when it has accomplished what we desire. After 
the sore is cauterized, a piece of lint, dipped in a solution of watery 
extract of opium, one dram to four ounces, should be laid on it: and 
the organ enveloped in another piece of lint soaked in tepid water, 
and covered in oiled silk. The patient should remain at rest as much 
as possible, keeping the penis elevated, and repeating the opium 
dressing to the wound, and the water dressing to the whole organ, 
night and morning. In addition, the patient should take two pills 
(19), to be followed, night and morning, for three or four days, with 
a tablespoonful of (20). In some cases, a piece of lint, wet with the 
tincture of muriate of iron, diluted and kept upon the chancre, will 
cause it to heal kindly, and with safety to the patient. 

If this treatment be adopted early and properly, the patient is 
cured, and nothing further needed. But time is generally lost. The 
poison is absorbed before the patient is seen by the physician ; and 
the question then is, how it is to be driven out. 

To accomplish this, the diet should be regular and unstimulating; 
alcoholic drinks and tobacco should be forbidden ; the mind should 
be kept at rest ; a cold or tepid bath should be taken daily ; the ac- 
tion of the bowels and kidneys should be kept properly regulated. 
These things will put all the expelling agencies in proper condition 
for work ; and no single medicine will put them all into actio u like 
mercury. For this reason, no other single drug has enjoyed a repu- 
tation for curing pox so wide as this. 

But it must be used with judgment. No remedy is more safe, if 
judiciously employed, or more destructive, if abused. The profuse 
and ill-considered way in which it was used in former times, raised a 
prejudice against it which is unreasonably cherished at the present 
day. Abuse made mercury a curse ; judicious use makes it a blessing, 
— at least in this disease. 

The blue pill is one of the best forms of it (148), combined with 
extract of henbane. One pill at night is the usual amount to be 
taken. Some prefer the mercury with chalk (149) ; others, the corro- 
sive sublimate (150) ; others, the proto-iodide of mercury (136). 
Some one of these should be given about five days, in the doses named 
under the recipes, — being careful not to produce salivation. After 
the fourth or fifth day we can generally increase the frequency of the 
dose. Should salivation be accidentally induced, it should be arrested 
by a solution of chlorinated soda (205), one part to twelve of water. 
The mercurial treatment should continue for two years after the sore 
has disappeared; after this prolonged treatment iodide of potassium is 
used for another year in as large doses as the patient can take with- 
out producing ill effects. At the expiration of two years, if the 
patient has taken his medicine regularly, he may be considered cured, 
at all events, sufficiently so to marry and have children. 

Water should be taken freely, and various diluent drinks. They 
wash the poison out through the millions of avenues, called pores, 
just as we wash filth out of cities by pouring water into the sewers. 



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VENEREAL OR SEXUAL DISEASES. 369 

I should mention that there are those who claim to cure the disease 
with other remedies, without mercury, and I am not disposed to be 
dogmatical, and say it cannot be done. For this purpose, perhaps as 
good a recipe as has been proposed is the compound syrup of stillin- 
gia, tincture of poke-root, tincture of sheep-laurel, each four ounces, 
mixed ; of which, from a teaspoonf ul to half a tablespoonf ul is to be 
taken three times a day. I think well of this remedy, especially if it 
be in connection with a small amount of mercury. If stillingia be 
used, obtain McDade's stillingia comp., 1 dram three times daily. 

The Bubo, if not attended with pain, may be treated with com- 
pression, by a piece of plaster of ammoniac with mercury, or by 
touching it with nitrate of silver. Should there be inflammation, 
and the formation of matter be inevitable, the bubo should be opened 
by touching it with the caustic potassa ; and the resulting sore must 
be treated with the solution of opium and water dressing. Should 
the sore need stimulating, it may be touched lightly with nitrate of 
silver. 

Eruptions upon the Skin. — In treating the disease after it appears 
upon the skin, etc., we shall derive great advantage from the use of 
either the warm or the vapor bath once a day. With this, if the case 
be not very old, we may employ (148) or (150) ; but if the disease 
be an old one, showing itself in the throat, or attacking the bones of 
the face, we must give iodide of potassium (138), combined with 
compound decoction of sarsaparilla. This is the great remedy for 
tertiary syphilis ; but when the case is obstinate, it may sometimes 
be discontinued, and the corrosive sublimate (139) be substituted 
for it. 

It is to be observed that the older the disease grows, and the more 
chronic its character, the more does mercury lose its control of it. In 
the first attack, the blue pill is the best ; in the second, as a general 
tiling, the iodide or the biniodide of mercury; in the third, the cor- 
rosive sublimate ; in the attacks subsequent to this, particularly in 
the tertiary form of the disease, the iodide of potassium. When the 
throat and nose are so ulcerated as to make a case absolutely terrible 
to contemplate, it is surprising to see how rapidly the recovery will 
often take place under the influence of this latter remedy. 

For syphilitic iritis, apply frictions twice a day on the eyelids and 
eyebrows with ointment (172), (173); and administer internally two 
pills of (136) daily. 

Clap. — Gonorrhoea. — Blenorrhagia. 

The reader is aware that the nose, mouth, and lungs are lined 
with a mucous membrane, which is liable to become inflamed from 
various causes. This inflammation we call a cold or catarrh. During 
its continuance, mucus and other matters, of different colors and 
degrees of consistency, are more or less freely discharged. 



370 VENEREAL OR SEXUAL DISEASES. 

The mucous membrane of the private parts of both sexes is just 
like that of the mouth and throat, and subject to similar inflamma- 
tions and discharges. But these inflammations of the private parts, 
instead of being produced by change of weather, etc., generally result 
from the application of the specific poison or germ-microbe of 
gonorrhoea. When a woman abandons herself to unlimited inter- 
course with different men, the private parts become stimulated to so 
unnatural an extent, that the secretions of the parts, which are largely 
augmented, at length become altered in their nature, acrid, and finally 
poisonous, — so acrid and poisonous that they cause inflammation of 
the parts, and when brought in contact with the male organ, in the 
sexual act, they poison and inflame that. The specific germ of 
gonorrhoea is called the gonnococcus. 

This is the shortest and plainest explanation I can give of clap. 
From this explanation, one may learn why a man will sometimes take 
a disease from a woman who has never had any evidence of being 
diseased herself. If she have indulged her sexual propensities un- 
reasonably, though not enough to produce inflammation upon herself, 
her secretions may yet have become acrid enough to poison one whose 
organs are delicate and sensitive. And more than this, — the secre- 
tions of a female may become acrid and poisonous from other causes 
than excessive venery. The discharges in bad cases of whites will 
sometimes irritate and inflame the male organ, and induce a disease 
which has every appearance of gonorrhoea. A husband, in great 
distress of mind, sometimes submits a case of this sort to the phy- 
sician's inspection, and lays upon him the delicate and responsible 
duty of deciding whether the wife has been unfaithful. No act in a 
whole professional life can be more momentous than a decision of this 
sort. If a man be well skilled in his art, he may give an answer in 
such case, which shall dispel the most terrible apprehensions, and 
save the peace of a loving family. 

The poison, when communicated by a diseased person to the male 
or female organs, requires a certain time for the germs to produce 
their peculiar effect, — generally from three to eight days. 

Symptoms. — The first symptom of the disease is uneasiness in the 
end of the penis, accompanied, generally, with a little redness, and 
difficulty in passing water. The color of the first discharge may be 
white or straw-colored. There is tenderness where the parts are red. 
Scalding in passing water is sometimes, not always, present at first. 

This is the beginning, or first stage of clap. Now is the time to 
cure it easily. But, unfortunately, the physician seldom sees a case 
in this early stage. Before he is allowed to inspect it, the second 
stage has generally appeared, which is known by violent scalding 
when water is passed, by chordee, or painful erections of the penis, 
and by an increased discharge of greenish matter often tinged with 
blood, and coming from much farther down the urethra, or water- 
passage. The matter sometimes comes from as far down as opposite 



VENEREAL OR SEXUAL DISEASES. 371 

the scrotum, or bag which holds the testicles. There is more or less 
pain the loins and back. The whole body of the penis may become 
affected, and abscesses form. 

A third and more terrible stage of the disease begins when the in- 
flammation has reached the lowest part of the water-passage, just 
where it enters the bladder. Around this part of the passage, and 
lying upon the bladder, is a gland in size and shape like the largest 
chestnut. It is called the prostate gland. On either side of it lie the 
receptacles of the semen, each of which sends its duct into the water- 
passage. When the inflammation extends through this gland, it irri- 
tates the neck of the bladder, and causes a distressing desire to pass 
water ; and from its proximity to the larger bowel, it sends its irrita- 
tion thither likewise, and impels a terrible effort to evacuate the 
bowels, called tenesmus. It is the same awful feeling experienced in 
dysentery. Few things can be more terrible than these two distress- 
ing feelings conjoined, — the desire to pass water and to empty the 
bowels. Racked with terrible pains and awful tenesmic distresses, 
and often with painful erections, the patient passes back and forth 
between the bed and stool, — often vowing in the sincerity of his 
heart, that if he can but recover from this, he will never be caught 
again. The enlargement of the prostate gland may become chronic 
and permanent, and be the affliction of a man's life. 

Stricture. — One of the most troublesome and persistent conse- 
quences of gonorrhoea is a partial closing up of the water-pipe, at- 
tended generally by quite a serious obstruction to the passage of the 
water. It is called stricture. The mucous membrane which lines 
this passage, being long inflamed, becomes thickened and less pliable 
or elastic. The tissues which lie underneath this membrane also 
become swollen and hardened, and, pressing upon the water-passage, 
lessen it still further, making the stricture more difficult of cure. 

In stricture, the stream of urine is altered in size, length, and force. 
Its course is changed, when the stricture is lateral. The stream is 
often flattened, like the blade of a pen-knife, or twisted like a gimlet, 
or forked, one stream reaching beyond the other. In consequence 
of obstruction, the bladder is not entirely emptied, and the desire to 
urinate immediately returns, and is very urgent. 

Gleet. — Another very troublesome result of gonorrhoea is gleet, — 
a thin, colorless discharge, which persists, in a chronic form, after all 
active inflammation has subsided. It is very annoying, and very ob- 
stinate. It is often dependent on the altered condition of the mucous 
membrane occasioned by stricture. 

Orchitis. — Another very severe result of clap is swelling of the 
testicles, called orchitis. . It begins frequently with chills and fever, 
with a feeling of weight in the scrotum, and pains in the loins. The 
swelling rapidly increases, and reaches its height in from three to five 
days. 



372 VENEREAL OR SEXUAL DISEASES. 

Besides the above, there are still other mischiefs which follow this 
disease, such as inflammation of the prostate gland, already described, 
of the bladder, and of the kidneys. 

In the female gonorrhoeal inflammation affects the external geni- 
tals called the vulvae, the water-pipe, the vagina, and the neck of tKe 
womb, and often plays havoc with the ovaries and Fallopian tubes. In 
women the disease is often fatal by ascending the tubes and penetrat- 
ing to the abdomen, where an acute peritonitis is set up, with the 
formation of pus. 

There is a difference of opinion as to whether gonorrhoea ever pro- 
duces secondary or constitutional symptoms. Ricord, the great 
French authority on this subject, affirms, and with him a great num- 
ber of followers, including most of the profession in this country, 
that constitutional symptoms never follow clap ; that they never re- 
sult from anything but a syphilitic ulcer. Vidal, a French authority, 
safer, in my judgment, than Ricord, though not as renowned, says, on 
the contrary, that secondary and tertiary complaints do follow viru- 
lent gonorrhoea. Wilson, the highest English authority, and many 
others, agree with him. Unprejudiced observers feel well convinced 
that this latter opinion is right. I have myself seen not less than 
half a dozen cases of secondary and tertiary syphilis, which were 
preceded by gonorrhoea, and nothing more. 

Treatment. — In the first stage of the disease, there are two meth- 
ods of treatment, either of which may be adopted with success. The 
first, which has many advocates, is the local treatment. An injection, 
with a glass syringe, is immediately made, of a solution of nitrate of 
silver, of the strength of five to ten grains to the ounce of water. It 
should be retained from one to five minutes, by pressing the head of 
the penis between the thumb and finger. If done before the third 
day, this will generally cure the disease. 

The physician should have entire control of the patient, and com- 
pel him, if possible, to keep his room, and live for a few days on 
crackers and water, or something equally simple. All meats and 
stimulating drinks are to be excluded. 

The other mode of treatment, which is perhaps the more commonly 
adopted, is more general in its nature. It embraces the use of warm 
baths, warm sweating drinks, and rest. If the patient is full of blood, 
and strong, from five to fifteen leeches are applied to the space be- 
tween the scrotum and fundament. These things, with a low diet, 
will frequently reduce the disease in a few days. If the discharge 
should continue, after a fair trial of the above, then copaiba and 
cubebs (272) are to be used. Several articles are added in the above 
prescription, to make the copaiba acceptable to the stomach. This 
preparation can be taken by most persons, and generally produces 
very gratifying results. Vidal strongly recommends an electuary, or 
thick paste (273), of which a piece twice as large as a nutmeg is to 
be taken in the course of the day. The prescriptions which contain 



VENEREAL OR SEXUAL DISEASES. 373 

copaiba and cubebs are numerous ; but the above two are as good as 
a hundred. With these articles, the baths, the leeches, and the re- 
pose, are to be united. 

Vidal says he never resorts to injections first, but employs the anti- 
inflammatory course first. If that fail, then he uses the injection 
(207), three or four times a day ; and if he employs the nitrate of 
silver at all, it is only as an astringent (208). Prescription (304) 
is a valuable injection. 

When the second stage sets in, and the symptoms become more 
violent, injections must not be used. For the very severe scalding in 
passing water, which is now felt, take thirty drops of a solution of 
potassa in half a tumblerful of water, twice or three times a day. 
Persons of full habit, may be benefited by dissolving a grain or two 
of tartar emetic in a tumbler of water, and taking to the extent of 
producing a little nausea. Relief is occasionally obtained by holding 
the penis for some time in warm water. 

For the painful chordee, or erections, camphor and opium (120) are 
required, — from one to three pills a day. Thirty drops of laudanum 
maybe given when the patient retires. Cold applications to the gen- 
ital organs, or walking barefooted upon the cold floor, will frequently 
give relief. When other things fail, three pills a day may be taken 
of extract of hyoscyamus, containing from one to four grains each. 
The quantity of drinks must be diminished, and cold lotions must be 
applied to the penis on going to bed, — the patient covering himself 
lightly. 

Gleet is generally very obstinate, and often requires a very pro- 
tracted treatment. If there be any tenderness along the under side 
of the penis, it is well to apply three or four leeches. Occasionally 
recipe (272) will have an excellent effect. But gleet is an unhealthy 
action, sustained by habit, and may often be cured by simply exciting 
a new action which shall break the old habit. It is always well, 
therefore, to resort to injections. Sugar of lead and sulphate of zinc 
(207) answer a good purpose ; or sulphate of zinc and tannin (209) 
may be tried. Chloride of zinc (210), does well in some obstinate 
cases. 

But gleet is often dependent on stricture, and when this is the case, 
we must learn the location of it by exploring the water-pipe with a 
bougie. When the instrument reaches the constricted part, the pa- 
tient feels pain, or the surgeon meets an obstruction, — often both. 
When the stricture is found, it is either to have the solid nitrate of 
silver applied to it with an instrument called the forte caustique, or a 
solution of nitrate of silver (211), or of acid nitrate of mercury 
(226), with a shower-syringe. When these means fail, we must pass 
a small bougie gently through the stricture ; then a larger, and then 
a still larger one, until the obstruction be removed. They should be 
used once or twice a day, and not be retained long in the passage. 
They frequently have to be used ten or twelve weeks, and should 



374 VENEREAL OR SEXUAL DISEASES. 

not be discontinued till the cure is complete. Put no confidence in 
those quacks who promise to cure these old troubles in a few days. 
They want your money, but have no expectation or ability to cure 
you at all. 

For inflammation of the testicles, apply leeches at once. To this 
should be added warm fomentations and poultices. If these means 
fail, more serious measures are to be adopted, which it would be out 
of place to describe in this book. 

Inflammation of the prostate gland is also to be treated with 
leeches and poultices ; likewise a warm hip-bath. The water must 
be drawn off with a catheter until it can be passed in the natural 
way. 

Prevention of Sexual Diseases. — I have several times been in 
doubt as to the best method of presenting some of the topics which 
the wide scope of this book has brought before me ; but no one sub- 
ject has perplexed me like the one announced in the above head- 
ing, — not that it is not easy enough to furnish the rules for 
preventing venereal disease, but that it is a grave question in morals 
whether to instruct the world in the methods of such prevention is 
right. Is it proper to give any other advice than the simple direction 
to abstain from all liability to disease ? That is the question. 

If such advice would be heeded, of course no other should be 
given. But it would not. If the person disregarding it would alone 
suffer the penalty of the transgression, it might then be best to em- 
body the whole advice in the simple imperative word, abstain! But 
this cannot be. The infection will be imparted to a third person, and 
onward to thousands ; and many of these thousands will be innocent 
wives, who will perish of the disease, or send the infection down to 
the second, the third, the fourth, and to all generations ! While a 
strict morality might seem, therefore, at first view, to forbid the in- 
culcation of rules for avoiding infection, the good of the race would 
appear to justify and lequire it. 

The first requisite for prevention is cleanliness. Frequent washing 
is of prime importance. 

The precautions should not be the same before and after the vene- 
real act, when a person is about to expose himself to risk. Before 
the act, the parts should be carefully examined to see if there be any 
break in the skin. The least breach in this covering of the penis 
greatly promotes contagion. Before coition, there should be no wash- 
ing with soap, for this deprives the parts of the mucus and oil, = — 
thus rendering the naked and exposed skin liable to infection. On 
the contrary, to apply a solution of alum, tannin, or a decoction of 
oak-bark, or aromatic wine, constringes or hardens the covering of the 
organ, and renders contagion more difficult. An article called con- 
dom is often used to ward of! disease. It is a sack made of gold- 
beater's skin, and is drawn over the penis like a glove over the finger, 
and thus protects it from contact with poisonous matter. 



VENEREAL OR SEXUAL DISEASES. 375 

Of still greater importance are prompt measures of prevention 
after the act. Lotions should be immediately applied to every part 
of the organ, and in the case of females, should be used as injections. 
These lotions should be acids or alkalies. A mixture of vinegar and 
water has been recommended as an excellent wash. Ricord recom- 
mends aromatic wine ; Malapert, corrosive sublimate (212), in the 
form of solution. Probably the best preventive is composed mainly 
of alcohol and soap (213), as recommended by Langlebert. 

An exposed person, using any one of these solutions, particularly 
the last, or, in the absence of all these, washing thoroughly with soap 
and water, will be likely to escape contagion. 

Medical Police. — What is called general prophylaxis, or preven- 
tion, or medical police, is not a subject of legislation in this country. 
The moral sense of the American people does not admit its necessity. 
In Europe, the authorities watch over prostitution. They even go so 
far as to regulate it. They appoint practitioners, whose duty it is to 
act as a sort of medical police, and particularly to visit houses of 
prostitution once or twice a week, and examine all the inmates. 
When a girl is found diseased, she is immediately removed to a hos- 
pital, and not permitted to return until she is well. 

Self -Pollution. — Masturbation. 

There is probably no vice to which so many boys and young men, 
and even girls and } r oung women, are addicted, and from which so 
many constitutions break down, as self -pollution. Small boys and 
girls learn the vile practice of the larger ones at school, and generally 
continue it up to maturity, without the least suspicion that they are 
inflicting upon themselves either a moral or a physical injury. 

This comes of the false modesty and bastard morality which with- 
holds from the young all knowledge of the proper functions of their 
sexual organs, and of the inconceivable mischief resulting from their 
abuse. A gentleman of distinction lately said to me: "I instruct my 
boys as faithfully on this subject as upon any other moral or physical 
question, and I tell my wife it is her duty to do the same with the 
girls." This is wise. Yet, how few parents ever speak to their boys 
or girls on the subject, to give them the least reason to suppose there 
is any better rule for their conduct than their own desires ! 

Symptoms. — These are very numerous. The principal are, head- 
ache, wakefulness, restless nights, indolence, indisposition to study, 
melancholy, despondency, forgetfulness, weakness in the back and 
private organs, a lack of confidence in one's own abilities, cowardice, 
inability to look another full in the face, and, among females, hyster- 
ics, whites, and a desire for seclusion from society and solitude. 

I have already spoken of the receptacles of semen, lying on each 
side of the prostate gland. From the fore part of these receptacles, 
the semen passes through two ducts, about a finger's breadth in 



376 VENEREAL OR SEXUAL DISEASES. 

length, into the urethra or water-pipe, just in front of the prostate. 
From excessive self-pollution, these ducts become very irritable, and 
also debilitated and relaxed, — so much so that they will not retain 
the semen ; and during lascivious dreams, it flows off. These semi- 
nal losses are called "nocturnal emissions." So constant is the drain 
they keep up upon many young men who have abused themselves 
excessively, that *the whole man, mentally, morally, and physically, 
becomes a wreck. There are few objects more pitiable to behold 
than a young man in this condition, — his nervous system feeble, 
tremulous, and broken ; his memory weakened and fading out ; his 
eye unsteady and incapable of looking a friend in the face ; his loins 
and back weakened, giving him the feeble gait of old age ; his once 
erect form cowed and bent; his high sense of manliness all oozed out 
of him ; his mind taking up and dropping the simplest threads of 
thought, losing its way in the plainest paths of reflection, and often 
starting back affrighted at the glimpse of chaotic insanity opening 
before him, — turning here and there for relief, but finding little hope 
of recovery, except in marriage, and yet knowing himself unfitted to 
be the husband of an intelligent woman ! 

Treatment. — Every kind of treatment, no matter how judicious or 
well applied, will be unsuccessful, unless the vice which has produced 
the disease be absolutely and entirely abandoned. This is the first 
thing to be secured. It may be extremely difficult for the patient to 
do this, with his mental and moral nature all broken and in ruins, — 
with no heart to feel, nor will to execute ; and yet it must be done, 
or a cure cannot be effected. 

To bring this about, everything must be done by the physician to 
strengthen the moral nature of the patient, and to raise his self-respect 
and hope. The most careful directions must be given for restraining 
the imagination. The patient must be directed and encouraged to 
drive out from the mind, instantly, and upon all occasions, every 
lascivious thought; to cultivate the society of the most intellect- 
ual and virtuous females ; to make himself busy with useful and, if 
possible, agreeable employment; to avoid solitude; and to sleep with 
some friend. He should sleep on a mattress, and never on feathers ; 
always on the side, never on the back. 

Where there is considerable debility, tonics will be required, as the 
mineral acids (GO), (62), (78), and bitters (77), (67), (66), (59), 
and strychnine (83), (95), (85), and iron (80), (93), (72), (73), 
(71). In addition to some of the above preparations, the syrup of 
the hypophosphites should be taken for some time. 

The food should be nutritious and easy of digestion, and the cold 
alkaline sponge-bath should be taken once a day, with brisk rubbing; 
and the private parts should be washed daily with cold water, espe- 
cially just before retiring. 

In conclusion, I say emphatically to parents, do not let your sons 
and daughters remain ignorant on this subject. It is plainly your 



VENEREAL OR SEXUAL DISEASES. 377 

duty to enlighten and to warn them. It is a matter in which young 
persons are generally disposed to do right, if rightly instructed. 
Avail yourself of your right to give counsel, and, if need be, to use 
authority. 

Says Ware : " The deleterious, the sometimes appalling conse- 
quences of this vice, upon the health, the constitution, the mind itself, 
are some of the common matters of medical observation. The vic- 
tims of it should know what these consequences are ; for, to be ac- 
quainted with the tremendous evils it entails, may assist them in the 
work of resistance. 

" To you, parents, on whose shoulders is carried the weighty re- 
sponsibility of rearing your children in a pure atmosphere, let me say 
that to shut your eyes against the probabilities of youth is an error 
and a sin. Let the mother learn to know the restlessness and ac- 
tivity of youth ; let the father recall his early ambitions, his longing 
for excitement, and his reaching out after life and activity in various 
ways. Do not repress these natural instincts, but learn to guide them 
into proper channels. Keep at home the attractions of public places ; 
have music and games, mirth and gayety; invent amusement and 
mirth, and banish dullness and apathy. Do not argue that your boy 
is better than other boys and your daughter superior to your neigh- 
bor's frivolous girls. The boys and girls guilty of this vice are 
somebody's children, and these somebody's children are nine to one 
your children. See that your children lead an active, physical life, 
that out-door games and gymnasium exercises enter largely into their 
lives ; keep them busy, give them something to do to occupy their 
attention beside their studies ; let them study with a will when they 
study, and play equally hard when they play. Do not be afraid to 
talk on, these matters with your children, and explain in a rational 
way what passion is, and how it is to be governed and how used. 
If you have that unfortunate amount of prudery and false shame 
so common to many people, and feel you cannot talk with your chil- 
dren about such matters, send them to your family physician and let 
him have a plain honest talk with the children. 4 Well stated in- 
formation never yet contributed to human inflammation.' Read 
them Storer, Ware and Wilder on 'What Young People should 
Know,' and make them realize that a 'healthy knowledge is the 
best preventive against an unhealthy ignorance.' Do not wait till 
the young have already grown up in the vice, — your admonitions may 
then be too late, — nor fancy your children have not been thrown in 
with influences which corrupt, and that by broaching the subject to 
them you are informing them of a subject they may never otherwise 
have heard of. Remember the statement : ' whether or not we 
ought to hide this subject from the young, if we could, the truth is, 
we cannot if we would."' 

To you, young men, in particular, let me warn you against a seem- 
ing propriety on your part to keep your silence. If 



378 VENEREAL OR SEXUAL DISEASES 

to the habit, however slightly, go to your father, your mother, your 
family doctor. Confession will strengthen your will and purpose to 
overcome the temptation. Do not lie to the family physician in his 
inquiries : he is your friend and wishes you only success ; he is ac- 
quainted with these ailments and knows your temptations ; he ap- 
preciates and respects your noble desire to rid yourself of the evil. 

Do not, above all else, read the numerous pamphlets on Sexual 
Debility, Lost Manhood, etc., or be duped into answering advertise- 
ments in the public prints offering to send you literature on the sub- 
ject. No man can afford to send you free publications and postage- 
stamps unless he sees as an outcome a fee at the end of the book in 
the shape of medicines and other promised help. Steer religiously 
clear of these smoothly written books and these specialists in the art 
of restoring lost manhood. Your experience with them will be 
much like the countryman with bunco-steerers. 

Make every honest endeavor to conquer an unruly passion while 
it is young, and the more readily conquerable, but never despair of 
being helped by suitable aid, however long the passion may have been 
victorious over you. Do not ascribe your weakness in fighting temp- 
tation to the Almighty, the sins of your parents, or the example of 
your elders or associates, but go at the demon with a will and the 
fight is yours. Having conquered the enemy, the results of the past 
can be overcome by a pure life and the dictates of your physician ; 
nay, I may even add, Nature restores herself if only she can be as- 
sisted. In fact there is no specific for the troubles that arise from 
this vice. The only cure is to absolutely stop the habit and imme- 
diately thrust out all lascivious thoughts as soon as they enter the 
mind. Build up the strength and in time nature and marriage will 
do the rest. 



FEMALE DISEASES. 



In addition to the diseases common to both sexes, women are 
subject to a class of distressing complaints peculiar to themselves, 
and denominated, in general terms, female diseases. Involving con- 
siderations of a delicate nature, these complaints have too generally 
and too long been shut out from works intended for popular distribu- 
tion. Hence there is a general ignorance of a class of diseases which 
are fast unfitting woman for the high duty of continuing the race; 
and the subjects of these maladies are generally themselves so unin- 
formed of the true nature of their sufferings, that they are neither 
prepared to seek relief in the proper direction, nor to submit to the 
remedy if it chance to be proposed. 

It is intended here to speak of these disorders, as I have done of all 
others, in a plain and simple way, to describe them, so far as the 
present state of medicine permits, just as they are, and to make 
known the modes of treatment which have been found available for 
their cure. The sufferings of woman require this ; the interests of 
humanity require it ; and the writer is impelled to it, as he thinks, 
by a just sense of responsibility. 

Physicians, in my judgment, are chargeable with a great wrong in 
concealing within their own breasts information upon what are called 
delicate subjects, — information which the good of the world requires 
should be divulged, and which they ought to pour into the public 
mind, and make common, and which they would thus popularize, but 
for their stiff pride and conservatism. 

The idea that our knowledge cannot be imparted to the world 
without injuring the public morals, is simply absurd. We are more 
afraid of bringing the common people too near to us, of letting down 
our dignity, and of opening our profound secrets to popular eyes. 
The result is as it should be, that unsophisticated people are apt to 
give physicians a wide berth, and to have nothing to do with them 
unless necessity compels. Let doctors strip off their reserve, and 
while they remain gentlemen, become likewise companions, impart- 
ing their knowledge freely and familiarly to all, and the public con- 
fidence, now considerably shaken, will be frankly restored to the pro- 
fession. 

It should be the object of a good physician to know all he can, and 

379 



380 FEMALE DISEASES. 

to impart his knowledge to as many as possible. Knowledge is not 
merely power : it is happiness, it is wisdom, it is health, it is virtue ; 
yes, it is always virtue, except in some rare instances, where the worst 
natures pervert it. No physicians are so much loved as those who 
are frank, and have no concealments. The day for mysterious nods 
of the head, and rollings of the eyes, and shrugs of the shoulder, has 
gone by. Men, and women too (or those of them who are wise), 
wish to know distinctly what their diseases are, and what is neces- 
sary, not to palliate and prolong, but to cure them. 

Time when Female Diseases Begin Female complaints begin 

to make their appearance at the period of life called puberty, — the 
time when the girl passes from childhood to womanhood. This is the 
period when menstruation is established, which consists of a discharge 
from the genital organs, composed of blood and mucus, and which 
occurs, when regular, every four weeks. Up to this period, the system 
of reproduction has remained dormant. By the intervention of this 
mysterious function, the young female becomes a new being. The 
heart unfolds itself to new emotions; the mind assumes a solidity 
before unknown, and even the body acquires beauty from a sudden 
rotundity of form. 

This is the period when the great question of female health is very 
apt to be settled once for all, and for life. The girl who is well 
trained at this time, generally has a foundation laid for health and 
character, which is worth more to her than riches. At no time does 
the mother need so much wisdom and knowledge as now. To es- 
tablish the health and develop the affections of the daughter at this 
critical period, is a sacred trust which she can devolve upon no other 
being ; nor can she meet her responsibilities at this time, uuless better 
informed than most mothers are. The general apathy in regard to 
this maternal duty is deplorable. 

False Delicacy The refined delicacy which withdraws these 

subjects from the public gaze is commendable, for it casts a beauti- 
ful charm over society; but when carried so far as to cast a veil even 
over the eyes of mothers, it is quite unnatural, and leads to the worst 
results ; for in the bad management of girls at this critical period is 
laid the' foundation of so many of the diseases which shatter the con- 
stitution of so many women. For this bad management, it is not 
mothers alone who are to be blamed. The neglect of the medical 
profession to furnish the necessary information should come in for its 
full share of reproach. 

The Establishment of the Menses. — Nature always comes slowly 
and by degrees to the inauguration or establishment of any of her 
great functions. It is so in regard to menstruation, or, as it is va- 
riously called, " the menses," " the courses," " the change," etc. For 
some time before the flow begins, there are certain symptoms, or pre- 
monitions, which to the eye of the physician plainly enough foretell 



FEMALE DISEASES. 381 

the impending change. To the mother these signs would be equal- 
ly intelligible, were she as well informed as she should be. It is 
plainly her duty to be intelligent enough to assist nature in the es- 
tablishment of this important function. But how often, either from 
ignorance or from false ideas of delicacy, does she fail to interfere, 
and allow the daughter to be taken by surprise, and perhans fright- 
ened and thrown into convulsions ! 

From inquiries made of about one thousand women, a distin- 
guished English physician found that about one-quarter were unpre- 
pared for the appearance of the menses. Some of the girls were 
frightened and went into hysterical fits; others thought they were 
wounded, and washed with cold water. The flow was stopped in 
several cases, and in some never restored ; while the health of all 
in whom it was interrupted was seriously impaired. 

Symptoms of the First Menstruation. — A variety of symptoms 
precede and foretell the first menstruation. Headache, dizziness, 
sluggishness of thought, and disposition to sleep ; these occurring in 
a girl, may be taken as hints that the " change "is at hand. If to 
these be added pains in the back and lower limbs, the intimations 
will be still more significant. 

At this time a girl loses a relish for the society of children ; she is 
apt to acquire a taste for solitude ; her temper becomes wayward and 
fretful ; her eyes acquire a peculiar lustre ; she becomes a sort of 
mystery to her friends and herself ; not her physical frame only, her 
whole character is changed. She is about stepping into a new life. 
Her emotions, thoughts, anticipations, retrospections, are all new to 
her, and her outward manifestations are new to her friends. An in- 
telligent mother will not fail now to prepare her mind for the impor- 
tant event close at hand. 

The age when this change takes place depends very much upon 
a variety of circumstances. It occurs much earlier in warm than in 
cold climates. It is hastened by high living ; by the whirl and bustle 
and excitement of city life ; by reading novels which are full of love- 
incidents ; by attending balls, theatres, and parties ; and by mingling 
much in the society of gentlemen. 

Early Menstruation not Desirable. — It is a law, both in animal 
and vegetable life, that the later the period at which maturity is 
reached, the greater the solidity of the body, and the longer it lives. 
Girls who menstruate early do so because the body is weakened by 
climate or luxury, and the nervous system unduly developed by ex- 
citement; while those who come late to womanhood have firmer 
constitutions, enjoy better health, and live longer. Those mothers, 
therefore, commit great errors, who are anxious and administer 
"forcing medicines," because their daughters do not menstruate at 
fourteen or fifteen. If girls are suffering from no special ill-health, 
no anxiety need be felt if " the custom of women " do not come to 



382 FEMALE DISEASES. 

them till the age of eighteen, or even twenty. The delay should 
excite thankfulness rather than regret. It shows that the constitu- 
tion has not in it the seeds of early dissolution ; that it is fortifying 
itself against future disease. 

Girls who come thus tardily to maturity are much more " regular" 
in after life. They bear children with fewer accidents, and are af- 
flicted much less with female diseases. The duty of mothers is plain : 
it is to bring their daughters forward as late as possible, by refusing 
their early admission to society, by withdrawing from them all excit- 
ing reading, by prohibiting their early attendance at parties and 
theatrical entertainments, by prescribing for them the most unstimu- 
lating diet, and by requiring a large amount of exercise in the open 
air. 

A wide investigation has shown that the first menstruation occurs, 
in hot climates, at the average age of thirteen years and nineteen 
hundredths ; in temperate regions, at fourteen years and seventy-four 
hundredths ; in cold latitudes, at sixteen years and fifty-three hun- 
dredths. Under the hot-house culture of modern society, and espe- 
cially among the wealthy classes, where indolence, luxury, and excite- 
ment unite to weaken the constitution, this change is constantly oc- 
curring at a more tender age. 

How Female Diseases are Induced. — All living things have 
their origin in germs. The germ from which the higher animals 
spring, man included, is an ovum or egg. Every animal and every 
vegetable is provided with an organ for the production of germs. In 
woman, this organ is called an ovary. There are two ovaries, about 
half an inch in length, one lying on each side of the womb, to which 
they are attached by ligaments or cords. The ovarian bodies con- 
tain vast numbers of vesicles, or cells, or eggs, which are the true 
germs of human life, and the only sources from which, it can spring. 

Between the ages of fourteen and forty-five (speaking in general 
terms), every healthy woman matures and deposits an ovum once in 
twenty-eight days. This vesicle, some time before the monthly flow, 
begins to germinate and swell, and after a time, like a grain of wheat 
in the earth, it bursts its covering and springs forth. It then passes 
through what is called the Fallopian tube into the womb, whence it is 
cast off. 

During the swelling and bursting of this vesicle or germ, the ves- 
sels of the ovaries and womb, and particularly of the membrane 
lining the womb and its neck, are so crowded with blood as to pro- 
duce in the parts a state of congestion. If the parts be examined 
with a speculum at this time, they will be found red, sensitive, and 
almost inflamed. So great is this congestion, that the woman often 
complains of pain in the ovaries and the womb, and a general 
sense of heat, aching, and dragging down in the lower part of the 
bowels. The pain often extends to the back, the groins, and the 
thighs. 



FEMALE DISEASES. 383 

This Condition Repeated Every Month. — When we consider 
that this state of things is repeated every four weeks, and that the 
congested or crowded state of the vessels begins some days before 
the monthly flow, and lasts, in all, some ten days, making about one- 
third part of every month, we need not wonder that inflammation so 
often supervenes, with all its attendant ill-health and suffering. 

Increased by Various Causes If we reflect, further, that this 

congestion is increased, among the wealthy, by high living, and 
among all classes, by over-stimulation of the nervous system, and by 
the lascivious morals of the age, we see stronger reasons for expect- 
ing — what is realty occurring — a continually increasing amount of 
suffering from female diseases. 

And when we know, still further, that American females are care- 
less of their health ; that they often attend balls and theatres at the 
very time of suffering from this monthly visitation; that they fre- 
quently wet their feet, and otherwise expose themselves to colds, we 
cannot feel surprise, even when we learn that from one-half to three- 
fourths of all women in cities, and quite a large proportion of them 
in the country, have inflammation of the ovaries, or of the womb, or 
of the neck of the womb, or suffer some of the forms of displace- 
ment of this latter organ. 

Child=Bearing. — The inflammatory state of the uterine organs is 
often induced by injuries received in child-bearing, and by excessive 
indulgence in sexual pleasures. 

Weakness of the Sexual System The womb, moreover, like 

any other organ, may be naturally frail, and easily affected by dis- 
ease. This weakness of the sexual system is indicated by the diffi- 
culty with which menstruation is established, and the presence of the 
whites, both before and after each monthly flow. Women in whom 
the generative organs are weak, are much more liable to inflamma- 
tion of the womb, and to all complaints peculiar to the sex. 

Description of the Sexual Organs Before describing the par- 
ticular diseases to which the female generative organs are liable, it 
is proper to give the reader a brief description of the chief of these 
organs. 

The Womb itself, in its healthy, natural state, is about two inches 
long, and one inch broad — weighing a little more than an ounce, 
and is in shape like a pear. It is lined with a mere rudimentary 
mucous membrane. 

The Neck of the Womb has a cavity distinct from that of the 
body of the organ, and is lined with a mucous membrane well sup- 
plied with follicles or glands. 

The Fallopian Tubes open, one from each side of the base, or 
largest end of the womb, and extend outward to the ovaries. 



384 FEMALE DISEASES. 

The Ovaries are glandular bodies lying one on each side of the 
base of the womb. They are more particularly explained else- 
where. 

Fig. 136 gives some idea of these organs. A, is the body of the 
womb ; B, the neck of the womb ; C, C, the vagina ; D, one of the 




Fig. 136. 

ovaries ; F, F, the Fallopian tubes ; E, E, the fimbriated extremi- 
ties ; G, the small ligament attaching the fimbriated extremity to the 
ovary. 

Inflammation of the Neck of the Womb Inflammation of the 

body of the womb is a comparatively rare disease, but inflammation 
of the neck of this organ is so common that in nearly nineteen out 
of twenty cases, when females seek relief for whites, for painful men- 
struation, for stoppage of the menses, or even for what they suppose 
to be a falling of the womb, a careful examination will show that 
this pendant portion of the womb is in a state of marked inflamma- 
tion, or of absolute ulceration. The whites, if they continue with- 
out intermission from one menstrual flow to another, are almost al- 
ways the result of one of these conditions of the uterine neck. 

It would surprise most persons out of the medical profession, and 
many physicians, to know how large a proportion of the more grave 
diseases which inflict such terrible suffering upon woman, and so 
completely shatter her constitution, are dependent for their exist- 
ence upon a simple local inflammation, either in the neck of the 
uterus, or in one or both of the ovaries. Many a female has for 
years suffered agonies, greater than those of death itself, arising, as 
she supposed, from a complication of ills which invade every part of 
the system, while the whole of her troubles arose, in fact, from an in- 
flammation of the neck of the womb merely. 

Difficulties of Studying Uterine Diseases The social rela- 
tions of the sexes, and the great delicacy of the matters to be inves- 
tigated, for a long time prevented direct examination and investiga- 
tion, so that little knowledge was gained, and as little benefit con- 
ferred. 



FEMALE DISEASES. 



385 



Woman, always distinguished for her modesty, could not be ex- 
pected to invite investigations which were not proffered, whatever the 
extremity of her sufferings ; and man, scrupulously sensitive lest he 
should make himself an intruder by stepping within delicate enclos- 
ures, have both, in times past, mistaken their duty by misinterpreting 
the demands of the highest delicacy. 

Needful Examination not Indelicate. — Rightly viewed, no in- 
quiries or examinations are indelicate which are necessary to a full 
understanding of the nature of disease, and which are made with the 
sole purpose of rendering its cure possible. I agree with Dr. Meigs, 
the elder, that the delicacy or indelicacy of examining the persons of 
females for the purpose of exploring disease, depends on the motive 
with which it is done. To pure-minded persons, it is never, I think, 
a source of impurity. On the contrary, the self-restraint, the honor- 
able feeling, and the nice sense of delicacy which it calls into exercise, 
often heighten the tone of a man's virtue, and certainly increase a true 
woman's respect for it. Unfortunately, there is now and then a gross- 
minded man in the profession, who, in these investigations, will vio- 
late the most sacred of all trusts committed to his hands ; but such 
monsters — few in number — soon find their level, and are shunned 
as the most vile of the race. 

It is now so well understood that these investigations do not lead 
to immoralities, that the most highly educated, intelligent, refined, 
and virtuous females almost invariably raise the fewest objections to 
such examinations as a physician of character may propose. 

Methods of Investigating Female Diseases. — The symptoms of 
these complaints will be spoken of in their proper place, as the 
several diseases come under a brief review. I merely wish to allude 
here to the methods of physical exploration which modern practice 
has called to its aid. 

The Touch. — These methods consist, first, of what is called the 
touch, which is made either externally upon the bowels, or internally, 
with the index finger, through the vagina, or passage, from the external 
genital organs to the neck of the womb. 

The Speculum. — In the 

second place, of ocular in- 
spection of the vagina and 
neck of the uterus, through 
an instrument called the spec- 
ulum. By this instrument, 
the eye, as well as the finger, 
is made to assist in learning 
the real condition of the parts. 
The finger informs us 
whether there is any devia- fig. 137. Sims' speculum. 




386 



FEMALE DISEASES. 



tion from nature in the bulk, the firmness, the smoothness, or the 
sensibility of the parts ; while the sight, through the speculum, affords 
absolute certainty as to ^— -^ 

whether the parts are suf- 
fering from inflammation, 
ulceration, abrasion, or 
eruption. 

There are a variety of 
specula in use by modern 
physicians, but all are es- 
sentially of two kinds ; first, a so-called Sims' 
Speculum (Fig. 137), the end of which, when 
inserted into the vagina and pulled upon, allows 
the air to enter and balloons out the vagina so 
that the parts can be readily seen. This specu- 
lum necessitates what is known as Sims' posi- 
tion, i. e. the woman's hips resting on the edge 
of the bed or table, knees flexed, and chest rest- 
ing on bed with left arm out from behind her. 

The second variety of speculum is what is 
known as the duck-bill pattern (Fig. 138). By 
a separation of the two blades, the neck of the womb slips in between 
them. The speculum is then fastened with a thumb-screw, leaving 
the hands of the physician free. This speculum is used with the 
woman on her back, and feet resting on the bed or table, with knees 
flexed. 

We also give an illustration of an older kind, which is still used 
to some extent. The end is so shaped as to catch the neck of the 




Duck-bill Speculum. 




Fig. 139. 



womb, and then by drawing the instrument forward slightly, the 
diseased surface is presented for as perfect inspection as if located 
externally (Fig. 139). 

Inflammation, Ulceration, and Enlargement of the 
Neck of the Womb. 

Inflammation of the neck of the uterus is very common ; ulcera- 
tion and permanent enlargement (technically called hypertrophy), are 
its results, when it is not arrested in due time. These affections, in 
fact, and the same troubles as they affect the ovaries, make up the 



FEMALE DISEASES. 387 

bulk of female diseases, — being the real causes of the most of those 
symptoms which have passed under the name of whites, suppression, 
painful menstruation, sterility, general debility, etc. 

The neck of the womb, when healthy, is soft and smooth. No 
hardness or condensation of tissue can be felt by the finger on press- 
ing over it. It is elastic, too, and feels unctuous to the touch. This 
latter sensation is communicated by the layer of mucus which covers 
it. Pressure upon it produces no pain. 

Inflammation, when found in this part, may begin in the mucous 
membrane which covers the neck, or in that which lines its cavity, or 
in the small glands in the body of the organ. 

Symptoms. — Inflammation of the mucous membrane covering 
the neck of the uterus destroys the unctuous feel which it has in 
health. It also causes the neck to swell, its vessels being crowded 
full of blood. If the body of the organ, as well as the surface, be 
reached by the inflammation, it will be hardened and enlarged; and 
in consequence of its increased weight, it is apt to drop down some- 
what into the cavity of the vagina. In married ladies, it is often, by 
physical pressure, pushed a little backward, or retroverted. Exami- 
nation with the speculum shows the inflamed neck to be of a vivid 
red, instead of a pale rose-color. It may be covered with red or 
white pimples, which are glands enlarged with muco-pus. 

In the healthy state, the mouth of the womb is so much closed as 
to be just perceptible when the finger passes over it. Inflammation 
causes it to be more or less open, and its lips to be parted. 

Inflammation followed by Ulceration. — In a majority of cases, 
inflammation of the neck of the womb and of its cavity is soon 
followed by ulceration, which generally appears first around the 
mouth, and just within the cavity of the neck. From thence it 
spreads both inward and outward. 

Various Degrees of Ulceration, etc. — Of course, these inflamma- 
tions and ulcerations mix and run into each other in all possible 
forms, — presenting excoriations, or raw places ; granulations, or 
pimply surfaces ; and indurations, or hardened parts. Sometimes 
these pimply patches will be red and hard, and again the whole sur- 
face will be spongy, and will bleed upon the slightest touch. 

In many cases, these ulcerations make wretched work with the 
mouth of the womb, eating deeply into the cavity, and giving it a 
ragged and unsightly appearance. 

Velvety Feel from Ulceration. — Ulceration generally gives to the 
surface on which it exists, a soft, velvety feel, which the finger gener- 
ally recognizes. This velvety sensation, with the open state of the 
mouth, are the most important evidences we can derive from the 
touch, of this form of disease. 

The Discharge from these Ulcers is always Pus, or, in common 



388 FEMALE DISEASES. 

language, matter. It is sometimes poured out scantily, at other times 
very freely. It may be thick and yellow, or thin, and of a lighter 
color. 

The inflammatory and ulcerated condition of the neck of the 
womb often gives rise to pain ; and when the seat of the disease has 
not been examined, as it should be, this pain has frequently been 
called neuralgia. In this way, ignorance has compelled neuralgia to 
stand sponsor for a great many pains with which it has had nothing 
to do. 

These Ulcers Disturb Menstruation. — Menstruation is generally 
changed more or less in its character by the presence of inflamma- 
tion or ulceration in the neck of the womb. It usually becomes more 
painful. In some cases it is made more profuse, in others more scanty. 
It may come on more frequently, or it may be postponed, protracted, 
or abridged in its continuance. There is generally pain of a dull, 
aching kind, low down in the back. There is often a feeling of full- 
ness, pain, and a sense of bearing down in the lower part of the 
bowels ; sometimes the pain extends to the groins and thighs. 

Extensive Disturbances from these Inflammations, etc. — The 

nerves with which the womb is liberally supplied belong to those of 
the sympathetic system. Hence, the condition of the uterus influ- 
ences a wide circle of sympathies. By these nerves this organ is 
brought into close relationship with the organs of animal life. If the 
former suffer, the latter suffers also. The stomach, being intimately 
connected with the womb, physically, feels keenly these inflammations 
and ulcerations of the uterine neck. At times, the pain, debility, 
general disturbance, and dyspeptic state of the stomach are such as 
to cheat both the doctor and the patient into the belief that this organ 
is the seat of the disease. But in such cases, the symptoms of stom- 
ach disease will all disappear the moment the local affection is re- 
moved from the neck of the womb. 

The liver, too, often participates in these troubles, and becomes 
sadly deranged. It is sometimes even greatly enlarged and congested, 
and patients frequently have the various symptoms of what are called 
liver complaints. 

Severe pains are sometimes felt under the breast-bone, and over 
the chest generally, making the patient apprehensive of disease of 
the lungs ; and indeed consumption is not a very infrequent result 
of uterine diseases. 

Pains are often felt in the region of the heart, which organ is often 
harassed with palpitations. 

The flesh is apt to waste under the symptoms excited by these in- 
flammatory and ulcerative processes in the uterine neck ; and even 
the brain, though lying in some measure beyond the circle of influ- 
ences set in motion by the organic nerves, suffers disturbance and 
pain. 



FEMALE DISEASES. 389 

Even the special senses of sight and hearing may be drawn into 
this general vortex, and both be much impaired. And to crown this 
catalogue of ills, it may be mentioned that those distressing things 
called hysterical fits proceed from the same local disorders. 

In brief, there is scarcely a point in the human body to which these 
inflammatory and ulcerative conditions of the uterine neck may not 
send their sympathetic pains and aches, and where they may not in 
time induce real disease. This is the reason why so many women 
suffering from these local complaints, tell the physician, when con- 
sulting him, that they are " diseased all over" If asked where the 
complaint is located, they will answer, " It is everywhere" In the 
most earnest manner the assurance will be given, "Doctor, there isn't 
any well part about me." 

Treatment. — It is just as unreasonable and useless to treat these 
inflammations and ulcerations through the stomach, as it is an in- 
flamed or ulcerated throat. They are local diseases, affecting a par- 
ticular part, and the remedy must be local. 

Like all other affections, these can only be managed intelligently 
after their nature is well understood. Nothing can really be done to- 
wards a cure until it is known what the matter is; and no competent 
physician will move a single step in the treatment of one of these 
cases until he has made a thorough examination. He owes this to 
himself and to his patient, the more so as the neck of the womb 
may be as easily examined as the upper part of the throat, and the 
local remedy may be almost as. readily applied in the former case as 
in the latter. 

If, upon the introduction of the speculum, the uterine neck be 
found simply inflamed and enlarged, the application of ichthyol and 
glycerin to the canal will reduce the swelling and inflammation; 
while a tampon of wool soaked in the same and placed behind the 
womb will reduce the entire swelling- of the womb by the watery 
discharges which are produced. The patient must learn to lie down 
most of the time. If this should not succeed (though it will in most 
cases) then introduce a speculum, and when the neck of the womb 
is fairly lodged in its extremity, drop in two or three leeches and al- 
low them to fill. 

One who is not accustomed to treat these affections in this simple 
way, will at first be surprised at the rapidity with which the local 
trouble will disappear, and with it the thousand and one aches and 
pains which torment the whole body. As the terrible pains in the 
whole face and head which are produced by a single tooth all in- 
stantly come to an end when* the tooth is extracted, so do the bad 
feelings all over the body subside as fast as the local ailments of the 
uterine neck are cured. There is no exception to this rule, except 
where the sympathetic affection has become fixed by long neglect 
of the primary uterine disease. It is, therefore, surprising that so 
many excellent women, whose lives are of the greatest value to them- 



390 FEMALE DISEASES. 

selves and friends, should be permitted to perish of these ailments, 
when the cure is so simple, and many times so entirely within the 
reach of the most ordinary skill. It is a reproach to the profession 
which should be wiped away. 

If there are a hundred motives for gaining the mastery over other 
diseases, there are a thousand for learning to control these. More 
than any other disease, or all others, they make the homes of men 
desolate, by robbing them of women, their ornament and solace. The 
physician who neglects to make himself acquainted with all there is 
to be known of these complaints, shows himself not only unfit for his 
profession, but deficient in some of the prime elements which combine 
to make a true man. 

Hardening of the Uterine Neck. — In many cases the uterine neck 
is not only inflamed and enlarged, it is indurated and hardened. At 
times it is enlarged and hardened on one side, and not much on the 
other. In still other cases, there are enlarged spots, or nodes, giving 
the whole neck a knotty feel under the finger. 

These hardened conditions of the uterine neck proceed from vari- 
ous causes, and are more difficult to cure than the ordinary inflam- 
mation, or even ulceration. They sometimes indicate cancerous dis- 
ease, and then, of course, involve the most serious considerations. 
The glycerin tampon and the hot vaginal douche will do more for 
this hardening than all else combined. 

Uterine Syringe. — For applying the several remedies to the inter- 
nal cavity of the uterine neck, I have contrived a silver syringe, which 
is bent a little at the extremity, and pierced with fine holes all round. 
With this instrument, the remedy is carried directly to the diseased 
part, and applied instantaneously to every side of the cavity. 

Besides these local applications, it is frequently necessary to resort 
to soothing or astringent injections into the vagina, hip-baths, and 
injections into the bowels, some mild physic, and rest in a horizontal 
position. These matters will all be judiciously regulated by the at- 
tending physician, if he is master of his business. 

Inflammation, etc., of the Ovaries. — Ovaritis. 

The inflamed condition of the ovaries is indicated by increased 
heat, and pain upon pressure. The pain in the ovarian region is 
sometimes intermittent, sometimes constant, and occasionally passes 
down to the loins and thighs. 

There are acute and chronic inflammations of the organs; but it 
will be sufficiently accurate, in a work of this kind, to treat of them 
as essentially one. 

The effects of inflammation upon the ovaries, as upon other bodies, 
are various, sometimes enlarging and hardening, at other times col- 
lapsing and blasting them. This last effect, it is hardly necessary to 
say, cuts off all hope of bearing children. 



FEMALE DISEASES. 391 

The Causes of ovarian inflammation are numerous. One of the 
most important causes has already been noticed, namely, the conges- 
tion of the parts, for several days, at every menstrual period. This, 
amounting as it does almost to inflammation, is often intensified by 
other causes, such as wetting the feet, taking sudden colds, excessive 
fatigue from dancing, and exciting drinks. 

Sexual indulgence often proves a cause of inflammation in these 
bodies. It is particulary apt to have this effect in the newly-married 
female, with whom it is a novel stimulus, and often applied with im- 
moderate excess. In late marriages, when the stimulus to the ovaries 
has long been denied, its sudden presentation is liable to make an in- 
flammatory impression. Its entire absence, too, in persons of strong 
passions, may result in ovarian disease. 

This inflammation may be produced by the new state of things 
existing at the critical period called the turn of life, when it reacts on 
the womb, producing the floodings which often bring menstruation 
to a close. The congestion, too, which has been present every month 
for many years, does not immediately cease at this change ; and not 
finding relief by the accustomed flow, the ovarian bodies are exposed 
to inflammation. 

In all large cities, the pest-houses of civilization, where the women 
are more numerous than the men, there are many females whose vir- 
ginity is a burden, and numerous others who give themselves up to 
sexual excesses ; to both these classes, the turn of life is very liable 
to promote these ovarian disorders. 

There is another class of causes, which, though not so easily re- 
cognized, are equally cogent in exciting this form of disease. I mean 
all those excitements which arise from unbridled thoughts, from 
books of questionable character, from music, social intercourse, and 
stimulating food and drinks, — all which promote and intensify burn- 
ing desires, which, though natural and proper in themselves, cannot 
lawfully be gratified in a community where the female sex greatly 
preponderates, numerically, over the male. When we consider how 
powerful within a woman's breast the conflict often is between the 
impulse of passion and the dictates of duty, and how strongly this 
conflict must react upon the sexual organs, and especially upon the 
ovaries, the centre of the sexual system, we can easily see in how 
many cases they may become inflamed. 

Another cause of this disease is suppression of the menses. The 
engorged and crowded state of the vessels of the womb, of the ute- 
rine neck, and oi the ovaries, not finding vent in the accustomed flow, 
inflammation in any one of these organs is a very natural result. 

The inflammation of these ovarian bodies is a frequent result, too, 
of a similar condition, previously existing in the neck of the womb. 
In passing from the uterine neck to the ovarian bodies, the inflamma- 
tory condition often fastens itself upon the broad ligament, the fallo- 
pian tubes, and their fimbriated extremities. The whole, it will be 



392 FEMALE DISEASES. 

seen, presents an amount of disease which it is painful to contem- 
plate. 

The womb being turned over, and pressing against one of the 
ovaries, may cause it to inflame by mechanical irritation. Pessaries, 
injudiciously used, may do the same thing. 

Symptoms. — The first and most obvious symptom is a pain a little 
to the right or left of the womb. This pain is almost always increased 
by walking, riding, or by external pressure. It is especially aug- 
mented by straightening the thigh, by which the parts over the in- 
flammation are put upon the stretch. When standing up, ladies 
suffering from this disease are generally compelled to rest the foot 
on a stool, so as to bend the thigh, and relax the muscles. The pains 
radiate from the ovaries, and go down* to the loins and thighs, and 
sometimes to the fundament. They are of a dull, dragging, heavy 
nature. 

Sometimes the ovarian bodies become very much enlarged, and 
dropping down somewhat, press upon the lower bowel, causing con- 
stipation, or upon the neck of the bladder, creating a frequent desire 
to urinate, and an inability to pass the water freely. 

Treatment. — As inflammation of the ovaries is always increased 
during the menstrual flow, it is not proper to meddle with it at these 
monthly periods, lest the trouble be aggravated. Immediately after 
one of the turns has passed, from six to eight leeches should be ap- 
plied over the diseased ovary. When the bites are healed, a blister 
may be used in the same place. The scarf-skin should not be re- 
moved, and the irritated surface must be healed as soon as possible. 
The blister should be camphorated to prevent strangulation. The 
part should next be rubbed for a few minutes, night and morning, 
with an alterative and anodyne ointment (169). 

After the next menstruation, the same things should be repeated, 
and again after the next, and so on, for five or six months, or even 
longer, if need be. The already bloodless condition of the patient 
may require, however, that the leeches should not be applied more 
than once, or, at most, twice. 

The bowels should occasionally be opened by some simple cathartic, 
for the purpose of removing all hard substances which may press 
against and fret the inflamed ovaries. The purgatives employed 
should be of the most cooling kind, such as salts or oil ; while aloes, 
and all harsh cathartics must be avoided. 

Injections of tincture of belladonna and hyoscyamus are useful for 
quieting neighboring parts, and warding off external disturbances. 
They act like soft substances thrown upon the pavement in front of a 
sick man's house. A piece of flannel soaked in hot laudanum, laid 
over the ovary and covered with dry flannel, will give great relief and 
enable the patient to sleep. 

The patient should be kept, as much as possible, in the recumbent 



FEMALE DISEASES. 393 

position, lying upon the bed or the lounge, and should only be per- 
mitted to move about to such extent as will not irritate the inflamed 
parts. 

Whites. — Leucorrhcea. — Fluor Albus. 

Leucorrhcea is from two greek words, Xefyog and psm, andfluor 
albus from two Latin words, albus and fluo, having precisely the 
same meaning as the Greek, namely, a white discharge. Hence, in 
popular language, the disease is called the " whites "; it is also called 
^female iveakness." 

These terms are well enough, perhaps, if we have in mind that 
they conve} r to us only the idea of a symptom of disease. They all 
mean, with the exception of the last, a white discharge from the 
female genital organs. They are slightly inaccurate, as the discharge 
is sometimes yellow, or green, or otherwise variant from white. Any 
discharge from the female genital organs which is not bloody, comes 
under the term " whites." 

A Symptom Only. — As the name of a disease, the term whites has 
no specific meaning. It does not designate any particular complaint. 
It is a symptom, just as the matter expectorated and raised in lung 
diseases is a symptom ; and as such only should it be regarded. 
When persons cough and raise a great deal, they do not, on consult- 
ing a physician, say they have got the expectoration ; but they say 
they fear they have some disease of the lungs, because they expecto- 
rate. They look upon the expectoration as the sign or symptom of 
disease. 

So females, and physicians too, must learn to look upon the whites, 
not as a disease, but as the sign or symptom of disease, which sign 
they should become skilled in interpreting. 

There is no reason why the discharge from the genital organs 
should not be as well interpreted as the expectoration or discharge 
from the throat. The parts from which it comes may be about as 
easily and as well inspected. 

No Female Ailments so Common. — There are no female troubles 
to which the attention of the physician is so often called as these 
annoying and debilitating symptoms called whites ; and there is no 
department of medical practice in which the really able as well as 
conscientious and painstaking physician is so well tested. If, re- 
garding these discharges as they are, simply as signs, he searches 
faithfully for their cause, he will be led to a treatment which in a 
great majority of cases will be successful. And surely no success in 
life can be more prized by a right-minded physician. It procures 
health, the highest earthly boon, for suffering woman, and gratitude, 
the most prized of all rewards, for himself. 

There are Four Kinds of Discharges from the female genital or- 
gans, — mucus, pus, mucus and pus combined, and the watery. The 



394 FEMALE DISEASES. 

first, mucus, does not in itself imply disease ; but when pus is dis- 
charged, we know that inflammation exists, because such a cause 
alone can produce it. 

Seat of the Disease. — The cause which produces the whites may 
have its seat either in the vagina, or in the neck of the womb ; and 
in practice it is of course quite important to know where its location 
is. The character of the discharge generally settles this point. If it 
be thin and watery, or thick and cream-like, it is from the vagina or 
passage which leads to the womb ; if ropy, gluey or albuminous, like 
white of egg, it is from the cavity of the uterine neck. 

Treatment. — Some physicians always prescribe the same remedy 
for the whites. They might as well have but one prescription for 
expectoration. The remedy must have reference to the cause of the 
discharge ; until the cause be searched out, every prescription is a 
mere trial at guessing, — a sort of practice well enough adapted to 
quacks, but not becoming scientific men. 

When a case of whites is brought before a physician who under- 
stands his business, he makes no prescription until he has discovered 
what the disease is. Having determined this point, his remedies have 
an intelligent bearing upon the case. 

If the discharge be of a ropy, tenacious character, one of the best 
remedies is a strong solution of nitrate of silver, used as an injection 
with a female syringe, once a day (254). Of this, not more than two 
teaspoonfuls should be used at a time ; and great care should be ob- 
served not to stain the underclothes with it. When the discharge is 
either yellow and thick, or lighter colored and watery, some one of 
the following: (200), (202), (203), (207), (209), (220), (230), 
(232), (243), (244), may be used with advantage as an injection, 
twice a day. An infusion of the white pond-lily, one ounce to the 
pint of water, makes a very excellent injection, which may be used 
twice a day. A very simple injection, and sometimes quite effectual, 
is a strong infusion of green tea. 

Some one of the above remedies will generally afford some relief ; 
but if whites exist in a somewhat aggravated form, they furnish evi- 
dence of some serious disease in the vagina or neck of the womb, 
and the case ought to be submitted to a competent physician. 

Absence of the Menses. — Amenorrhea. 

The absence of the menses is divided into two kinds, — retention 
and suppression. It is retention when the monthly flow has never 
appeared ; suppression, when, having been established, it is, by one 
cause or another, stopped. 

Retention Explained. — The ovaries, as we have before said, are 
the centre of the female sexual system. It is the swelling or ripening 



FEMALE DISEASES. 395 

of an ovum or egg, every four weeks, which causes the large flow of 
blood to the parts, and the consequent menstrual discharge. 

But it sometimes happens that the ovaries are not developed at the 
usual time of life. The monthly evacuation does not then appear. 
There is retention. There may be retention, too, from other causes, 
after the ovaries are matured. Costiveness may sometimes occasion 
it ; so may a degenerated and low state of the blood. 

There may be mechanical causes of retention. The mouth of the 
womb may be entirely closed, or the neck may be so constricted as 
to close the passage through it, leaving no outlet for the monthly ac- 
cumulation. The hymen, also, may have no opening through it. 
When these mechanical obstructions exist, there are sometimes large 
collections of fluid in the womb, which cause enlargement of the body, 
and in some instances, painful suspicions that the sufferer has com- 
mitted imprudences, and is in the family way. Physicians should be 
on their guard against falling into such errors, and lending the sanc- 
tion of their name to these blasting mistakes. 

Suppression Explained. — Suppression — a stoppage after flow 
has been once established — may be caused by inflammation of the 
ovaries, the blood, in this diseased condition, being drawn so entirely 
to these swelling and germinating bodies, that the accustomed flow 
from the womb does not take place. 

Inflammation in the neck of the womb may also cause a stoppage. 
So may a fright, as from a fire occurring in the neighborhood, or a 
cold taken by being caught in a shower. Girls sometimes, in their 
utter thoughtlessness or ignorance, dip their feet in cold water, when 
their courses are upon them, and bring on a suppression of a most 
dangerous character. The most lovely and innocent girls have done 
this for the purpose of attending a party; and, in some instances, the 
stoppage induced has ended in death within a few hours. The pro- 
found ignorance of their own mechanism, and of the laws which gov- 
ern it, in which girls are kept who are just budding into life, is a 
serious reproach both to parents and physicians. 

Suppression may be induced by whatever reduces the quantity or 
quality of the blood, as consumption, or by great depression of spirits. 
With some rare exceptions, women have not their turns while in the 
family way. 

Treatment. — Before anything can be done in the way of treat- 
ment, the case must be thoroughly investigated, and the specific cause 
of the disease searched out. 

If it prove to be retention, and arises from a bloodless condition 
and an undeveloped state of the ovaries, iron is the proper remed} r 
(61), (73), (74), (75), with a generous diet and exercise out of 
doors. If caused by an inflammatory state of the uterine neck or ova- 
ries, the proper treatment has been already indicated. If from cos- 
tiveness, relief may generally be found from prescriptions (5), (9). 



396 FEMALE DISEASES. 

The mechanical causes alluded to above, when found to exist, must 
be removed by gently dilating the mouth of the womb or the uterine 
neck, with bougies, beginning with the smallest, and increasing the 
size, or by puncturing the hymen, as the case may require. Per- 
manganate of potash, in capsules of 2 grains each, after meals, is 
one of the best remedies. 

In Treating Suppression, it should be borne in mind that at a cer- 
tain time each month nature makes an attempt to restore the lost 
function. Even when she is not successful, probably an ovum is ma- 
tured and in some way disposed of. The intelligent physician will of 
course avail himself of this favorable moment to try his skill in bring- 
ing about the desired regularity. When this time arrives, he should 
order three or four leeches applied to each groin at night. The next 
night, he should direct the use of a pungent foot-bath (242) ; also 
(16) as a cathartic. 

When suppression exists, it is not always proper to try in this 
direct way to bring on the turns. There may be no blood to spare ; 
and this may be the sole reason why the courses do not appear. 
When this is the case, nothing is to be done but to build up the 
health as rapidly as possible, and when this is sufficiently established, 
the courses will be all right. 

Profuse Menstruation. — Menorrhagia. 

Menstruation may. continue too long, or occur too often, or be too 
profuse while it lasts; or all these irregularities may be experienced 
by the same person. Any one of them will prove a serious irritation, 
and a drain upon the constitution ; the whole together, if not arrested, 
will undermine and destroy it. 

The Cause of this, like the source of all other female diseases, is, 
in a great majority of cases, overlooked. 

It is not to be attributed, as so many suppose, to a congested state 
of the womb ; but is rather the result, in a great many instances, of 
the inflammatory or ulcerated condition of the uterine neck. 

In still another large number of cases, it arises from a succession 
of ovarian abortions. When the blood has run low, and nutrition is 
defective, as in the consumptive habit, the ovarian vesicles fail to 
reach maturity. Like other products of the economy, they become 
blighted, and abort. And as these blights occur often, nature is busy 
every two or three weeks casting them off. Hence, the menses 
appear often. They come and go without order, because they spring 
from a process which is a contraversion of nature's laws. 

Profuse menstruation, like scanty menstruation, is a symptom of 
a variety of diseases. The quantity may be increased only on one or 
more days, or be so great as to cause death from hemorrhage. At all 
events, the amount of blood lost is often so great as to cause anaemia 



FEMALE DISEASES. 397 

and impaired health for a long time. This is, however, usually the 
result of continued free bleeding extending through a number of 
months. 

The local causes of uterine hemorrhage are fibroid tumor of the 
womb ; inflammation of the womb, or metritis ; inflammation of the 
lining membrane, or endometritis ; uterine congestions from any 
source ; cancer of the womb in its early stages ; retroversion, or tip- 
ping over backward of the womb onto the rectum ; polypus ; enlarge- 
ment of the womb following labor or abortion ; the retention of pla- 
cental tissue, etc., etc. These also are among the local causes of hem- 
orrhage. But not infrequently the excess of flow is due to impaired 
general health. Wasting diseases like phthisis or consumption cause 
the blood to be so thin as to render it unable to form a clot, thus 
facilitating the easy or profuse hemorrhage often seen in young girls 
in the earlier stages of consumption ; later, amenorrhcea ensues from 
utter lack of blood. This flowing often attends acute fevers, pur- 
pura, Bright's disease, jaundice, heart-disease and debility. This 
last cause is often seen in the case of young girls who have grown 
rapidly since puberty and pursued a vigorous course of study with 
little or no out-door exercise. The strain on the nervous system in 
these girls is kept up constantly by sharp competition, and no heed 
is paid to nature's demand for rest and relaxation at the menstrual 
time. The claims of society on the young girl add no small share in 
the production of this evil. 

Explanation. — It is not easy to explain how inflammation and 
ulceration of the uterine neck should in one case produce suppression, 
and in another profuse menstruation. Yet it is a settled truth that 
such opposite results do come from one and the same apparent cause. 
Probably the explanation is to be found in the different degrees of 
inflammatory action, in the varieties of 
constitution, and in the variant degrees 
of tenacity with which the vessels hold 
the blood. 

Bleeding from the female genital or- 
gans may be produced by a variety of 
causes which have nothing to do with 
menstruation. Such bleedings are prop- 
erly uterine or vaginal hemorrhages, and 
not profuse menstruation. They are the 
result of inflammations, or tumors within 
the uterine neck (Fig. 140), or weak- 
ness. The womb may bleed for days, or even months, from pure 
debility. 

Treatment. — As profuse menstruation and uterine hemorrhage 
spring from a variety of causes, so the remedies are various. Here 
again we are confronted with the same absolute necessity to investi- 




398 FEMALE DISEASES. 

gate accurately the true nature of the complaint before we venture 
a single prescription. All the cases present one general feature. 
There is too great a loss of blood ; and the first thought is that 
astringent medicines are necessary to arrest it. But if the bleeding 
be occasioned by a polypus, or by inflammatory ulceration, astringents 
would not arrest it, and might do great mischief. 

When the immoderate flowing is caused by a general breakdown 
of the nutritive powers, and by ovarian abortions, the great aim must 
be to rally the vital powers by iron, quinine, porter, wine, a generous 
diet, exercise on horseback and on foot, and warm and cold bathing. 
When produced by local diseases of the ovaries and neck of the 
womb, the treatment is to be local, — such as has been described. If 
a polypus or other tumor be the cause, the remedy must be sought 
for under the appropriate head. If the womb has become relaxed, 
and bleeds from pure debility, — as it may, — something must be 
found, if possible, which will condense its substance, making it 
harder, smaller, and more solid. For this purpose, cold bathing, as- 
tringent injections into the front passage, and acid drinks are useful. 
But one of the best remedies is the wine of spurred rye (267). One 
teaspoon ful should be taken three times a day. This article, by 
causing the womb to contract, solidifies and condenses it, thus arrest- 
ing the blood which oozes from its relaxed tissues. Of course, the 
object of all treatment is twofold : the one to stop the hemorrhage 
for the time being, the other to remove the cause. The physician 
may have to be called, and resort had to tampons in the vagina ; the 
uterus itself might have to be packed with gauze ; hot douches of 
115° to 120° F. will frequently quiet a stubborn hemorrhage, espe- 
cially if rest in bed with the hips elevated be strictly enjoined. The 
hot douche should be repeated every three hours. Besides the giving 
of ergot, hydrastis, hamamelis and atropia are also quite useful, as, 
for instance : Fluid extract ergot, fluid extract hydrastis, fluid extract 
hamamelis, of each twenty drops, in water every three hours, with 
the addition of ^ grain of atropia at the same time. 

Sedatives, like the bromide of soda, in ten-grain doses every hour 
or two, will be of service if the hemorrhage be caused by fright, grief, 
or injury. The treatment of the intervals must depend on the cause, 
but generally some systemic tonics like iron or quinine are of great 
service ; rest in bed is, par excellence, the treatment in most cases at 
some stage of the flowing, generally during the flow itself ; but rest 
from excitement and freedom from overwork are equally important 
when the hemorrhage is due to this cause. Out-door exercise, fresh 
air and good food are none the less important for weary brains and 
tired nerves. 

Hemorrhage between the periods, or menorrhagia. — When hem- 
orrhage from the womb occurs between the periods, it is called Men- 
orrhagia, and is more apt to occur in women past thirty years of age, 
or, at all events, in married women. It is of more significance usually 



FEMALE DISEASES. 399 

than profuse menstruation, and almost always proceeds from the womb 
itself. This bleeding comes on often after the menopause, or " change 
of life." The causes are quite similar to those just considered, but 
local causes are oftener found. Some sloughing surface, as from 
cancer, fibroid, erosion of the lining membrane, exists in half the cases. 
Abortion, and the retention of small pieces of afterbirth, are frequent 
causes of this kind of flowing. 

This trouble demands the immediate attention of the family phy- 
sician or the specialist, who will examine the uterus and ascertain the 
cause ; and, as not infrequently, the cause consists in something to be 
removed, a brief mention of the methods employed will not be out of 
place. 

The size, shape, position and firmness of the uterus and ovaries are 
made out by the examining fingers of the left hand being pressed 
into the abdominal walls above the bladder, while the fingers of the 
right hand, with the knees drawn well up, are introduced into the 
vagina and pressed against the neck of the womb. An endeavor is 
then made to bring the womb between the two sets of fingers, which 
maps out its locality, position, etc. The ovaries and ligaments are 
likewise located. Any erosion of the mouth of the womb, foreign 
growth there, malposition, excessive size, etc., can thus be readily 
detected. To explore the inside, one of the various specula before 
described are used, and the uterus dilated either with tents, so-called, 
or more commonly with a steel dilator. If, then, there is found 
aught to be removed, a sharp, spoon-like instrument, called a curette, 
is used to scrape away all diseased tissue or foreign growth, and the 
womb then washed out with some antiseptic solution. The womb is 
then often packed with gauze to still further disinfect its interior and 
afford a means of draining away all oozing blood or forming mucus. 

This operation called curetting is now frequently done as a regular 
means of treatment to do away with the causes of hemorrhage and to 
restore the normal bulk and character of the womb, instead of resort- 
ing to the slow, tedious, and less successful methods of former times. 
It is, to be sure, a regular operation; but when done under so-called 
aseptic methods, to be described later, is a perfectly safe and trust- 
worthy treatment, far in advance of old-fashioned methods, which 
seem less heroic. 

It necessitates rest in bed, nursing, and the disadvantages of sick- 
ness; but on the other hand, it saves lives, stops disease, and renders 
useful what otherwise might become useless and dangerous to life and 
health. 

Painful Menstruation. — Dysmenorrhea. 

Dysmenorrhea is from three Greek words Bv<s, ^v and pew which 
mean, literally, a difficult monthly flow. These words do not pre- 
cisely describe the complaint; for it consists not so much in a 
cult, as in a painful flow. 



400 FEMALE DISEASES. 

Symptoms. — This affection is always marked by more or less pain 
while the courses are on, — especially during the first day or two. 
The pain sometimes begins two or three days in advance of the evac- 
uation. It extends over the whole lower part of the belly, running 
down, at times, to the thighs, and causing great distress in the back. 
It is frequently so violent as to resemble the pains of labor, compel- 
ling the sufferer to take the bed, and drawing from her tears and 
groans, and occasionally throwing her into spasms most painful to 
witness. So terrible are the monthly sufferings which some women 
experience from this cause, that the anticipation of it destroys much 
of their peace, even during the intervals of respite. 

The Causes of this complaint are very numerous. There is, 
doubtless, such a thing as pain in the womb from rheumatism, and 
especially from neuralgia, though these are much rarer forms of the 
complaint than many suppose. 

Pains at the monthly periods are often induced by a displacement 
of the womb. If the organ fall over backward or forward, its nerves 
are pressed upon in an unnatural way, and when the parts are crowded 
with blood, it is very natural for painful sensations to be excited. 
In these cases, the neck of the organ is bent at right angles, and the 
canal which passes through it is, of course, strictured, so that the 
evacuations are necessarily made with difficulty. 

And this leads me to remark, that the passage through the uterine 
neck becomes, occasionally, from inflammation or other cause, almost 
closed. The result is, much difficulty and great pain in passing the 
monthly secretion. 

There are no causes which excite painful menstruation more often 
than inflammation in the uterine neck and the ovaries. An increased 
flow of blood to an inflamed part always causes pain. An inflamed 
foot or leg has to be laid up in a chair, because it aches when put 
down. The reason is, that when hanging down it is more full of 
blood, and the sensitive nerves are painfully compressed. When the 
finger is hot with inflammation, we assuage the pain by holding it up 
for the blood to run down. For the same reason, the inflamed ovaries 
and uterine neck ache when the blood flows to them in large quanti- 
ties, at the menstrual period. 

Congestion of the lining membrane of the womb itself is a frequent 
cause of painful menses. It is a condition of the membrane of the 
womb similar to that of the larynx in membranous croup. There is the 
same pouring out of what physicians call coagulable lymph, winch 
forms itself into a membrane. This membrane the womb strives by 
strenuous contractions to throw off, and finally succeeds in expelling 
it, not whole and entire, but in shreds and patches. These shreds, 
which women sometimes call skinny substances, are characteristic of 
the disease. The efforts to expel them cause pains very much like 
those of natural labor, and sometimes almost as severe. 

Treatment. — Painful menstruation, excited by the falling over of 



FEMALE DISEASES, 401 

the womb, backward or forward, is cured, of course, by putting the 
organ back into its proper position. 

Pains caused by stricture of the canal through the uterine neck, 
are cured only by enlarging the passage. This is effected by intro- 
ducing at first a very small bougie, and then a larger and a larger, 
until the passage is of the usual size. It is a delicate operation, 
quite successful in careful and skillful hands, but liable to produce 
mischief when improperly conducted. 

In all the forms of this disease, the treatment should aim, not 
merely at palliation, but at a cure. And generally, I am happy to 
say, a cure is attainable. Yet how many women suffer for years 
until health has fled, and life has become a burden, receiving from 
their medical attendant the assurance that palliation only is possible ! 

It is necessary at each monthly turn to do something, in these 
cases, to quiet the pain. For this purpose, twenty drops of spirits 
ether in a wineglass of tepid water, thrown into the bowel, will be 
highly serviceable. For a like purpose, one pill (116) may be taken 
twice a day, beginning one day before the menstrual flow. A bella- 
donna ointment (170) maybe rubbed upon the neck of the womb 
with great advantage, and a teaspoonful of viburnum compound taken 
each hour. 

In the congestive form of this disease, — that in which the membrane 
is formed on the internal surface of the womb, and thrown off in frag- 
ments, — the liquid acetate of ammonia, or spirits of Mindererus, is 
a very valuable remedy taken in two-teaspoonful doses, in a table- 
spoonful of cold water, three or four times a day, while the pain lasts. 

Medicines almost innumerable have been put on the market for 
this complaint, of which Hayden's viburnum, liquor sedans, diovi- 
burnum, and a host of others, are examples. These are usually 
harmless, and may be used. Gin, in goodly doses, is often service- 
able by stimulating the circulation. Turpentine cloths, the hot-water 
bottle, rest in bed, etc., also help amazingly. But whatever remedy 
may be used at the time, even though the pain be severe enough to 
require an anodyne, the cause must be sought and treated. 



Chlorosis, — Green Sickness. 

Before the age of puberty, the girl is only a child. She has 
within her only the elements of a woman. The change to which she 
is destined brings with it a wonderful development both of body 
and mind. 

To effect this development, and bring out the new being in the 
perfection designed by the Creator, a large amount of hidden nerve- 
power is required. She requires to have been born with a well-vital- 
ized constitution, and to have been physically trained in a way to 
harden and energize it. Without these antecedents, her development 
at puberty will be feebly and imperfectly made. Her development 



102 FEMALE DISEASES. 

and evolution of germs will be so defective as to cause her menstrua- 
tion to be only partially established, or to fail altogether. 

Symptoms. — "Where the inherent powers of the sj^stem are just 
sufficient to bring about a first menstruation, it often happens that 
they seem to be spent by the effort, and that the evacuation fails to 
appear again for several months. Indeed, the whole organization 
may break down at this point, and become blasted, as it were, like a 
blade of wheat which has grown well for a time, but which fails to 
develop the kernel. 

The blood at this period may become impoverished, and fail to 
distribute adequate nourishment and development to the various 
tissues. "When this occurs, it loses a part of its red globules, and 
increases its watery portion. As a result, the skin becomes pale, and 
sometimes of a yellowish hue,- the bowels become torpid and con- 
fined ; the nervous system sensitive and weak ; the digestion is 
impaired ; the appetite is either lost, or perverted, — longing for un- 
natural food ; the tongue is white ; the heart palpitates ; the spirits 
are depressed ; the temples and ears throb ; the head occasionally 
aches and whirls with dizziness ; the sleep is disturbed and abbrevi- 
ated, and hysterics are now and then superadded to close the cata- 
logue of ills. 

This is Chlorosis, briefly depicted in its origin and its symptoms. 
The word is from the Greek x Aw p°s> which means green and pale. 
By nurses it is called the " green sickness." 

Its Causes are quite numerous, among which may be reckoned 
impoverished diet, damp atmosphere, sedentary habits, long confine- 
ment indoors, overworking the mind in childhood, constipation of the 
bowels, and an inherited feeble constitution. This disease is very 
frequently met with in domestics emigrating to this country from 
Ireland, Sweden, and the Provinces, and depends on the failure of 
Nature to accustom herself to the new climate. These cases, how- 
ever, all respond well to treatment, but when left alone, lapse into 
consumption, Bright's and similar diseases. 

Treatment. — Chlorosis, as a general thing, is connected either 
with retention or suppression of the menses; and in treating it. 
physicians are too much in the habit of resorting indiscriminately to 
forcing-medicines, called emmenagogues. From such practice great 
injury often results. 

It is not always sufficiently considered that a woman fails to men- 
struate, or ceases to do so, because she is sick ; and if we would cause 
her courses to return, we must restore her health. To do this, should 
generally be the great object of treatment. Let the health be restored, 
and the menses will come back. The only philosophical treatment is 
that which will invigorate the system. 

In chlorosis, the vital powers are in a state of dilapidation. How 
can they be roused? By exercise on horseback and on foot; by 



FEMALE DISEASES. 403 

wearing clothing enough to keep warm ; by a tepid bath two or 
three times a week, and brisk rubbing with a coarse towel ; and by 
a generous diet, composed of tender meats, animal broths, etc. 

This treatment, however, should be preceded by unloading the 
bowels with prescription (35) or (40), according to choice. One 
pill should be taken at night. When the liver is considerably de- 
ranged, perscription (40) will be particularly serviceable. Half a 
pint of tepid water thrown into the bowel, night and morning, will 
help relieve costiveness. 

The bowels having been well opened, give a tablespoonful of pre- 
scription (59), two or three times a day; or of prescription (60), a 
teaspoonful, the same number of times each day. 

In the treatment of this disease, iron, in some form, is almost 
always needed. Prescriptions (61), (71), (73), (74), (75), (80) 
and (316), are suitable preparations. Among the more recent 
remedies for building up the blood in chlorosis, perhaps none is more 
successful than the combined pill of iron and manganese, called 
Bland's modified pill, or, if preferred in liquid form, the same remedy 
may be obtained in still milder and more physiological form in the 
preparation known as Gude's Peptomangan. The peptonate of iron 
is also one of the best modern remedies. 

A girl suffering from this disease should always be taken out of 
school. The mind should be divided between rest and recreation. 

Cessation of the Menses. — Turn of Life. 

There is probably no period in woman's earthly existence which 
she approaches with so much anxiety as that which she is in the 
habit of calling " the turn of life." The anxiety is not without some 
reasonable ground for its existence. She has been accustomed, for 
thirty years or more, to lose, every four weeks, a certain amount of 
blood. When this evacuation stops, disturbances of the system may 
well be expected. .So well is this understood, that this climacteric 
has come by general consent, to be called the " critical period " in 
female lif«^ 

If it be well and safely passed, the health is generally better than 
before, and a " green old age " is likely to follow. But if the seeds 
of disease are in the system, — if there be a tendency to cancer or 
ether malignant disease, which has been held in check by the monthly 
flow, it now takes up its destructive work, and shows itself ; or, if 
there be a predisposition to apoplexy or congestion of any organ, it 
is more likely to become active, now that the accustomed waste-gate 
is closed. A distinguished writer has said that about half the deaths 
among women, about the age of forty-four, are from cancer. 

Nervous Complications. — It is the duty of the physician to look 
carefully after those females who come under his care at this critical 
time. For, in addition to the organic and malignant diseases which 



404 FEMALE DISEASES. 

attack her at this time, she is exposed to a host of nervous irritations, 
which, if neglected or badly managed, make her life a cross and a 
burden. The symptoms of these irritations are in number, legion. 

Age at which the turn of life comes. — As a general rule, the 
turn of life comes between the ages of forty and fifty ; but occasion- 
ally occurs at other periods, varying from thirty to seventy. If the 
menses appear early in life, they terminate early. 

Symptoms. — When there is a tendency to corpulency at this 
period, the symptoms are headache, dizziness, and a sense of suffoca- 
tion. It is common, when the period of cessation approaches, for 
deviations from regularity to occur. At one time the menstrual dis- 
charge will be profuse ; at another, scanty. It will now disappear 
for a time, and be replaced by the whites. Then it will appear for a 
few times with considerable regularity. Next will come a suspension 
for several months, to be followed by a flow of such profusion as to 
amount almost to flooding. 

Mixed up with these irregularities will be palpitations of the 
heart, constipation of the bowels, a variable appetite, and broken 
sleep, weakness and inquietude, timidity, a dread of impending evil, 
irritability of temper, hysterical attacks, bad feelings in the head, 
with sounds in the ears, as of the rolling of carriages, sparks before 
the eyes, and an unsteady gait. 

Treatment. — If there be, at this period, fulness of habit, with 
dizziness, headache, sparks before the eyes, a sense of suffocation, 
etc., there is a plain indication that the brain is oppressed with too 
much blood. I am not much in favor of bleeding, but this is a case 
in which from a gill to a half-pint of blood may, if ever, be drawn 
from the arm with positive advantage. Cups applied to the back of 
the neck will also be useful. Give at night, also, three of the com- 
pound cathartic pills, and then keep the bowels regular with pre- 
scription (18), — a wineglassful to be taken occasionally. The diet 
should be spare, and strictly vegetable : to which should be added 
much daily exercise. 

For the flushes and sweats to which women are subject at this 
time of life, ergot often answers admirably, in teaspoonful doses 
every few hours. Atropia in y^-grain doses not infrequently helps 
the sweating. 

Purging should not, in any case, be carried too far. If nervous 
affections show themselves, with disturbance of the digestion, and 
general debility, even leeches would be improper, and physic should 
be swallowed very sparingly. 

When serious organic disease is suspected, as cancer, it is the duty 
of the physician to investigate the case very thoroughly, and to give 
the patient the advantage of the most prompt and decided treatment. 
That treatment is spoken of in the proper place. 



FEMALE DISEASES. 405 

Hysterics. — Hysteria. 

The name of this complaint is from a Greek word signifying the 
womb. It took this name from the belief that this organ is the seat 
of the irritation which produces the hysteric disturbance. 

This belief is correct, if we include with the womb the ovaries 
and the other sexual organs. The sexual system is doubtless the 
centre of the reflex nervous derangement called hysteria. 

It has been sufficiently demonstrated that hysterics are dependent 
for their existence either upon organic disease, or upon simple irrita- 
tion of the sexual organs. Sir Benjamin Brodie mentions cases of 
the hysteric paroxysm, produced by pressing upon an inflamed and 
tender ovary. 

Symptoms. — An attack of hysterics is generally preceded by de- 
pression of spirits, restlessness, and a frequent desire to pass water. 
It is sometimes marked by convulsions, or fits ; at other times, it is 
not. At times, the attacks are local, and are manifested by spasms 
of the throat at the top of the windpipe, or in the bronchial tubes ; 
the patient feels a ball rise up in her throat (globus hystericus), her 
heart beats violently, and she laughs and cries by turns. 

When the disease is more general, the muscles of the limbs are 
thrown into spasms ; the patient struggles violently ; rising up in a 
sitting posture, and then throwing herself back; twisting the body 
from side to side, clenching the hands, and throwing the arms about, 
so that she is with difficulty held by persons much stronger than 
herself. Soon after these paroxysms, the patient generally passes a 
large quantity of very pale urine. 

The Causes of this complaint are as numerous as the causes of 
female diseases, for in truth there is no female complaint which may 
not produce it. Whatever develops and excites the sexual system, 
and at the same time weakens the constitution, lays the foundation 
of this malady. Nervous women are much inclined to it. In large 
cities there is more of it than in the country, because there is more 
excitement and luxury, and more of their consequences, — nervous 
and female diseases. 

Treatment. — To treat this complaint successfully, it is necessary 
to search out its cause, and remove that. Like the whites, it is not 
so much a disease in itself as a symptom. 

The first inquiry to be made should have reference to the real 
origin of the complaint. Is it dependent upon inflammation of the 
ovaries or the womb, or to displacement of this latter organ ? or does 
it arise from the low state of the blood, and the weakened condition 
of the nerves, acted upon by some irritation or heightened sensibility 
of the sexual organs ? 

If dependent upon inflammatory disease, that is to be treated ac- 
cording to directions elsewhere ; if upon falling of the womb, no 



406 FEMALE DISEASES. 

remedies will avail until that is put in its proper place. If diluted 
blood and weakened nerves be the cause, iron and quinine are the 
remedies. When the complaint arises from deficient menstruation, 
iron and aloes (47) will be serviceable. The nervous spasm can 
sometimes be broken up by pouring cold water upon the head, or 
face, or limbs of the patient. 

The Hygienic and Moral Treatment are of great consequence. 
The complaint is very much under the control of the will. Whatever 
tones the moral nature and strengthens the will, tends to subject this 
disorder to the control of the patient. Plain, wholesome diet, exer- 
cise, bathing, and the enforcing, as far as possible, of a rugged, self- 
reliant habit, generally go far towards breaking its force. 

Polypus of the Womb. 

This is simply a foreign body, or tumor, growing either within the 
womb, or in the vagina, and attached to the uterine neck. It is 
rather a serious affection. 

These tumors vary in weight from half an ounce and less to many 
pounds. They are, in color, whitish, red, brown, and even black. 
They have almost every consistence, — being soft, spongy, gristly, 
and hard. 

The Symptoms of polypus are various, resembling those of almost 
every other womb-complaint. It is often mistaken for displacement 
of the womb, for dropsy of this organ, and for pregnancy. 

These tumors are apt to give rise to dangerous bleeding from the 
womb, and other discharges which greatly weaken and derange the 
system. They are liable to terminate in cancer. In pregnancy, they 
may produce miscarriage. When they are suspected, therefore, the 
utmost scrutiny should be employed to search them out. This is 
especially desirable, since the fallen or inverted womb may carelessly 
be taken for a polypus, and be operated on as such. 

Treatment. — This is of two kinds, medical and surgical. The 
first consists in means of supporting the strength of the patient, and 
checking the discharges by means of injections, rest, etc., and in en- 
deavoring to cause the removal of the tumor by absorption. 

This last object is sometimes effected by an unstimulating diet ; 
and by the use of iodine (101) for some time. This treatment does 
not often succeed, however, and cannot be relied upon. 

If the polypus be within the womb, of course it cannot be reached. 
The only thing to be done, in such case, is to cause its expulsion. 
This is sometimes effected by causing the womb to contract by the 
use of spurred rye (267), or by the use of the electro-magnetic 
machine. This latter remedy can do no harm, and had better be 
tried first. 

When the polypus is outside the womb, the methods of removing 



PLATE 8. 



Fig.l 




M 



m 



W 



Fig. 2. 




Hg.3. 



Fig. 4. 





FEMALE DISEASES. 407 

it are various. It is sometimes done by cauterization, or burning it 
off by hot iron or caustic. This is a harsh method, and not resorted 
to by skillful surgeons. Another method is that of crushing the tumor 
with an instrument. Another still is that of torsion, or twisting it 
off. And still another, that of applying a ligature, or tying a string 
around the neck of the tumor, and strangling it by preventing the 
blood from going to it. By this means it falls off in a few days. 
There is one other method, that of cutting the tumor away with a 
knife, or with a pair of curved scissors. These three last methods 
are the chief ones now used by skillful surgeons. 

Uterine Hydatids. 

This name is given to a bladder-like substance, occasionally found 
growing in the womb. It is filled with a white or yellowish fluid. 
Sometimes a bundle of them grow together, like a bunch of grapes. 
Some are elongated, like a bean, and have a sort of claw, by which 
they are attached; others are shaped like an egg. 

Those with a claw are generally supposed to be living beings, like 
worms in the bowels. When expelled from the womb, they move 
about if placed in warm water. 

The Causes which produce these singular growths are obscure. 
Probably whatever improperly excites or irritates the uterine organs 
may produce these vesicular bodies. 

The Symptoms may be easily mistaken for those either of preg- 
nancy, or of water or inflammation in the womb. 

From the growth of these bodies, the bowels may enlarge, the 
breasts swell, and the menses stop. If to these symptoms be added 
sickness at the stomach, the woman, if married, feels confident she is 
in the family way. There is no certain method of correcting this 
mistake, until the collection of bladder-like bodies is expelled from 
the womb. 

It is rare that these bodies appear in the virgin woman. They are 
supposed to be connected, in some way, with imperfect conception. 

Treatment. — We can seldom say absolutely that hydatids exist, 
until we see them expelled. Whatever will produce contractions of 
the womb, will cause their expulsion ; but it will not do to give these 
remedies indiscreetly, lest the cause be one of real pregnancy instead 
of hydatids. When once reasonably assured that hydatids do exist, 
the only logical treatment consists in their removal. This is best 
effected by the dilatation of the womb and a thorough curetting or 
scraping as described under hemorrhages. Ergot often causes suffi- 
cient contraction of the womb to drive out these masses, and may be 
judiciously tried before resorting to the curette. It should be given 
in teaspoonful doses every four hours till pains ensue. 



408 FEMALE DISEASES. 



Inflammation of the Womb. — Metritis. 

This disease very often follows delivery, and is connected with 
child-bed fever. 

Various Causes also produce it in the unimpregnated state. In«- 
flammation of the ovaries, or of the uterine neck, may extend to the 
womb. Falling of the womb may cause it to be irritated by being 
placed in a new position, and thus bring on inflammation. In some 
temperaments, marriage may produce tins disease ; in others, single- 
ness. It may also be brought on by painful menstruation, by forcing 
medicines, by constipation, by tight corsets, by solitary vices, and by 
excited sexual feeling. 

This is the most common variety of inflammation found in the 
pelvis. It is often limited to the neck of the womb, and is then called 
endocervicitis ; it may be limited to the lining membrane of the womb, 
and is then called endometritis, but practically it is all one and the same 
disease, and sooner or later involves not only the mucous membrane 
of the interior, but also the muscular structure of the womb itself. 
It is now considered a germ-disease and rarely results in spontaneous 
cure. It proceeds from the entrance of germs into the uterus either 
at the time of labor or miscarriage, or from the entrance of the germ 
of gonorrhoea ; germs, however, from the vagina, which are normal to 
that region, may often be carried into the cervix and there set up a 
trouble. 

Symptoms: — Pain in the back, nape of the neck, the right or left 
iliac region ; leucorrhoea ; painful menses ; hemorrhage from the 
womb; symptoms from neighboring organs (bladder, rectum) ; and 
symptoms from distant organs, as stomach, heart, nerves, etc. 

No disease gives rise to so many and so complex symptoms. Nau- 
sea and vomiting, flatulence, constipation, palpitation, headaches, 
cough, nervousness, loss of appetite, etc., are frequent symptoms of 
the various forms of metritis. On examination a. hard, congested 
womb is felt, with perhaps enlargement either of the neck or the en- 
tire organ, erosions, ulcerations, eversion of the lips from a tear may 
be found, while issuing from the mouth of the womb is seen a plug of 
mucus which is either white, translucent and ropy, or yellow and 
more pus-like. The womb is tender to touch, and this tenderness 
may be transmitted to the appendages (tubes and ovaries). 

Treatment. — This varies with the variety and the length of time 
the disease has existed. If there is inside the uterus any retained 
product of conception, placental tissue, or granulating surfaces, they 
must be curetted out as described in a previous article. This process 
is practically an operation and must be done thoroughly and under 
ether. If there is active inflammation going on in the tubes or ova- 
ries, this procedure must be postponed and milder measures used for 



FEMALE DISEASES. 409 

the time being, such as painting the vagina and neck of the womb with 
iodine and similar remedies. 

Tampons of wool wet with glycerine are frequently used to de- 
plete the engorgod womb, applications of creosote and iodine will 
often heal over simple erosions, while hard cicatricial masses are often 
absorbed by applications of iron. Tampons are to be worn from 
twelve to forty-eight hours, but should be removed whenever pain is 
produced. Leeches applied to the neck of the womb often relieve a 
congested state. The womb is to be thoroughly scraped and washed 
out, and a good drainage kept for the escape of forming secretions 
whenever there is severe inflammation of the body of the organ. 
Lacerations of the neck, when extensive, are to be sewn up, but when 
only moderate may be successfully treated with strong styptic iron. 
Hot douches not only serve a good purpose in reducing congestion 
and inflammation, but are often very soothing. They are to be taken 
in the recumbent position ; the water to be hot as can be borne — 
110° to 112° F. — and as much as six quarts are to be used. One 
should purchase for this purpose a large fountain syringe, or a tin pail, 
and hang it two feet above the head ; it is to be used twice daily, and 
may be used every three or four hours. Patients suffering with this 
and similar diseases must not dance or take long walks, nor should 
they use the sewing-machine ; neither should they stand long at a 
time, but should have light exercise in the open air and general sys- 
temic medicine ; they should lie down every day from two to four 
hours, and in severe cases must retain the recumbent position. The 
bowels must be kept relaxed with cascara-sagrada or some morning 
saline ; a teaspoonful of the aromatic cascara at night, or a half-glass 
of Hunyadi Janos water on rising, are excellent for this purpose. 
If the woman is pale, a prescription of some iron tonic will be useful, 
such as the four chlorides or Aiken's tonic pill. 

Falling of the Womb. — Prolapsus Uteri. 

The womb is often found out of its natural and proper place. 
There are certain ligaments and muscles intended to act as stays, 
and hold it up in its position. These, from various causes, become 
relaxed. It then, losing its support, drops down into the vagina, be- 
tween the bladder in front and the large bowel called the rectum, 
behind. It is then said to he fallen or prolapsed. 

The womb of a married woman is more apt to become prolapsed 
than that of the unmarried, because it is more liable to have its weight 
increased by congestions, enlargement, torn perineum, etc. 

The Symptoms are dull pain in the small of the back, a dragging 
sensation in the groin, and a feeling of fullness around the funda- 
ment; dragging pain in the nape of the neck; headache, constipation, 
etc. 

Treatment. — The complaint is easily cured if the remedies be 



410 



FEMALE DISEASES. 



applied early. If the prolapse be due to relaxed, weakened supports, 
tonic constitutional remedies must be employed. The diet must be 
full and easy of assimilation, exercise taken in the open air, proper rest 
secured, and electricity be used. 

If the womb be tipped over, some support must for a while be used 
in the shape of pessaries. If by reason of its increased size and weight 
the womb hang too low down in the pelvic cavity, then it must be 
made smaller and lighter by treating the coexisting inflammation and 
subinvolution. If the floor of the vagina has been torn during labor, 
thus allowing the womb to sag, this must be sewn up and a new floor 
formed. 

In complete prolapse of the aged, the uterus often protrudes from 
the vagina. This condition in the middle-aged is best met by ampu- 
tation ; while in the very aged a support may be adjusted after hav- 
ing replaced the organ. 

Falling Over of the Womb. 

Anteversion. — The womb sometimes falls over forward upon the 
bladder, towards the pubes. This is called anteversion. The top is 
turned forward to the bladder ; the mouth, back towards the large 
bowel. (Fig. 141, 6.) 

a be 




Retroversion. — When the womb falls over backward, between the 
rectum and the vagina, it is said to be retroverted (c?). This is just 
the opposite of being anteverted. In this displacement, the mouth is 
turned forward, the top backward. 

This displacement may occur suddenly or gradually. If the former, 
there is generally great distress, and the organ should be immediately 
put back in its place; if the latter, the pain will be less intense, and 
the replacement must be effected by pessaries, — particularly with the 
ring pessary, made of India rubber. 



FEMALE DISEASES. 411 

Anteflexion and Retroflexion. — When these occur, the womb is 
doubled upon itself, the mouth of the organ not being tilted up before 
or behind, but retaining its natural position. These flexions are rep- 
resented by a, c, and e. 

Besides these more common displacements of the womb, there are 
several slighter deviations which it is scarcely necessary to describe. 
There is the obliquity of the womb, which is simply a leaning of the 
organ backward or forward, or to one side. 

There are still other more serious troubles, which are so very rare 
as not to require me to dwell upon them, such as the inversion of 
the womb, or turning it wrong side out, like the finger of a glove ; 
and the hernia of the womb (hysterocele), which is like that of the 
bowel. 

^Pessaries. — Much might be said about pessaries : they are at 
times of the greatest assistance in keeping a badly placed uterus in 
its proper position ; on the other hand, they are serious hindrances 
to health. By their pressure they often cause inflammation of the 
ovaries and tubes and light up afresh old, quiescent chronic inflam- 
mations. They often stretch unduly the uterine ligaments and 
make a relaxed vagina. But it must be said that often, too, they 
keep in place a simply misplaced womb with no trouble and little 
expense to the wearer, thus avoiding long treatment and perhaps an 
operation. Tttey should always fit accurately and nicely and should 
never cause pain or make the wearer conscious that she wears such a 
thing. The soft rubber variety, or at least those made of wire and 
covered with rubber, are the least likely to cause trouble ; but they 
need, on the other hand, more frequent -inspection and cleansing. 
The hard rubber are more easily kept clean, but are more dangerous. 
Whenever a pessary is worn, it should be under the surveillance of 
the family doctor, lest ulceration of thp vagina and undue pressure 
on the internal parts ensue. Pessaries no doubt are very use- 
ful in keeping in place a womb that has been replaced and in 
warding off an operation otherwise indicated. They are of all 
shapes and designs, so that a description of them seems superfluous 
here. 

Displacements. — The various displacements of the womb are 
such common occurrences among womankind that they have always 
received considerable attention by the gynaecologist. They result 
from falls in young girls, from enlargement of the organ, from weak 
uterine supports and poor health, from torn muscles of the vagina 
during labor, and from new growths in the womb. 

The symptoms of a misplaced womb are from nothing to an amaz- 
ing amount of trouble. Many a woman goes through life with a 
badly torn vaginal floor and retroflexed womb without the slightest 
ill-effect, while her neighbor suffers intensely from a much less de- 
gree of displacement, 



412 FEMALE DISEASES. 

Operative Treatment. — When for any reason a pessary cannot 
or ought not to be worn, and there is much inconvenience from the 
misplacement, resort must be had to packing the vagina and reducing 
the size of the womb, and allaying inflammation and pain before again 
trying a pessary, or else some of the several operations must be per- 
formed. Of these latter there are at the present day three principal 
methods in vogue, viz. : — 

Alexander s operation consists in cutting down on the little holes 
in the lower abdomen, near the pubic bones, called the hernial rings, 
through which in the male the cord and vessels of the testes run, 
where hernia or rupture occurs, and through which in the female the 
the round ligament of the womb runs. This ligament is a small 
round cord attached to the anterior and top part of the uterus, acting 
as a stay. This ligament is dissected out and pulled up taut on 
either side (there are two, one on each side of the womb) till the 
womb is brought up into its normal position and there fastened. 
This operation is a very ingenious one, and answers well in simple 
uncomplicated cases. 

Ventral Fixation is a second method of fastening the womb in 
place, and consists in opening the abdomen, lifting up the womb and 
fastening it to the under side of the abdominal wall. This method 
is tolerably free from danger, like the preceding, but has the advan- 
tage of parting adhesions which may bind down the uterus and pre- 
vent its rising, and of permitting the operator to see and correct any 
existing disease of the tubes and ovaries which so commonly accom- 
pany bad cases. 

Vaginal Fixation is a third method, whereby the uterus is likewise 
fixed, but this time to the vagina in front of the bladder. Tins last 
method is at present receiving considerable attention ; but it may be 
said that no one method is the best for all cases, the surgeon being 
the best judge of the situation. These operations are safe and effi- 
cient, and forever do away with pessaries and the existing disease. 
Women go on to term in labor quite generally after these operations. 

Tumors of the Womb. 

The womb is especially prone to be the location of foreign growths. 
These occur mostly in middle life, and are commonly either of a 
fibroid or cancerous nature. 

The fibroid is a firm, hard mass of fibrous tissue, growing either on 
the inside wall and suspended like a polypus, or developing in the 
uterine muscle itself, or on the outside of the womb in the abdominal 
cavity. They attain oftentimes huge proportions and weigh many 
pounds. They are not necessarily fatal to life or detrimental to 
health, but usually give rise to a train of symptoms which may be 
annoying and fatal. Hemorrhage and profuse menstruation to such 
an extent that the patient is rendered pale and almost blanched are 



FEMALE DISEASES. 413 

not infrequent. Pressure on the bladder and surrounding organs 
often causes serious disturbance to urination and defecation; di- 
gestion is interfered with, and pain is frequently present. When 
these tumors, which are of slow growth, are small, painless and free 
from trouble, they may be let alone ; but when large, bleeding freely, 
and causing symptoms oi pressure, they must be dealt with. Many 
gynaecologists of the present day claim that every fibroid should be 
removed; but as this means the enucleation of the womb and ovaries 
(hysterectomy), — a very severe operation, — we cannot endorse this 
view, especially as hundreds of women go through life unscathed 
even with large tumors. 

The menopause, or " change of life," has a twofold effect on them : 
some begin to atrophy and grow small after the blood ceases to come 
to these parts in regular monthly congestion, and they may even dis- 
appear entirely : others are increased in size and even change their 
structure into malignant growths. Hence it will be seen that these 
tumors require the supervision of the family doctor or specialist, that 
their growth may be watched. It remains to be added that many 
advocate the use of strong galvanic currents, applied according to 
the method of Apostoli, a noted French savant, to diminish the size 
of these tumors. Many cures are claimed, and at one time it seemed 
as though this method was destined to supersede all others ; but now, 
after a few years' trial all over the world, it is generelly conceded 
that only certain varieties are amenable to this treatment, and that 
the tumor does not entirely disappear. This method, however, ob- 
viates the necessity for operating, and is in many cases an admirable 
way of reducing and keeping in check what otherwise might threaten 
life. It is still a much used, though often abused, method of treating 
them, and appeals to the timid and obdurate. 

Cancer of the Womb. 

This is another but more dangerous growth of the womb* and oc- 
curs mostly in women near middle life, especially in cases which have 
a family predisposition to cancer, and when the neck of the womb 
has been badly lacerated from labor or miscarriage. It usually be- 
gins in the neck of the womb like a little bunch, which bleeds easily 
on touch, and extends rapidly into the neck and finally up into the 
body of the uterus. Its entire life-duration may not exceed one or 
two years before death claims the sufferer. Hemorrhage and foul 
leucorrhcea are often the only signs which attract the patient's notice. 
Pain finally sets in, with breaking down of the cancerous tissue, and 
then a very foul and peculiar odor commences. This odor is very 
penetrating and is characteristic of the disease. Emaciation, loss of 
appetite and strength, painful days and nights supervene, and finally 
death comes to relieve the sufferer of one of the worst diseases to 
which womankind is liable. 



414 FEMALE DISEASES. 

Treatment. — The only treatment consists in the early detection 
of the disease and the enucleation of the entire uterus by the vagina. 
If it has been discovered early, before the cancer-cells have got out- 
side of the womb, it may be successfully treated at least for a num- 
ber of years. I can not better advise women than by warning them 
to consult a physician at once on the occurrence of any unusual 
hemorrhage near the change of life. So many ascribe these slight 
hemorrhages and aches to tins broad mantle of ignorance, that pre- 
cious time has been wasted and the golden opportunity passed for 
curing the dread disease. Do not waste time and money, either on 
nostrums or other quackish methods, nor listen to what Mrs. So-and- 
So did, but proceed at once to the best authority you have at your 
disposal. So much is being successfully done now for the relief 
and cure of these growths, women owe it to themselves and their 
families to take advantage of modern skill and knowledge. The 
microscope will detect it earlier than the eye or finger, and thus a 
suspicion may be corroborated or a fear dispelled by timely advice. 

Of palliative treatment, the application of styptics and the curette 
cause a delay of the growth and a cessation of hemorrhage ; while 
anodynes like morphine or opium in some of its forms will allay pain 
and anguish. 

Ovarian Tumors. 

OVAKIAN tumors are rather frequent growths, occurring for the 
most part as cysts and attaining a huge size ; not infrequently they 
grow to such an extent that their weight far exceeds that of the en- 
tire body. They are rilled with a clear light-yellow fluid. Their 
treatment consists in their removal through the abdomen (ovari- 
otomy), and should be operated upon as soon as detected. The rate 
of mortality following these growths is not large. It was this oper- 
ation, began in America in the forties, that was the beginning of a 
new era for surgery of the abdomen. Only when neglected does one 
now-a-days meet with these enormous growths. 

When for any reason an operation is inadvisable, they may be 
tapped and comfort received for a long time. 

The ovary is likewise the seat of other growths both benign and 
malignant. 

Inflammation of the Fallopian Tubes. 

To speak of this disease means to review the growth of gynaecolo- 
gical science within the last fifteen years. 

The operation of laparotomy, or opening the abdomen, is now per- 
formed so successfully by almost every surgeon, that it has taken its 
place among the every-day measures for relief, and frequent oppor- 
tunities have of course been presented to the profession, of corrobo- 
rating or refuting some old-time theories. Many a notion of inflam- 
mation of the bowels, or peritonitis, has become a thing of the past ; 



FEMALE DISEASES. 415 

many an unexplained death has been made clear, and many, many 
lives have been saved by a timely recognition of the true state of 
affairs within the pelvis. 

Many cases of what formerly was regarded as peritonitis are now 
known to have been either salpingitis, ovarian abscess, appendicitis, 
etc. Of these diseases the most prolific of trouble, as well as the 
most common, is salpingitis, or inflammation of the tubes which con- 
duct the ovum to the interior of the womb, where it is fructified by 
the male germ. 

These tubes are lined with a mucous membrane like that of the 
interior of the womb, and continuous with it, so that whenever in- 
flammation from whatever source is present in the cavity of the 
womb, it is extremely liable to travel up the tubes, even to the ova- 
ries and peritoneum. This inflammation may be merely catarrhal, 
and only become bothersome by its chronicity, or it may become 
purulent and suddenly cause violent illness. 

The catarrhal form begins very slowly and gradually from some 
old neglected uterine disorder, or it may follow a labor where there 
was some septicaemia or blood-poisoning; it may spring from venereal 
disease, either contracted by the woman illicitly or given her by her 
husband ; and it may come in several ways not of general interest to 
the reader. At all events, it is essentially a germ-disease, and when 
anyways severe has a tendency to spread and become worse. 

Symptoms. — These little tubes, which are normally about the 
size of a slate-pencil, become swollen, and very painful and tender, 
causing inability on the woman's part to do a full day's work, and 
even confining her to bed. The temperature is raised, the belly 
bloated, the urine often being frequently passed ; the bowels are 
constipated, appetite poor, and digestion bad; sleep is disturbed and 
the nerves weakened. 

On examination, the trained finger in the vagina feels a large, 
swollen, tender tube on the affected side, and often a bulging of the 
roof of the vagina. 

Treatment. — Rest in bed, hot douches, painting the side with 
tincture of iodine, and the using in the vagina, every night and 
morning, of a suppository of five grains of ichthyol, with laxatives 
and nerve sedatives, will do much toward reducing a slight and even 
moderate attack. The disease, however, does not usually exist alone, 
and therefore much time is generally necessary in eradicating it. 

When the catarrhal form, however, gets worse, and pus forms, we 
then have the so-called purulent salpingitis, or pus-tube. Pus gathers 
here as elsewhere, stretching the tube more and more ; finally the 
pus-germs work through the tube and out of the end, where they set 
up an active inflammation, and new tissue forms about the tube, 
shutting it off from the general cavity. Everything in the neigh- 
borhood becomes glued together, fixing the womb in an immovable 



416 FEMALE DISEASES. 

position. The tube goes on stretching more and more, till finally it 
becomes one large abscess-cavity. It may then, at times, be punc- 
tured through the vagina and thus drained ; but generally an opera- 
tion is required, either to remove the womb and its appendages 
through the vagina, or else to open the abdomen and take away the 
large mass of exudation, in the centre of which is the pus-cavity. 
When matters have reached this stage, the patient is of course in a 
very grave condition. There is a high fever, with sweats and perhaps 
chills, loss of appetite, pallor, pain, and all the evidences of being 
extremely sick. The patient either dies shortly or becomes bed-rid- 
den, unless an operation can relieve her. This latter variety of the 
disease is calle pyosalpinx. 

Acute Salpingitis is best treated by rest in bed, douches, saline 
purgatives, and a liquid diet. It gradually subsides without serious 
results. 

Chronic Salpinitgis is the more common variety, is very protracted 
in its course, and rarely ends in spontaneous recovery. It requires 
great patience on the part of both physician and patient, and often 
can only be cured by the removal of the offending organ by lapar- 
otomy. 

It must be remembered that all these various forms of tubal dis- 
ease are produced by one form or another of bacteria or disease-germs, 
and that in their treatment strict cleansing of the vagina by antisep- 
tics is necessary. 

Salpingitis is always preceded by some form of metritis or endo- 
metritis, as, for instance, the gonorrhceal metritis, that caused by 
septicemia or blood-poisoning, the metritis following labor, etc. 

Inflammation of the Vagina. 

This may be produced by many of the same causes which induce 
inflammation of the uterine neck. It may follow tedious child-bear- 
ing, especially if instruments have been used. Marriage is not an 
infrequent cause of it, — so may a pessary be, if an improper one. 

The Symptoms are pain in the groins, a feeling of heat and tight- 
ness in the passage, and a difficulty in passing water. In a few days 
a discharge, like gum-water, begins to flow, which gradually becomes 
thicker, like cream, and is green or yellow. Sometimes the disease 
gets well in a few days ; at other times it degenerates into the chronic 
forms, and lasts a long time. It should be cured as soon as possible, 
lest the inflammation cause the walls of the passage to grow together, 
and make a stricture, as in Fig. 142. 

In this Figure, b represents the mouth of the womb ; a is the 
lower entrance to a narrow passage in the vagina, called a stricture. 
It is caused by inflammation, which so thickens the walls of the 
vagina as to bring their inner surfaces near together. In examining 
a case of this sort, a practitioner needs to be on his guard lest he 



FEMALE DISEASES. 



417 



mistake the entrance to the stricture, a, for the mouth of the womb, 
b, — a mistake which might lead to evil consequences as well as seri- 
ously damage his professional character. 




Fig. 142. 

Treatment. — The diet should be light and unirritating. The 
bowels should be kept open. A cooling wash (207), (218), should 
be used several times a day, until the discharge becomes thick; then 
employ injections (232), (202), (244), (243), of a more astringent 
nature. Let the marriage-bed be abandoned till the recovery is com- 
plete. 

When the discharge arises from small granular elevations upon 
the inner surface of the vagina, the whole diseased surface should 
be painted over with a solution of nitrate of silver, twenty grains to 
the ounce of water, — the disease being brought to view by the use 
of a speculum. This may be done every other day, 



Itching of the External Parts. — Prurigo of the Vulva. 

This complaint is apt to attack females about the cessation of the 
menses, though they are liable to it at other periods. It is a most 
annoying and distressing affection. So terrible and tormenting at 
times is the itching of the external genitals, that the woman is una- 
ble to avoid rubbing and scratching, and she is occasionally compelled 
to absent herself from all society. She feels, as she says, as though 
she could tear herself to pieces. 

Sometimes this irritation of the sexual organs excites venereal 
thoughts so dominant and controlling as to constitute a real mania, 
called nymphomania, from the name of a part involved. 

This complaint generally indicates some disease of the womb, or 
its appendages, or of the bladder. When this is the case, of course 
it cannot be cured without seeking out and removing the disease of 
which it is a symptom. 

Treatment. — To alleviate the local suffering, the lotion (223), 
or the ointment (171), may be applied to the parts several times a 
day. I prefer the lotion. A weak solution of nitrate of silver (211) 



418 FEMALE DISEASES. 

will sometimes do well. A four per-cent solution of cocaine is the 
best application. 

When the disease is brought on by masturbation, as it sometimes 
is, this habit must, of course, be broken off before a cure can be 
effected. In this case, also, moderately cold water must be applied 
to the parts several times a day ; some of the preparations of iron 
should be taken, and some active employment be engaged in, which 
will absorb the energies of mind and body. 

Tubal Pregnancy. 

Tubal or ectopic pregnancy is mentioned here in connection with 
womb diseases, because it assumes the symptoms of certain uterine 
affections, and must be so treated. 

When, for any reason, the ovum cannot pass through the Fallo- 
pian tube into the womb, where it is normally impregnated by the 
male germ, but is arrested in the tube, it not infrequently happens 
that the spermatozoon of the male travels upward through the womb 
into the Fallopian tube, and there meets the impeded ovum. Fecun- 
dation takes place, the ovum swells and grows, the tube stretches 
more and more till it bursts, and then a hemorrhage occurs into the 
abdominal cavity, from the leaking tube. A large clot of blood is 
formed, which generally arrests further hemorrhage and causes the 
death of the embryo, but not necessarily; after a time, another 
hemorrhage occurs, with pain, fainting, and even collapse, depend- 
ing on the severity of the hemorrhage. If allowed to follow its 
natural course, the hemorrhage finally causes the patient's death. 
She dies suddenly, as if she were bleeding from a ruptured artery. 
The cause of all this mischief lies in the diseased tube in which the 
obstruction occurred. The Fallopian tubes are lined with a beauti- 
fully constructed mucous membrane: on the ends of the cells are 
small rod-like processes, which look (under the microscope) like a 
field of grain swaying with the wind ; they move in one direction, 
from an erect position toward the uterus, and then relax and straighten 
up again to repeat the process ; thus the ovum which has been grasped 
by the fimbriated ends of the tube from off the outside of the ovary 
(see Fig. 136) is carried down into the interior of the womb, where 
nature meant it should be impregnated. Now, when these tubes be- 
come diseased by catarrhal, and especially by purulent inflammation 
(see Salpingitis), the little rod-like extremities of the cells are de- 
stroyed, and the ovum finds no ready way of getting into the womb. 
An unusually active spermatazoon climbs up into the tube, because 
it has the power of motion so long as it lives ; and thus the trouble 
begins. 

Symptoms. — A woman misses her menstruation, and goes on a 
month ; possibly missing a second or even a third menstruation, 
without many of the usual accompanying symptoms, till suddenly 



FEMALE DISEASES. 419 

she is seized with cramp-like pains in the lower bowel, and takes her 
bed ; she may get up from this first shock of pain (due to hemorr- 
hage), till a second, or even a third still severer attack ensues, when 
the doctor is called. If he is thoughtful, he at once examines and 
finds a bunch in the pelvis, on the side of the pain. This bunch is 
the clot, and the contained sac with the foetus. Not every case is 
taken alike, but many are crippled at the first onset of pain and 
hemorrhage ; inflammation ensues, and sickness in bed attracts the 
attention. Usually, there is some slight hemorrhage of blood 
escaping through the tube into the womb and out into the vagina. 

Treatment. — This disease, like appendicitis, belongs to modern 
surgery, as only recently has it been recognized, and treatment on 
a sound basis been formulated. Death is sure, unless surgical aid 
comes to the rescue. Laparotomy, or opening of the abdomen, must 
be performed at once, the clots washed out of the abdomen, of which, 
usually, there are a quart or more, the sac containing the embryo 
removed, and the tube tied off. The successes are brilliant, and 
lives are daily saved. The operation is a grave one, but not as much 
so as many^ others performed on the abdomen. 

Sterility or Barrenness. 

It has doubtless occurred to every person who has thought upon 
the subject, that there must be some special reasons why so many 
women do not and cannot bear children. These reasons I propose 
now to explain as simply and as plainly as the nature of the subject 
admits. To this explanation I shall add some remarks upon treat- 
ment ; for, in nine cases out of ten, barrenness is completely curable. 

Reproduction. — Throughout nature, life is perpetuated by repro- 
duction. The vegetable and the animal die ; but before death comes, 
they reproduce the germ of a new thing, or being, which lives after 
them. The law of reproduction, throughout the realm of nature, is 
one, and but one. All living things have male and female structures. 
Every new being is evolved from an egg^ the product of an antece- 
dent parent. 

Reproduction consists in the growth of an egg^ or germ, in con- 
nection with some living part, until it is capable of independent exist- 
ence. This germ or egg is the product of the female parent, and will 
abort or perish unless brought into connection with a fructifying ele- 
ment from the male. Thus, two palm-trees, growing about forty miles 
from each other, the one with stamens (the male organs), the other 
with pistils (the female organs), bore no seed for many years; but 
when they had risen in height above all intervening and obstructing 
objects, the winds bore the pollen from the stamens of one to the 
pistillate flowers of the other, which immediately began to produce 
fruit. A knowledge of this great law, as applicable to all living 



420 FEMALE DISEASES. 

things, enables horticulturists to raise such varieties of fruit as they 
wish, by shaking the blooming male branch, which has stamens, over 
the female flowers, supplied with pistils. Sometimes the male and 
female flowers are upon the same plant, at other times, upon differ- 
ent ones. The strawberry is of the latter kind, — the pollen being 
found only on the plants which have the largest flowers, — the pistil- 
late flowers being only on the smaller plants. The pollen, or dust, 
is carried from the male to the female plant, on the feet of honey- 
bees, as they fly from flower to flower. It has been discovered that 
the reason why many beds are unfruitful (strawberry beds, I mean), 
is that the large male-plants are allowed to monopolize the beds to the 
exclusion of the smaller female plants. The plants with large flowers 
should be thinned out, leaving only a few to furnish pollen for the 
females, which are the real bearers. 

A New Branch of Industry. — It is only comparatively recently 
that this law has been understood in its wide applicability. How 
wise and merciful an arrangement of Providence that an unseen 
hand should turn for man the mystic leaves of knowledge at the very 
time when he is most in need of the instruction imparted ! At this 
very moment, the more complete knowledge of this great law is open- 
ing a new branch of industry, and a new supply of food, and is thus 
helping the solution of the great problem of how the increasing in- 
habitants of civilized countries are to be worked and fed. I refer to 
the propagation and culture of fish. 

A committee appointed by the legislature of Massachusetts, re- 
ported very ably upon this subject. The eggs of the fish may be 
fecundated almost as easily as the pistillate flowers of the plant. It 
is only necessary, when the eggs of the female are mature, to hold 
her over a basin of water, and make gentle pressure upon the belly, 
when the eggs will pass freely into the water; then to pass the milt 
of themale into the same water, and shake them thoroughly together. 
By this means, the eggs are impregnated, and fish may be raised to 
any extent. 

The egg of the higher animals is more difficult to fecundate, and 
that of the human female most difficult of all ; for in nature, as in 
art, the more perfect structures are begun and reared with less ease. 

Propriety of Imparting this Knowledge. — Men are naturally 
curious, and love to understand the mystery of their own origin ; 
and yet there is scarcely any subject upon which they have so little 
reliable information. It has been held that this is a kind of informa- 
tion which it is not proper to impart to the multitude ; that the curi- 
osity which seeks this knowledge is based upon improper feelings ; and 
that to gratify it by imparting what is sought, would lead to immor- 
ality. 

I do not believe it. Such ideas are based upon a shallow philoso- 
phy. They overlook the fact that nothing excites the imagination 



FEMALE DISEASES. 



421 



like that which is covered with mystery. It is because the immensely 
important subject of the procreation of the race is so carefully hidden 
from the public eye ; because it is purposely buried so deep in obscu- 
rity, that any allusion to it excites improper thoughts. If the subject 
be properly viewed, it is no more indelicate to explain the mode of 
reproducing a human being than to explain that of propagating a 
plant or a fish. Both are effected in the same way, under precisely 
the same natural law. 

True, the propagation of the human being involves moral laws 
likewise ; but these relate only to the social relations in which it may 
take place, and do not affect in any way the propriety of making it 
understood by the people. 

The Germ Furnished only at Certain Periods. — These general 
remarks bring me to the immediate subject in hand. Throughout 
animated nature, the female furnishes the mature germ or egg only 
at certain periods. The healthy 
human female, — as I have al- 
ready explained, — matures a 
germ once in four weeks. These 
germs or eggs are constantly 
advancing, in succession, from 
the rudest beginning to a state 
of ripeness or maturity. Every 
person must have seen the eggs 
taken from a hen when killed 
in the laying season. Fig. 143 
furnishes a good illustration. 
They are in all stages of progress, 
from the invisible germ up to 
the nearly mature egg. 

Such is the progress of the 
human egg^ — only that it does 
not attain to any such size.' So 
far as the maturing is concerned, 
it occurs in the same gradual way. 

Conception or Impregnation can take place only when a germ or 
egg is ripe ; and as an egg ripens, bursts, and passes into the Fallopian 
tubes and thence to the womb only at the time of menstruation, it is 
plain that conception must happen somewhere in the neighborhood 
of this period. Intercourse with the male may take place at interme- 
diate times ; but, except in some rare instances, conception will not 
occur, because there is no mature egg to be impregnated. 

Now, as every healthy woman brings to maturity a germ or egg at 
the time of every monthly flow, and as every ripened egg is capable, 
under favorable circumstances, of being fecundated, it follows that 
every woman who menstruates, and is well, can, under certain cir- 




FlG. 143. 



422 



FEMALE DISEASES. 



cumstances, be impregnated. To effect it, it is only necessary that 
the vivifying portion of the male semen, called spermatozoa, come 
into union with the ripened egg. 

This union (for, that men and women may have a ehance to know 
as much about themselves as they do about fishes and plants, I pro- 
pose to make the whole subject plain) takes place in the following 
way. In the act of copulation, the male organ penetrates the vagina, 
and deposits the sperm, spermatic fluid, semen, or, as the scriptures 
call it, the " seed," directly at the mouth of the uterine neck. Some 
suppose that when the sensation of the female is at its height, the 
womb opens to receive the injected semen. But this is uncertain. 
This spermatic fluid is composed, in large part, of mucus. A 
smaller portion of it is secreted by the testi- 
cles, and is the true semen, or life-giving prin- 
ciple. Tins last portion is composed, almost 
entirety, of fertilizing filaments or vesicles, 
which look like small animals (Fig. 144), and 
for a long time were supposed to be animal- 
cules. They are generally called sjiermatozoa. 
By some mysterious law of their nature, they 
are endowed with the power of motion; and 
when deposited near the mouth of the womb, 
they immediately begin to move, as if by in- 
a ripened egg. 




Fig. 144. 



stinct, in search of 
Passing through the uterine neck, they 
enter the womb. If an egg be found, 
in its ripened condition, they imme- 
diately embrace it, and, in some mys- 
terious way, mingling their own con- 
tents with the contents of the egg, 
they impregnate or fertilize it. Fig. 
145 shows the womb divided length- 
wise. A, is the internal month (os in- 
ternum), or point where the canal 
through the uterine neck enters the 
body of the womb ; B, is the external 
mouth (os externum) ; the space be- 
tween A and B, the passage through 
the neck; and C, C, the points where 
the Fallopian tubes begin. By looking 
back now, and examining Fig. 136, the 
whole thing will be understood. 

This is a very brief and simple ac- 
count of impregnation. It is supposed 
to be capable of taking place either a 
little before or a little after the monthly 
flow, and not at intermediate times, for the reason already stated. 




Fig. 145. 



FEMALE DISEASES. 4Z«3 

There are some reasons for believing that the same egg or germ, if 
fertilized just before the courses, will grow to be a male, while, if 
fecundated after the turns, it will be a female. One reason for this 
supposition is, that plants may be made to bear male or female 
flowers by simply subjecting them to different degrees of heat. If 
there be more heat than light, male flowers are produced ; if more 
light than heat, female flowers are the result. The heat of the female 
generative organs is raised to its highest degree about the time the 
egg bursts its covering, which is just before the beginning of the flow. 
It has been thought that the right ovary produces males, and the 
left ovary females ; but this theory is not supported by any facts, and 
is probably not true. 

Causes of Sterility. — From what has been said, it would appear 
that to ensure child-bearing it is only necessary that semen or seed, 
containing spermatozoa, come in contact with a germ-vesicle or egg, 
at the right time ; that there be no hindering disease ; and that the 
parties cohabiting be adapted to each other. 

It is evident enough that a want of adaptation between the parties, 
physical or moral, or both, is often an absolute bar to conception. 
A lack of moral adaptation was probably the obstacle in the case of 
Napoleon and Josephine, — her marriage with a previous husband, 
and his with a subsequent wife having both been fruitful. 

It is certain that indifference on the part of the wife towards the 
husband, and especially repugnance, may prove an obstacle. A mere 
lack of sexual feeling does not necessarily prove a bar, though it 
probably lessens the chances of a fruitful union. 

Conception may fail to take place from the diminutiveness of the 
male organ, — the semen not being deposited in the right place ; or, 
from its excessive largeness, — penetration of the vagina being impos- 
sible. In some rare cases, the womb is absent. The inflammation 
of the ovaries often prevents the ripening of eggs. The Fallopian 
tubes occasionally get diseased and plugged up, so that no egg can 
pass to the womb. Inflammation in the cavity of the uterine neck 
is probably the most frequent of all the causes of sterility. The 
viscid, gluey matter which is secreted in inflammatory conditions of 
this part, plugs up the passage, so that no spermatozoa can pass up 
in search of the egg. The acrid discharges in most of the cases of 
whites destroy the fertilizing spermatozoa, and render conception im- 
possible. All the displacements of the womb may act as bars to 
impregnation. If it fall over backward or forward, the mouth is 
tilted up before, or down behind, and is not in the right position to 
receive the semen. One of the most general causes is trying to avoid 
pregnancy in early years of married life. 

Treatment. — Judicious treatment will, in most cases, remove 
sterility, and open that "well-spring of pleasure," which the poet 
has so felicitously described as — "a baby in the house." 



424 FEMALE DISEASES. 

The obstacles to conception, stated above, are chiefly those diseases 
which have been previously described. To cure those diseases is to 
remove the obstacles. When it is dependent on the causes which 
produce painful menstruation, or profuse menstruation, or a suppres- 
sion of menstruation, the remedies are the same as are pointed out 
for those complaints. If inflammation of the ovaries be the cause, a 
cure may be effected, provided the inflamed condition be removed 
before the bundle of eggs be destroyed. If inflammation or ulcera- 
tion of the neck of the womb be the obstacle, the remedy may be 
found in the treatment recommended for those affections. 

Sterility depending on the causes just mentioned, I have had the 
pleasure of curing many times. When dependent on a lack of phys- 
ical or moral adaptation between the parties, it does not, of course, 
admit of relief. It is a misfortune to be borne in silence. It has 
happened, perhaps, through a lack of judgment or care in selecting 
a partner, and is one of the mistakes of a lifetime which a lifetime 
cannot repair. When this want of adaptation is not complete, a rem- 
edy may frequently be found. 

Unfortunately, many females do not regard sterility as an evil to 
be deplored, but rather as a blessing to be desired. Life, to them, 
has no high aims or duties, — it is a round of fashion and pleasure. 
To bear and rear children interrupts their frivolities, and they seek to 
escape such abridgement of their pleasures. This is wrong. Life is 
a great theatre, in which all should strive to act some worthy part, 
and feel that, upon retiring, it would be wrong to leave their garments 
upon the vacant stage, with none to put them on, and continue the 
drama. 

Midwifery, 

A stoppage of her courses is most commonly the first notice a 
woman has of her being in the family way. This is perceived about 
three weeks after conception, when she begins to experience other 
feelings peculiar to the situation. These feelings are nausea and vom- 
iting, or a decided languor, in the morning ; swelled and sometimes 
painful breasts ; the areolae, or colored rings around the nipples, darker 
than usual ; pain in the lower part of the back ; and, occasionally, a 
good deal of spitting of a frothy, cotton-like substance. 

These symptoms are more or less severe in different cases, and 
under different circumstances, according to the state of the patient's 
bowels and her habits of exercise. Ordinarily, she suffers most dur- 
ing the second and third months, on account of 

Sinking Down of the Womb, which, from soon after the period of 
conception, is gradually increasing in size and weight. As it grows 
larger and heavier, it sinks lower in the cavity of the pelvis, until 
about the fourth month, when, becoming so large that it cannot longer 
be accommodated within the narrow limits of this unyielding box of 



FEMALE DISEASES. , 425 

bones, it is obliged to mount higher to find room in the ampler and 
more distensible belly. This low position of the womb in the early- 
months of pregnancy occasions many disagreeble sensations, — as 
pain in the lower part of the back and sickness at the stomach. 

The Costiveness, too, from which women suffer so much at this 
time, is often caused, in part at least, by the pressure of the enlarged 
womb upon the lower bowel. Costiveness, thus induced, at length 
becomes itself a cause of serious mischief. The lower bowel, filled 
and enlarged with its hardened contents, reacts upon the womb, 
crowding it still lower in its narrow quarters, and greatly increasing 
its excitability. The enlarged bowel and womb combined make 
constant pressure, sometimes upon the urethra, or water-pipe, causing 
pain and difficulty in making water, and always upon the ascending 
veins, checking the return of blood, and producing congestion in the 
lower bowel, manifested by troublesome piles. 

Treatment of Pregnancy. — When the pregnant woman first rec- 
ognizes her situation, she should determine to " observe moderation 
in all things." Let her avoid violent and sudden exertion, and move 
about more calmly and evenly than usual. By this is not meant that 
she should give up her customary occupation ; but that she should 
pursue it with becoming carefulness, resolved in no case to hazard 
over-exertion, and rather leaning to the side of indolence. This 
would not be real indolence, for she is doing a great work internally, 
and should not unduly withdraw her energies to external affairs. 

Let her not be too much in the erect position. If of delicate 
constitution, and not in vigorous health, she should make it a point 
to lie down several times during the day. The standing position, 
continued for a long time, especially if it be under circumstances 
to induce fatigue, greatly favors the descent of the womb, — while 
a frequent rest in a horizontal position may enable it to keep its 
place. 

An Objection. — It may be objected by some, that a large majority 
of the mothers in the world are working women, and obliged to con- 
tribute by their industry to the support of their families ; and that 
they cannot afford, therefore, to lie still, and mind directions. 

To this it may be answered, that it is a great advantage to under- 
stand the best way, so as to have the privilege of at least aiming at 
it. Much is accomplished, in all circumstances, by aiming at doing 
the best thing ; and few women are so situated that they could not 
so favor themselves as to obey the laws of health a little more per- 
fectly, if they thoroughly understood them. All can better afford to 
avoid sickness, than to be sick. Many occupations, also, unless 
money tempt to excessive application, become, when steadily fol- 
lowed, comparatively easy and unexciting. Thus, most people can 
go through their usual round of duties, because they have got used 
to it. Indeed, there is nothing but indolence itself, to which we may 



426 FEMALE DISEASES. 

not become accustomed. The difference between the laboring and 
the privileged classes is more imaginary than real. All must work. 
None can escape the primeval decree — " In the sweat of thy face 
shalt thou eat bread." 

Many women, when they find themselves in the family way, will 
observe no caution, but work all the harder, and even use other 
means for the purpose of bringing on abortion, and preventing an 
increase of children. This unnatural and wicked, but too prevalent, 
disposition, results sometimes from a fear of the pains of child-birth, 
sometimes from a desire to avoid the necessary care and confinement 
connected with raising children, but most often from a wish to escape 
the expenses which the prevailing fashions and customs of society 
connect with a large family. The cost of a shattered nervous sys- 
tem, and of a body weakened and poisoned by powerful drugs, is not 
considered, because not understood ! Hence the success of those 
quack advertisements, impudently professing to cure female diseases, 
but whose chief object is disclosed by the insertion of the hypocritical 
caution — " Be careful not to take this medicine during pregnancy, as 
it will be sure to produce abortion." 

It seems as if the world would never learn that God loves children, 
although since Abraham's day he has said so much about them in 
his Word, although His Son, sent into the world on purpose to 
show the disposition of the Father, took them up in his arms, and 
blessed them, and although He has implanted a most wonderful 
love of them in the soul of man. 

Costiveness and Piles. — Let the pregnant woman use all proper 
means to keep her bowels in order. She will thus greatly diminish 
the distressing nausea, and may entirely prevent the accession of 
piles. To accomplish this object, the saline aperients (7), (5), or, oc- 
casionally, other mild cathartics (10), (12), (14), maybe used. But 
more important than either or all of these is the frequent use of a 
good self-injecting family syringe. An injection of half a pint of 
cold water every morning will do much towards regulating the 
bowels, and preventing or curing piles. 

Nausea. — If, as sometimes happens, there should be persistent 
nausea after the first three months, it will need to be combated by 
mild tonics and stimulants, as chamomile tea, or clove tea (58), 
(114), and by seeking a kind of diet which will be agreeable both to 
the palate and the stomach. Ten grains of ingluvin after each meal, 
and on arising, oftentimes prevent vomiting. Stretching the neck 
of the womb moderately, and replacing a retroverted womb, are fore- 
most in importance of treatment when structural causes demand such 
interference. 

The Nipples. — During the last month, particular attention should 
be paid to the nipples. Untold misery often results to the young 
mother from sore nipples; and it is well worth her while to use every 



FEMALE DISEASES. 427 

precaution against them. The nipples are, of course, in an excitable 
state during the whole period of gestation, and at length frequently 
become irritable and tender. Let them be daily bathed, for three or 
four weeks before confinement, with some astringent and cooling 
lotion, as oak-bark decoction, borax water, alum-water, or a solution 
of tannin (200), (201), (202), (203). 

The object of treatment, in this case, is to toughen them and ren- 
der them less susceptible, so that they may not be made tender by the 
subsequent application of the child's lips. 

When a woman is peculiarly liable to this trouble, the further pre- 
caution of having them gently drawn by some friend, every day, 
during this last month, would be of great service. 

At all events, let no pains be spared to guard against this evil ; for 
sore nipples make sore breasts, and sore breasts make broken breasts; 
and broken breasts are terrible things. They make the mother sick ; 
and if the mother is sick, the child is sure to be sick ; and all hands 
soon get sick and worried, and the whole business of having children, 
and taking care of them, is deprived of its peculiar joys and consola- 
tions, and brought into undeserved disrepute. Whereas, under wise 
and prudent management, there is something delightful to the young 
mother in yielding sustenance to her dependent offspring. For, when 
her nipples and breasts are in a healthy state, she can say with the 
poet, as 

" The starting beverage meets its thirsty lip, 
'Tis joy to yield it, as 't is joy to sip." 

Swathing. — In advanced pregnancy, much assistance in supporting 
the burden is sometimes derived from swathing the bowels. Healthy 
and vigorous women, however, need no such assistance ; it is chiefly 
applicable to cases of debility, either constitutional, or resulting from 
neglect, or from over-exertion during former pregnancies. 

Cramp in the Stomach is sometimes very severe, and if allowed to 
continue, may kill the child. The best remedies are warm carmina- 
tives (114), (115), or anodynes, etc. (121), (122), or antispasmodics 
(90), (94). 

Headaches. — These maybe relieved by antispasmodics, etc. (90), 
(94), or anodynes (121). 

Palpitation of the Heart may prove very distressing to delicate 
women. The remedies are the antispasmodics, with rest. Some- 
times tonics are useful, such as the muriated tincture of iron (73). 
The bowels should be carefully regulated. 

Fainting, which occurs before or at the time of quickening, is some- 
times very troublesome. The proper treatment is the avoidance of 
fatigue, and, during the fainting fit, the recumbent posture, cool air, 
application of cold water to the face, and ammonia to the nose. 

Cough is sometimes present. It is caused by the upward pressure 



428 FEMALE DISEASES. 

of the diaphragm against the lungs, by which they are irritated and 
convulsed. The remedies may be selected from the cough prepara- 
tions among the prescriptions. 

Varicose Veins. — These cannot be removed during pregnancy ; 
but they may be relieved by great care of the bowels, and by wearing 
tight bandages, or elastic stockings. 

Swelling of Lower Limbs is caused by pressure of the enlarged 
womb upon the veins ; and may be relieved by care of the bowels, 
and diuretics (130). 

Itching of the Gentials may be much relieved by borax, camphor, 
etc. A four-per-cent solution of cocaine, painted on, gives most 
relief, and is most curative. 

Miscarriage. — Abortion. 

When a woman in the family way throws off the contents of her 
womb, or loses her child, during the first six months, the accident is 
a miscarriage, or abortion ; when the same thing happens during the 
last three months of her term, it is a premature labor. 

Symptoms. — If abortion occur during the first month after con- 
ception, the symptoms may not attract much attention or, may be 
regarded only as an irregularity of menstruation. Occurring at later 
periods, it is frequently indicated by some feverishness, coldness of 
the feet and legs, a puffed-up condition of the eye-lids with purplish 
discolorations, shooting pains in the breasts, which become soft, pains 
in the back, bearing-down pains in the lower part of the bowels, 
which come and go, and at length take the character of real labor 
pains. As these pains increase, blood begins to appear, and, sooner 
or later, the bag of water breaks, and the foetus is thrown off. 

Causes. — These are very numerous. Some of the principal are, 
displacement of the womb ; ulceration of its neck ; syphilitic disease 
of the foetus received from the parent ; too much exercise ; heavy 
lifting ; falls, particularly when the woman comes down upon the 
feet, and is heavily jarred ; emetics ; powerful purges ; and too much 
nuptial indulgence. 

Treatment. — Where the symptoms are but slight, nothing may 
be required more than a little caution for a few days, and rest in the 
horizontal posture, using cold drinks, and taking for two or three 
nights, at bedtime, perhaps, a pill composed of one grain of camphor 
and two grains of sugar of lead. Besides these remedies, it may be 
well to put a mustard-poultice low down upon the back. 

If, notwithstanding, flooding comes on, and the symptoms of mis- 
carriage increase, a napkin wetted with cold water, or vinegar and 
water, or a bladder partly filled with ice, should be laid upon the ex- 



FEMALE DISEASES. 429 

ternal genitals, and pulverized alum, mixed up with a little honey, 
must be given internally, every half hour ; and if the flooding still 
increase, it may be proper in some cases to resort to the tampon or 
plug. To do this, take either lint, or absorbent cotton, or a piece of 
fine sponge, and having soaked it full of a strong solution of alum, 
or tannin, or, still better, Monsel's persalt of iron, one part to six 
parts of water, fill the vagina full, and then place a fold of linen 
in the genital fissure, and apply a bandage. This will generally stop 
the flow ; but the. plug must be removed in from five to ten hours. 

If the abortion cannot be prevented, — especially in the latter 
months of gestation, — then the case is to be permitted to go on, 
and to be treated the same as a natural labor. . 

Abortion (Criminal). 

Many married people who consider the bearing of children a bur- 
den, and those who suffer from a lapse of virtue, are tempted to 
commit abortion. 

I wish it were possible for me to express to them the sin and folly 
of such a course. The sufferings and evils that almost always follow 
are far worse than any care or shame which come from letting nature 
take its course. Any crime against nature is sure to be punished. 
In this case, consumption, nervous prostration, and various womb 
complaints are the usual accompaniments, ruining the future life or 
usefulness of, the woman, until finally life becomes a burden to her- 
self and friends ; it usually being impossible to obtain a cure, though 
she seek it carefully and with tears. No conscientious physician will 
commit abortion. She will be obliged to trust herself in the hands 
of quacks and rascals, who commit the crime either with medicine 
or instruments, in one case ruining the digestion, in the other the 
womb. Nature has not provided any way in which it can be done 
with safety, and it is justifiable in no case except when it will save 
the life of the mother. 

Prevention of Pregnancy. 

There are many cases in which, on account of some contagious 
or hereditary disease, it is not advisable for the wife to become preg- 
nant. It is not always advisable for a wife to have children too fast, 
the constitution not being strong enough to stand the strain of bear- 
ing children, or the care of bringing them up. In such cases, while 
it would' be wrong to commit abortion, it would be desirable to avoid 
pregnancy. I do not agree with many of the fashionable women of 
this age who consider the bearing of children a burden, and who do 
not know the joy of a baby in the house. How little they realize 
that the happiness and pleasure of a family of children is far greater 
than the care. That love makes labor light. It is hard for the 
young to realize the lonesomeness of childless old age. 



430 FEMALE DISEASES. 

While it may not be best to have children too fast when young, 
they must realize that if protective measures are carried on too long 
it will be impossible for the woman to become pregnant. Nature 
has provided a reasonable way ; if there is no coition for ten days 
after the courses, or three days before, the chances of pregnancy are 
much diminished. Douching with warm or tepid water (never on any 
condition use cold water), immediately after coition, is perhaps the most 
commonly used method to prevent conception. The addition of 
carbolic acid (one teaspoonful to the pint of water) is an extra safe- 
guard. Two quarts of water is none too much to use, although a 
pint might be sufficient. The safest, least harmful method to the 
woman with which I am acquainted, consists in the insertion into the 
vagina, as high as possible, of a tampon of wool. This piece of wool 
must first be moistened with glycerine and water, or vaseline, and 
bound by a small string to its centre. It should be about two inches 
square, possibly a bit smaller for some women. It is most easily 
inserted by the woman when lying on her back. .After coition, this 
wool is withdrawn by means of the string, and a warm douche taken. 
This procedure is not only certain to prevent conception, but is abso- 
lutely devoid of danger. 

There are condoms made of fine rubber, which can be bought of 
druggists, which are absolutely safe ; before use they should be wet 
with soap-suds or vaseline. This is not a healthy habit, and I would 
not advise its use, except where there is danger of a contagious dis- 
ease, or where it would endanger the life of the woman by becoming 
pregnant. 

In conclusion, I would say, the nearer a couple live to nature, the 
better and happier they will be. 

Labor. — Delivery. 

The expulsion, at full term, of the child, the after-birth, the mem- 
branes, and the fluids, constitutes labor, or delivery. It is supposed 
to occur about two hundred and eighty days after the last menstrua- 
tion ; but authors reckon it differently ; in truth, it is not possible to 
fix it exactly, for it evidently varies in different cases. 

When the time of her lying-in arrives, let every woman meet it 
with calmness and undoubting confidence. There is every reason to 
encourage this state of mind. Think of the vast multitudes of peo- 
ple in the world. Each once existed in the womb of a mother, and 
had to pass through its narrow portals to be admitted to the light. 
Successful delivery is the rule, the world over ; and it should be the 
rule to confidently expect it. 

In the midst of the pains of labor, nothing does more to bring to 
favorable result than courage and patience. Patience is able calmly 
to survey all the difficulties before her, because she never attempts to 
encounter but one at a time. There is much philosophy in the story 



FEMALE DISEASES. 431 

of the " discontented pendulum" which got discouraged, one morning, 
from reflecting how many millions of times it would have to swing 
during succeeding years, but became reassured upon considering that 
a single stroke cost but a very trifling effort, and that it really had 
to make but one at a time. So it is with labor ; its pains, which are 
really severe and agonizing, will become comparatively tolerable, if 
the whole attention of the woman be confined to present suffering, 
and her whole stock of courage and patience be brought to bear upon 
one pang at a time. 

Let her resist the temptation to a feeling of haste. Nature will 
often proceed more evenly and more speedily if allowed to take her 
own time. A hurry to get through is a great obstacle to successful 
delivery ; it always puts things back. 

Symptoms: — One of the first indications that labor is about to 
begin is, that the woman finds herself smaller, — the child having 
sunk down lower in the abdomen, and she accordingly breathes 
easier. The genital organs become relaxed and moist, and mucus 
escapes, which is called " the shows." The woman finds herself dis- 
posed to be nervous and fidgety, and perhaps a little depressed in 
spirits. 

When labor has fully set in, it is marked by lowness of spirits, 
flashes of heat and cold, a great desire to empty the bowels and to 
make water, and grinding, cutting pains, which grow stronger and 
more continuous, with intervals of ten or fifteen minutes' ease be- 
tween. Vomiting in the early stages of labor often occurs, and may 
be regarded as favorable, — indicating the softening and opening of 
the mouth of the womb. 

Treatment of Labor. — When labor begins, the attention should 
be directed to the state of the bowels and bladder. The child's head 
begins early to press upon the bladder and lower bowel, causing the- 
desire to make water, etc. ; and these should be immediately emptied 
to make room for the head to pass more easily. The bowel may be 
freed by a dose of castor-oil (10), if there is time for it to operate, — 
but more surely, and more satisfactorily, by an injection. Relief in 
the bladder may, perhaps, be obtained by a different position of the 
woman in the act of making water. • It is the pressure of the child's 
head upon the water-pipe which causes the trouble ; and to relieve it, 
the woman should get upon her hands and knees, with her shoulders 
lower than the hips, so as to throw the child upward and forward 
towards the cavity of the abdomen. Thus situated, she may often 
find it easy to make water, when in the ordinary position it would be 
impossible. If, however, this manoeuvre does not succeed, and the 
bladder becomes greatly distended, the catheter must be used. 

The Bed and Habiliments. — In the next place, fix the bed and 

the patient's habiliments. Reject feather beds ; use the mattress. 
Cover this with a rubber cloth, if convenient, and then with folded 



432 FEMALE DISEASES. 

sheets to absorb the discharges, and protect the bed. Let the woman 
be arrayed in the same garments she expects to wear after the com- 
pletion of the labor, and let these be well tucked up under her arms, 
and let the lower portion of her body, from the waist downwards, be 
enveloped in a sheet. This sheet can be easily removed, and the 
clean clothes pulled down without greatly disturbing the patient when 
in the exhausted state which follows labor, and when it would subject 
her to great fatigue to be obliged to sit up in bed to have her clothes 
changed. Let her lie upon her left side, with her body shortened by 
bending forward, so that the muscles may be relaxed ; let her head 
be placed in the middle of the bed, and her feet press against the 
right foot-post. Around this post a shawl or towel may be fastened, 
upon which she may be allowed to pull during the pains. 

Antiseptic Dressings. 

In one essential particular, the case of the modern woman differs 
widely from that of our grandmothers. Childbed-fever, blood-poison- 
ing, and other similar germ-diseases, have been from time immemo- 
rial the bete noire of the lying-in chamber, and the odium of the 
medical profession. Since the discovery by Sir Joseph Lister, of 
England, that these diseases were caused by the introduction of 
germ bacilli into the living tissue, and that to prevent them it is 
only necessary to kill these germs on all things which in any way 
come in contact with the mother's private parts, these diseases have 
become very much less frequent in occurrence, and much less fatal. 
We know now that the skin and vagina even normally contain living 
germs which act as scavengers of dirt, and exert a beneficial influence 
on health, so long as they remain in their natural abodes ; let them, 
however, be introduced into the system through raw surfaces, tears 
and excoriations consequent on labor, and the group of symptoms 
generated by this poison is truly frightful to think of. 

To avert such catastrophes, it must be the aim of the physician 
and nurse, and even the patient, to use scrupulous care in keeping 
away from the patient anything which has not first been rendered 
absolutely clean or germ-free. 

It thus becomes evident that, first of all, as soon as labor sets in, 
the thighs and privates should be thoroughly washed with soap and 
some antiseptic, as, for instance, a five per-cent solution of carbolic- 
acid, or better, sulpho-naphthol solution, which ma}* be made by adding 
one-half teaspoonful of sulpho-naphthol, or " oil of milk," to a quart of 
water ; better still is a solution of corrosive sublimate of the strength 
of one part in two or three thousand parts of water. This poison- 
ous drug is best bought in tablet form, so that by adding one tablet 
to two quarts of water, we have the required solution. During labor, 
and even after, all napkins and cloths used to protect or wipe the 
woman, must be wet in one of these solutions, or otherwise disin- 






FEMALE DISEASES. 433 

fected. Every examination by the physician or nurse must be made 
only after thorough scrubbing of the hands with soap and some dis- 
infectant. The napkins used may either be wrung out of these solu- 
tions, or steamed an hour before using. 

By such precautions we may expect to avoid blood-poisoning. The 
nurse must always wash and disinfect her hands before giving a 
douche or handling the patient's private parts. The douche is always 
a source of vexation to nurses, and the matter may here be thus 
stated : unless there has been given an order by the physician to the 
contrary, never use a douche after the baby is born. 

Remember the principle of always keeping surgically clean, i. e. 
germ-free, all objects which come in contact with the lying-in woman. 

The Presentation. — An examination with the finger is to be made 
to learn the presentation, — that is, to learn which part of the child 
comes first into the mouth of the womb. 

Head Presentation If the head present, the labor will probably 

go on without the need of medical aid. But in all labors there is a 
liability to dangers from unforseen accidents, which renders the at- 
tendance of an intelligent physician highly prudential. 

Breech or Feet Presentation. — If the feet or breech present, it is 
desirable to have the first part of the labor proceed slowly, so that 
the passage may become well dilated, and prepared for a more rapid 
delivery of the head. If the breech present, do not pull down the 
feet ; let the child come double ; it will make more room for the head. 
If the feet present, let there be no pulling upon them to hasten the 
birth of the breech. 

After the feet and breech have fully cleared the external orifice, 
the delivery may be judiciously hastened for the purpose of prevent- 
ing the death of the child from pressure on the umbilical cord, before 
its head is brought to the air, and the act of breathing thus permitted. 
For after the pulsations of the cord cease, the child must either 
breathe or die. 

In this kind of presentation, therefore, the child's life is in great 
danger. After the birth of the lower half of the body, the cord ex- 
periences severe pressure, sufficient to interrupt if not wholly prevent 
its pulsations. It then becomes necessary to hasten the birth of the 
upper extremities and head by all prudent means. Violence is never 
in order in midwifery ; but considerable force, skillfully directed, may 
sometimes be safely used. After the shoulders are delivered, the pas- 
sage of the head may be facilitated by carefully pulling down the 
arms. Then, as soon as possible, introduce the finger into the mouth 
of the child. This will serve the double purpose, perhaps, of per- 
mitting a little air to make its way into the child's lungs, and of fur- 
nishing a hold by which its head may be gently drawn along into the 
world. 

If there is much delay at this juncture, perhaps in some cases the 



434 FEMALE DISEASES. 

child's life may be preserved by inserting into its mouth one end of a 
male catheter, — thus furnishing an open tube for the passage of air, 
until more vigorous pains shall introduce it into the full liberty of the 
atmosphere. While the head is yet undelivered, great care should be 
used to keep the child's body warm by covering it with flannel, and 
also to keep it in a correct relative position with the head. If the 
body be incautiously turned round, of course the neck will be twisted ; 
and the child's subsequent delivery with a broken neck will be the 
miserable result, bringing confusion to the medical attendant, and 
unhappiness to all concerned. 

Arm or Shoulder Presentation If the arm or shoulder present, 

the child will probably have to be turned. In case this cannot be 
effected, its chest must be opened and emptied of its contents, that 
there may be room to bring down the head. It is barely possible to 
avoid a resort to art in this presentation. 

Flooding or Hemorrhage, occurring to an alarming extent, is hap- 
pily one of the rare incidents or consequences of labor. But when it 
does occur, it demands the most serious and prompt attention. 

Profuse bleeding from the womb is most commonly owing to a 
partial separation of the placenta, or afterbirth, from its attachment 
to the internal cavity; and it has been observed that the flow 
proceeds more rapidly from the detached portion of the afterbirth 
than from the corresponding exposed surface of the womb. A knowl- 
edge of this fact has an important practical bearing ; for if, in severe 
cases of flooding, the partially detached afterbirth can be entirely 
separated, the bleeding will often be speedily arrested. 

The most dangerous floodings occur in cases of placenta previa, 
when the afterbirth is over the mouth of the womb. In such cases, 
when the labor commences, and the womb begins to open itself, the 
afterbirth of course must be partially separated. These cases, unless 
promptly relieved by art, may prove fatal in a few minutes. Yet 
there is ordinarily sufficient time, if it be improved, calmly to choose 
and pursue the proper treatment. If the flooding be immediately 
dangerous to life, the child must be turned and delivered, or the 
tampon or plug be applied, as directed under the head of abortion. 
This expedient is used when, through rigidity of the mouth of the 
womb, the delivery is inadmissible. 

Before Delivery In all cases of flooding, we prescribe quiet, the 

recumbent posture, cold applications to the abdomen and the external 
genitals, and the internal administration of astringents and anodynes 
(151). 

After Delivery, our object is to promote contraction of the womb 
by cold applications and frictions externally, or, if necessary, by the 
introduction of the hand into the womb, for the purpose of removing 
the afterbirth, clearing out clots, or stimulating it to shut itself up for 



FEMALE DISEASES. 435 

the expulsion of the offending substance. Until this contraction is 
secured, the plug should not be used, lest internal bleeding into the 
enlarged and expanded womb should be profuse, and fatally exhaust 
the patient. 

After the Child is Born, our first duty is, if possible, to see that it 
breathes. In the vast majority of cases, the well-known cry which 
salutes the ear gives proof that the duty is unnecessary. But some- 
times we do not hear the welcome sound. The umbilical cord may 
be once or repeatedly wound around the child's neck, and must be 
immediately removed to prevent strangulation ; or, the child's mouth 
may be filled with phlegm, or some sticky mucus, which must be 
poked out with the finger, and its exit favored by turning the face 
downward; or, after tedious labors, the child may be born in a very 
feeble state, and may need the stimulus of cold water thrown sud- 
denly, in small quantities, upon its chest and body, with considerable 
rubbing, and perhaps the inflation of its lungs with air blown into its 
mouth. 

Tying the Cord. — When breathing is established, a piece of narrow 
tape or common twine is to be tied tight around the navel-string, 
about two inches from the child's navel, and the cord is then to be 
cut off, with a pair of sharp scissors, from half to three quarters of 
an inch outside the place where it is tied. The child is then to be 
delivered to the nurse. 

Washing the Child. — The child is now, while the physician is at- 
tending to the mother, to be washed and dressed by the nurse. Its 
skin is at this time covered with a suet-like substance, called the 
vernix caseosa. To remove this, it should be washed all over gently 
with warm water and castile soap. It is not material that this coat- 
ing should be absolutely all removed at the first washing ; but the 
soap and water should be again gently applied in eight or ten hours 
from their first use. It is improper to use spirits for this cleansing. 
All rough rubbing must be avoided as injurious to the delicate skin 
of so tender an infant. Washing with cold water would lower the 
temperature to a dangerous degree, and should in no case be allowed. 

Removal of the After=Birth. — The woman having rested fifteen 
or twenty minutes, a little gentle soliciting or pressure on the womb 
will generally bring away the after-birth. If, however, any serious 
obstacle prevent its expulsion, it may be slowly and cautiously taken 
away by the hand introduced. 

Cleansing the Bed, and Applying the Swathe. — Upon the re- 
moval of the afterbirth, a disinfected napkin is immediately applied 
to the external organs, a drink of water or tea administered, and 
another rest of an hour or more allowed. The swathe may consist 
of a towel pinned snugly around the body, or of a cloth, cut and 
fitted exactly for the purpose. Its object is to afford a firm and 
steady support to the contracting womb. 



436 FEMALE DISEASES. 

The Dressings for the Child's Navel should be so fixed that the 
navel-string or cord will not be left in contact with the healthy skin. 
To effect this, make a hole large enough to admit the cord in the 
centre of a piece of linen cloth four inches square ; pull the cord 
through this hole, leaving the cloth lying flat upon the child's belly; 
then, having bandaged the cord down to the belly, fold the cloth over 
it, and apply the belly-band. The interposition of these dressings 
will thus keep the cord, which is dead and in process of decomposi- 
tion, from irritating, and perhaps excoriating the living flesh, with 
which it must otherwise be in close contact. To wrap the stump of 
the cord in fresh absorbent cotton is another neat, dry, and practical 
method of treating it. 

Nourishment of the Child, etc. — After being dressed, the child 
should be kept next the body of the mother or nurse, that it may 
receive the natural warmth thus to be derived. Its nourishment 
should be obtained exclusively from the mother's breast. If it is 
hungry, be sure and keep it so. There is nothing more appropriate 
than a hungry child all ready to take hold and exhaust the full and 
almost bursting breast on the third day, when the milk has come. 
Alas ! How many children have been fed on sweetened water, and 
on milk and water, till they have lost all instinctive idea of, and all 
appetite for, nursing ! and how many bowel complaints and broken 
breasts have been the miserable consequence ! But meddlesome 
friends are afraid the " little dears " will starve ; and therefore they 
must, first be made sick by unnatural diet, and then for their cure be 
treated to that filthy, harsh, and indecent substitute for medicine, 
chamber-lye and molasses I 

But it maybe asked, "must not the child be fed at all, if it is hun- 
gry, and cries a great deal, and there is nothing in the mother's breast 
for it?" Such cases will be exceedingly rare, if the breasts have 
been properly solicited from the first by a hungry child. When they 
do occur, being themselves exceptions, their treatment must be ex- 
ceptional; but, even then, only so far as is absolutely necessary. If 
fed at all, the child should not be fed to satiety, but as little as the 
circumstances will possibly permit. The great rule remains : keep 
the child as hungry as possible till the milk comes. When it has to 
be fed, imitate the mother's milk as nearly as possible in the prepa- 
ration of the artificial diet. A little sweet cream, warm water and 
sugar, should be so mingled, that in warmth, richness, and sweetness, 
the mixture may closely resemble human milk. (See page 447.) 

Diet of the Mother. — For the first few days after confinement, the 
most appropriate diet for the mother is gruel, cocoa, rice-water, crust 
coffee, or some similar liquid nourishment. Different constitutions, 
however, need somewhat different management. 

A woman naturally robust, and of full habit, should confine herself 
more strictly, and for a longer time, to this light diet, than one who 






FEMALE DISEASES. 437 

is more slender and feeble. In some cases, weakly women require 
the juice of meat, and even wine or ale, as early as the second or third 
day. If she be subject to canker, or nursing-sore mouth, a generous 
diet is particularly serviceable. After the first week, she may gradu- 
ally return to her customary diet. 

Costiveness may be treated with the usual remedies. It was an 
old rule to give a dose of castor-oil on the third day, when there is a 
little increase of excitement in the system, from the filling of the 
breasts. This is not always necessary, and in most cases an injection 
would be far better. The mother should stay in bed from three to 
four weeks, according to the state of her general health. A little 
time now is a great gain later. 

The Perpendicular Position. — During the first month, let the 
woman avoid being often or long on her feet. This is a very essential 
caution to avoid prolapsus, or falling of the womb, with all its atten- 
dant weaknesses and pains, and to ensure a good " getting up," with 
a sound womb, in the right place, and subsequent months of health 
and enjoyment. 

Milk Leg. — Phlegmasia Dolens. — Crural Phlebitis. 

The popular idea is, that in this disease the woman's milk has 
fallen into her leg, which has inflamed. This is of course absurd. 
As to the real nature of the complaint, there are various opinions, — 
some holding it to consist in inflammation along the sciatic, crural, 
and pubic nerves ; others, that it is an inflammation of the lympha- 
tics of the groin which causes it ; others, that it is an inflammation 
of the crural veins. The fact of the matter is that this disease is one 
of the many evidences of septic matter entering the circulation and 
setting up local trouble where it is deposited. It is, in other words, 
a mild form of pre-existing blood-poisoning. 

Symptoms. — The disease begins in from two to seven weeks after 
delivery, with pain in the lower bowel, groin, or thigh. The pain is 
more violent when the thigh is extended. In a day or two, the pain 
diminishes, and the limb begins to swell, frequently in the calf of the 
leg first, thence extending upward ; but generally in the groin, and 
extending gradually down. The skin becomes entirely white, smooth, 
and glossy, does not pit when pressed, is painful to the touch, and is 
hotter than the skin upon the other limb. In connection with this 
local disease, there is general fever, with small and rapid pulse, thirst, 
etc. 

Treatment. — The patient must lie flat upon her back, with the 
swelled limb placed upon pillows, or a bolster, raised so that the foot 
shall be a little higher than the hip, and then charged not to put her 
foot down upon the floor until she is very nearly well. 

Apply a narrow blister along the course of the crural vein. When 



438 FEMALE DISEASES. 

this is removed, take a large piece of flannel, — Dr. Meigs says an old 
flannel petticoat, with the hem and the gathers cut off, — and dip it 
in vinegar and hot water, equal parts ; wring it out, and cover the 
whole limb with it. Put a piece of blanket or oiled silk over it to 
keep it from wetting the bed. Repeat this and keep it up for six 
hours. When it becomes tedious to the patient, remove it, and bathe 
the limb with warm sweet-oil, two parts, and laudanum, one part, and 
cover it with flannel. In two or three hours, return to the first appli- 
cation of hot water and vinegar. Continue this for five or six hours, 
and then take warm sweet-oil and laudanum ; and thus pass from 
one to the other until the inflammation is subdued, or, as Dr. Meigs 
says, till the calf of the leg can be shaken. 

If the bowels are confined, let them be gently moved by some 
mild physic (13), (14), (18), (25), (27), (41). 

In many cases, diuretics and cathartics combined will be proper 
(302), or diuretics only (128), (130). 

While the inflammation lasts, and there is fever, the tincture of 
veratrum viride must not be forgotten. 

If recovery does not take place after the active inflammation has 
subsided, the limb should be bandaged from the toes to the groin. 

Wrap up the leg in wet flannels, covered air-tight with rubber 
cloth, and great quantities of water will exude from the leg, 

Chi Id -Bed Fever. — Puerperal Fever. — Septicaemia. — 
Blood- Poisoning. 

Few complaints more justly excite the dread of the practitioner 
than tins. It cuts down woman at a time when she can least of all 
be spared by her young offspring, and at a moment when she most 
excites the love and sympathy of her whole family. It is a terrible 
disease. 

Until after the discovery of the germ character of many diseases, 
this fearful scourge was only suspected by medical men to be con- 
tagious. It has, however, long since been found to be highly conta- 
gious and propagated by the ordinary routes of travel by physician, 
nurse, friend, etc., who come in contact with women about to be 
confined or with people who have open wounds. 

We know that when a woman is confined the germs which natur- 
ally belong on the skin and in the vagina, if introduced into the 
little lacerations and wounds which are liable to ensue during labor, 
set up a violent form of blood-poisoning, which, for its severity, 
rapidity of development, and direful consequences, surpasses all other 
infectious diseases. Child-bed fever is purely and simply a germ- 
disease, caused by unclean hands, unclean instruments, unclean nap- 
kins, or, in fact, anything which contains germs, being brought in 
contact with the mother. For a further understanding of this cau- 
sation, see articles on Asepsis, Antisepsis, etc. 



FEMALE DISEASES. 439 

It becomes quite necessary for a woman to regard herself as about 
to undergo a surgical operation when she is to be confined, for the 
simple reason that she should be prepared for the labor just as the 
patient is for the operation, that she may have all the advantages of 
skilled nursing and the many little antiseptic precautions which ren- 
der not only operations but labor itself safe. 

Symptoms. — The train of symptoms belonging to this dreadful 
malady are too well known to many to repeat them in much detail. 
The first that one carefully observant of the sick one notices, is a 
slight rise of temperature, then perhaps follows a chill, sweating and 
headache ; discharges begin to smell badly, the bowels enlarge from 
the formation of gas ; the stomach is upset, and finally, if the disease 
is not checked, the infection spreads to the tubes and ovaries and 
into the general abdominal cavity, when death soon steps in to end 
the frightful scene. 

Treatment. — The nurse should always be on the alert to discover 
the least rise in temperature or any beginning odor ; it is just here 
that valuable time is often lost. The womb has become infected, 
but as yet the septic inflammation is only on the inside of the organ. 
At this point vigorous measures must be at once inaugurated and 
the womb thoroughly irrigated with some disinfectant solution, like 
the corrouve sublimate solution, with carbolic acid solution or sul- 
pho-naphthol solution. If this measure, repeated every eight to twelve 
hours, doe; not speedily correct the odor, lower the temperature and 
improve affairs at once, a thorough curetting of the entire lining of 
the womb must be made, as described under womb-diseases (page 
399) and the organ daily irrigated or packed with iodoform gauze. 

In many cases the womb and its belongings may have to be re- 
moved entirely. Blood tonics must be employed from the first, and 
the infection thoroughly removed lest subsequent womb troubles 
ensue. 

The chief preventive of this disease is extreme cleanliness and care 
in warding off its causes. 

Puerperal Convulsions. — Eclampsia. 

During the latter part of pregnancy, and even during the lying-in 
period, a pregnant woman may be suddenly seized with a convulsion 
from which she may never recover consciousness. These fits gener- 
ally last a few minutes, and complete consciousness follows with a 
terrific headache ; from one to a hundred more attacks may ensue. 
The urine usually is found heavily loaded with albumen, and contains 
all the evidences of serious kidney disease. 

Causes. — These disorders are supposed to be due to the pressure 
on the kidneys and its vessels by the increasing growth of the child. 
Some cases, however, remain still unsatisfactorily explained. 



440 FEMALE DISEASES. 

To avoid airy such sudden surprises women should have their 
urine examined every week or two in the latter part of pregnancy. 

Symptoms. — The disease is usually ushered in by some slight 
frontal headache, by swelling of the feet, ankles and eyelids ; these 
are symptoms of impending trouble, and precautions should at once 
be taken to ward off the consequent disease. The urine becomes 
scanty, thick and smoky ; the face or eyelids twitch, and soon the 
fit comes on, superinduced by the large amount of urea retained in 
the blood in consequence of the crippled condition of the kidneys, 
which normally throw off these poisonous products. 

Treatment. — In most cases the womb must be immediately 
emptied of the child and pressure thus moved from the kidneys, 
which are stimulated to secrete freely. The fits are for the time 
being controlled by the inhalation of ether or chloroform. Bleeding, 
the free use of veratrum viride, and the use of chloral or even mor- 
phine will materially aid the case toward recovery. 

It is a very fatal disorder if left to itself, the patient not infre- 
quently dying in the first convulsion, after prolonged unconsciousness. 

Here again the early discovery of the disease will often be sufficient 
to turn the tide in a favorable direction. 

Flooding and Hemorrhage. — Placenta Praevia. 

Sometimes during the latter months of pregnancy quite a little 
hemorrhage starts up from the fact that the afterbirth, which normally 
is attached to the side of the womb, becomes engrafted into the lower 
segment so as to cover the opening into the womb. This latter is 
often separated from its moorings and considerable hemorrhage en- 
sues, which may vary from a small to an extremely large and fatal 
amount. The physician should be summoned immediately and labor 
induced at once, if this condition is really found to exist. 

Flooding after labor is due to a relaxed womb or some open blood- 
vessel. The womb is to be seized and squeezed together into a small 
mass, driving out clots ; one teaspoonf ul of ergot in a little hot water 
is to be taken, and the foot of the bed elevated till the arrival of the 
doctor. 

Nursing Sore Mouth. 

Nursing women sometimes suffer terribly with this complaint. It 
begins with a scalding sensation upon the tongue, a pink color in the 
roof of the mouth, and a hot, watery discharge from the mouth. 
After a few days, small ulcers appear on the tongue, and in the 
throat. Costiveness is generally present ; but when the ulceration 
extends to the bowels, diarrhoea occurs. It comes to an end upon 
weaning the child. 

Treatment. — To relieve costiveness, give some gentle cathartic 
(12), (15), (25), (34), (36). 



FEMALE DISEASES. 441 

Iron in some of its forms and combinations is highly necessary 
(61), (71), (73), (349). 

Gargles will frequently do much good (227), (229), (230), (235), 
(243), (244), (347), (350). 

The diet must be simple, nourishing, and digestible, consisting of 
stale bread, tender beefsteak, broths, etc. 

Inflammation of the Breast. — Broken Breast. — 

Mammary Abscess. 

The mammary gland, or gland which secretes milk in the human 
breast, consists of a number of ducts, passing inward from their ter- 
mination in the nipple, and then spreading around 
like the roots of a tree, and terminating in minute 
glands. The mammillary tubes are straight ducts, 
ten or twelve in number, having their mouths at 
the centre of the nipple, dilating at its base into 
larger reservoirs, which extend some distance into 
the gland. (Fig. 146.) 

When milk is first formed, after confinement, 
these tubes and reservoirs sometimes get so full 
and hard that they crowd and compress each other, 
making it difficult to remove the milk, and under 
these circumstances, the breast will inflame. FlQ# 146 . 

Symptoms. — The inflammation generally begins with a chill, fol- 
lowed by fever, and pain of a shooting kind, which is much increased 
by pressure. An examination will generally reveal a circumscribed, 
hard, and painful tumor, even before there is any redness on the sur- 
face. After a time, the swelling spreads, the skin becomes of a dusky 
red, is hot and shining, will frequently pit a little on pressure, and 
soon gives a sense of fluctuation. Upon the formation of matter, the 
breast is enlargad, and there is local tenderness and throbbing pain. 

This complaint may be caused by taking cold, irregularities in 
diet, or by mental emotion; but more commonly it is caused by ac- 
cumulation of milk within the ducts ; still more commonly by septic 
matter from the uterus entering the circulation and causing a local- 
ized blood-poisoning. 

Treatment. — These afflictions may generally be prevented by 
keeping the breasts well drawn. It is the duty of a nurse to look 
well after this matter, and see that the breasts do not get hard and 
distended with milk. 

But when the inflammation has fairly set in, the first aim should 
be to prevent, if possible, the formation of matter. 

Active purging should be resorted to at once (29), (32). Sweating 
should be encouraged by the tincture of veratrum viride. If the ob- 
ject be to prevent the formation of matter, cold lotions, or cold water 
compresses should be used freely ; but if two or three days have passed 




442 FEMALE DISEASES. 

before active treatment, the suppuration will go on, and it is better to 
use warm applications. Dewees says warm vinegar is the most bene- 
ficial as well as the most comforting. Poultices and warm fomenta- 
tions are much used. Some apply stimulating liniments, made of 
essential oils, etc. (195), (198). Leeches are often used with advan- 
tage. They should be applied, not upon the breast, but just below it. 

During the progress of the disease, especially after the abscess is 
opened, the breast should be supported, and prevented from hanging 
down, by long strips of adhesive plaster carried below and around it. 
By this means a gentle pressure is kept up by which the matter is 
more easily evacuated. 

The breast should be opened with a lancet as soon as the abscess 
points, or fluctuation is discovered. Should the ulcer not heal, an 
astringent wash, such as a weak solution of nitrate of silver (211), 
may be applied to it once or twice a day. 

During the discharge of matter, the system of the patient should 
be supported by a nourishing diet, wine, tonics, etc. To lift up the 
breasts, and at the same time gently compress them with a gauze or 
thin flannel bandage, is one of the best methods of treatment. 

Sore Nipples. 

Womex suffering from excoriated nipples are apt to keep the infant 
chiefly to the healthy breast, and only to apply it to the tender side 
for the purpose of obtaining present ease from the pain of over-dis- 
tension. In this way the ducts remain always full, and are apt to 
get inflamed. Sore nipples, therefore, are to be attended to as much 
on account of the evils to which they lead, as of the suffering they 
directly occasion. 

The excoriation of the nipples begines as a chap. This shows no 
tendency to heal; and the child's mouth being often applied, rubs 
off the skin around the crack, and this naked surface soon becomes 
an ulcer. These ulcers are sometimes only on the surface ; at other 
times they are profound, going deep into the substance of the nipple. 

Treatment. — These excoriations and ulcers might be easily healed, 
were it not that the newly-formed skin is apt to be continually rubbed 
off by the child's mouth in the act of nursing. Two things are there- 
fore to be done, — to favor the healing, and to protect the tender part 
from renewed injury. 

For the first object, a strong infusion of green tea or port wine may 
answer very well in ordinary cases. A little alum or borax, dissolved 
in rosewater, or water (201), (202), is often used. A weak solution 
of sulphate of zinc, or sulphate of copper, or nitrate of silver (209), 
(211). But one of the very best articles is composed of glycerine 
and tannin (306). 

To protect the nipple from injury in the act of sucking, use a shield 
made of India-rubber. When the infant is not at the breast, the 
nipple should be covered by a shield. 



IAEEIED LADIES' PEEPETUAL CALENDAE. 



The utility of these tables, serving as a faithful and confidential friend in 
matters of urgent interest, cannot fail of being perceived. The young and 
newly-married might be spared an unpleasant amount of embarrassment by 
consulting the Calendar as to the time of confinement, which, in reckoning 
the full period of gestation 280 days from conception, may be very nearly ap- 
proximated; or, in the event of the time of conception being uncertain, from 
the period of quickening, which she can usually note, she may reckon 140 
days. It will be perceived that the Calendar has three columns of figures, de- 
noting the days of the months noted at the head of each. The first column 
gives the date of conception; the second, that of the period of quickening; 
and the third, that of delivery. Thus, if a lady dates the period of conception 
January 1, 1896, quickening will occur May 20, and confinement about the 8th 
of October following; or, if she is ignorant of the time of conception, by con- 
sulting the middle column as to the time of quickening, if it occurs May 20, 
she may expect her confinement to occur about the 8th of October following, 
or 140 days after the period of quickening. The date in the first column is 
that of conception; the corresponding date in the second column is that of 
quickening; and the corresponding date in the third column that of confine- 
ment. 






J 


ANUARY. 


February. 


March. 




April. 




Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- Deliv- 


Concep- 


Quick- 


Deliv- 


tion. 


ening. 


ery. 


tion. 


ening. 


ery. 


tion. 


ering, try. 


tion. 


ening. 


ery. 


Jan. 


May 


Oct. 


Feb. 


June 


Nov. 


March 


July *Dec. 


April 


Aug. 


Jan. 


1 


20 


8 


1 


20 


8 


1 


18 6 


1 


18 


6 


2 


21 


9 


2 


21 


9 


2 


19 7 


2 


19 


7 


3 


22 


10 


3 


22 


10 


3 


20 8 


3 


20 


8 


4 


23 


11 


4 


23 


11 


4 


21 9 


4 


21 


9 


5 


24 


12 


5 


24 


12 


5 


22 10 


5 


22 


10 


6 


25 


13 


6 


25 


13 


6 


23 11 


6 


23 


11 


7 


26 


14 


7 


26 


14 


7 


24 12 


7 


24 


12 


8 


27 


15 


8 


27 


15 


8 


25 13 


8 


25 


13 


9 


28 


16 


9 


28 


16 


9 


26 14 


9 


26 


14 


10 


29 


17 


10 


29 


17 


10 


27 15 


10 


27 


15 


11 


30 


18 


11 


30 


18 


11 


28 16 


11 


28 


16 


12 


31 


19 




July 




12 


29 17 


12 


29 


17 




June 




12 


1 


19 


13 


30 18 


13 


30 


18 


13 


1 


20 


13 


2 


20 


14 


31 19 


14 


31 


19 


14 


2 


21 


14 


3 


21 




Aug. 




Sept. 




15 


3 


22 


15 


4 


22 


15 


1 20 


15 


1 


20 


16 


4 


23 


16 


5 


23 


16 


2 21 


16 


2 


21 


17 


5 


24 


17 


6 


24 


17 


3 22 


17 


3 


22 


18 


6 


25 


18 


7 


25 . 


18 


4 23 


18 


4 


23 


19 


7 


26 


19 


8 


26 


19 


5 24 


19 


5 


24 


20 


8 


27 


20 


9 


27 


20 


6 25 


20 


6 


25 


21 


9 


28 


21 


10 


28 


21 


7 26 


21 


7 


26 


22 


10 


29 


22 


11 


29 


22 


8 27 


22 


8 


27 


23 


11 


30 


23 


12 


30 


23 


9 28 


23 


9 


28 


24 


12 


31 






Dec. 


24 


10 29 


24 


10 


29 






Nov. 


24 


13 


1 


25 


11 30 


25 


11 


30 


25 


13 


1 


25 


14 


2 


26 


12 31 


26 


12 


31 


26 


14 


2 


26 


15 


3 




Jan. 






Feb. 


27 


15 


3 


27 


16 


4 


27 


13 1 


27 


13 


1 


28 


16 


4 


28 


17 


5 


28 


14 2 


28 


14 


2 


29 


17 


5 








29 


15 3 


29 


15 


3 


30 


18 


6 








30 


16 4 


30 


16 


4 


31 


19 


7 








31 


17 5 









443 



444 



MARRIED LADIES' PERPETUAL CALENDAR. 



May. 


June. 


July. 


August. 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


tion 


ening. 


ery. 


tion 


ening. 


ery. 


tion. 


ening. 


ery. 


tion. 


en ing. 


ery. 


May 


Sept. 


Feb. 


June 


Oct. 


March 


July 


Nov. 


April 


Aug. 


Dec. 


May 


1 


17 


5 


1 


18 


8 


1 


17 


7 


1 


18 


8 


2 


18 


6 


2 


19 


9 


2 


18 


8 


2 


19 


9 


3 


19 


7 


3 


20 


10 


3 


19 


9 


3 


20 


10 


4 


20 


8 


4 


21 


11 


4 


20 


ilO 


4 


21 


11 


5 


21 


9 


5 


22 


12 


5 


21 


11 


5 


22 


12 


6 


22 


10 


6 


23 


13 


6 


22 


12 


6 


23 


13 


7 


23 


11 


7 


24 


14 


7 


23 


13 


7 


24 


14 


8 


24 


12 


8 


25 


15 


8 


24 


14 


8 


25 


15 


9 


25 


13 


9 


26 


16 


9 


25 


15 


9 


26 


16 


10 


26 


14 


10 


27 


17 


10 


26 


16 


10 


27 


17 


11 


27 


15 


11 


28 


18 


11 


27 


17 


11 


28 


18 


12 


28 


16 


12 


29 


19 


12 


28 


18 


12 


29 


19 


13 


29 


17 


13 


30 


20 


13 


29 


19 


13 


30 


20 


14 


30 
Oct. 


18 


14 


31 
Nov. 


21 


14 


30 
Dec. 


20 


14 


31 
Jan. 


21 


15 


1 


19 


15 


1 


22 


15 


1 


21 


15 


1 


22 


16 


2 


20 


16 


2 


23 


16 


2 


22 


16 


2 


23 


17 


3 


21 


17 


3 


24 


17 


3 


23 


17 


3 


24 


18 


4 


22 


18 


4 


25 


18 


4 


24 


18 


4 


25 


19 


5 


23 


19 


5 


26 


19 


5 


25 


19 


5 


26 


20 


6 


24 


20 


6 


27 


20 


6 


26 


20 


6 


27 


21 


7 


25 


21 


7 


28 


21 


7 


27 


21 


7 


28 


22 


8 


26 


22 


8 


29 


22 


8 


28 


22 


8 


29 


23 


9 


27 


23 


9 


30 


23 


9 


29 


23 


9 


30 


24 


10 


28 
March 


24 


10 


31 
April 


24 


10 


30 
May 


24 


10 


31 
June 


25 


11 


1 


25 


11 


1 


25 


11 


1 


25 


11 


1 


26 


12 


2 


26 


12 


2 


26 


12 


2 


26 


12 


2 


27 


13 


3 


27 


13 


3 


27 


13 


3 


27 


13 


3 


28 


14 


4 


28 


14 


4 


28 


14 


4 


28 


14 


4 


29 


15 


5 


29 


15 


5 


29 


15 


5 


29 


15 


5 


30 


16 


6 


30 


16 


6 


30 


16 


6 


30 


16 


6 


31 


17 


7 








31 


17 


7 


31 


17 


7 



September. 


XDCTOBER. 


November. 


December. 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


Concep- 


Quick- 


Deliv- 


tion. 


ning. 


ery. 


tion. 


ening. 


ery. 


tion. 


ening. 


ery. 


tion. 


ening. 


ery. 


Sept. 


Jan. 


June 


Oct. 


Feb. 


July 


Nov. 


March 


Aug. 


Dec. 


April 


Sept. 


1 


18 


8 


1 


17 


8 


1 


20 


8 


1 


19 


7 


2 


19 


9 


2 


18 


9 


2 


21 


9 


2 


20 


8 


3 


20 


10 


3 


19 


10 


3 


22 


10 


3 


21 


9 


4 


21 


11 


4 


20 


11 


4 


23 


11 


4 


22 


10 


5 


22 


12 


5 


21 


12 


5 


24 


12 


5 


23 


11 


6 


23 


13 


6 


22 


13 


6 


25 


13 


6 


24 


12 


7 


24 


14 


7 


23 


14 


7 


26 


14 


7 


25 


13 


8 


25 


15 


8 


24 


15 


8 


27 


15 


8 


26 


14 


9 


26 


16 


9 


25 


16 


9 


28 


16 


9 


27 


15 


10 


27 


17 


10 


26 


17 


10 


29 


17 


10 


28 


16 


11 


28 


18 


11 


27 


18 


11 


30 


18 


11 


29 


17 


12 


29 


19 


12 


28 


19 


12 


31 


19 


12 


30 


18 


13 


30 


20 




March 






April 






May 




14 


31 


21 


13 


1 


20 


13 


1 


20 


13 


1 


19 




Feb. 




14 


2 


21 


14 


2 


21 


14 


2 


20 


15 


1 


22 


15 


3 


22 


15 


3 


22 


15 


3 


21 


16 


2 


23 


16 


4 


23 


16 


4 


23 


16 


4 


22 


17 


3 


24 


17 


5 


24 


17 


5 


24 


17 


5 


23 


18 


4 


25 


18 


6 


25 


18 


6 


25 


18 


6 


24 


19 


5 


26 


19 


7 


26 


19 


7 


26 


19 


7 


25 


20 


6 


27 


20 


8 


27 


20 


8 


27 


20 


8 


26 


21 


7 


28 


21 


9 


28 


21 


9 


28 


21 


9 


27 


22 


8 


29 


22 


10 


29 


22 


10 


29 


22 


10 


28 


23 


9 


30 


23 


11 


30 


23 


11 


30 


23 


11 


29 






July 


24 


12 


31 


24 


12 


31 


24 


12 


30 


24 


10 


1 






Aug. 






Sept. 






Oct 


25 


11 


2 


25 


13 


1 


25 


13 


1 


25 


13 


1 


26 


12 


3 


26 


14 


o 


26 


14 


2 


26 


14 


2 


27 


13 


4 


27 


15 


3 


27 


15 


3 


27 


15 


3 


28 


14 


5 


28 


16 


4 


28 


16 


4 


28 


16 


4 


29 


15 


6 


29 


17 


5 


29 


17 


5 


29 


17 


5 


30 


16 


7 


30 


18 


6 


30 


18 


6 


30 


18 


6 








31 


19 


7 








31 


19 


7 



CARE OF CHILDREN AND THEIR 
DISEASES. 



Pure Air. — The first want of a child is a plenty of fresh air; and 
this want never ceases to the end of life. Impure air kills thousands 
of infants. Out of 7,650 born in the lying-in hospital of Dublin, 
2,944 were destroyed by impure air within two weeks after birth. 

Children should be kept in the open air as much as possible, and 
in well-ventilated rooms when indoors. It is wrong, when infants are 
sleeping, to cover their faces with bed-clothes, or draw curtains around 
their cots, or to envelop their heads in blankets and shawls when 
carried in the open air. 

The Skin. — The health of infants requires that their skin should 
be kept clean. Unless this is done they are liable to suffer much 
from cutaneous and other diseases. The skin of a new-born child 
is covered with a white, unctuous matter, called the vernix caseosa. 
It is injurious to let this remain for any length of time after birth. 
To remove this, Dr. Dewees recommends that the child be smeared 
with hog's lard, and then washed with soap and water. Dr. Eberle 
says, smear with yolk of egg^ and then wash with simple warm 
water. 

The young child should be washed every day with warm water, — 
then, after a time, with tepid water, then with temperate, and finally, 
after it is some months old, with cold water. This, if persevered in 
through childhood and youth, will ward off a thousand ills and sick- 
nesses to which the young are liable. 

The Clothing of Children should be so adjusted as to give their 
limbs ample play, and should be thick enough to keep them warm. 
They ought to have flannel next the skin in winter, and cotton in 
summer. At the risk of wounding some nice people's feelings, I 
must add that the fashion of a child's clothes is not important. 

The Food. — The natural and proper food of a young child is its 
mother's milk. To this it should be confined, unless prohibited by 
imperative circumstances, until a portion of the teeth are cut. When 
the mother cannot nurse her child, the breast of a suitable nurse 
should, if possible, be supplied. If the infant need any more food 

445 



446 CAKE OF CHILDREN AND THEIR DISEASES. 

than is supplied by the breast, give cow's milk and water, sweetened 
with a little loaf sugar. The nursing bottle, if used, must never be 
permitted to get sour. 

Health of a Nursing Woman. — During nursing the greatest at- 
tention to health is required by the mother or the nurse. A woman 
of a consumptive constitution should never nurse an infant. Nour- 
ished at the breast of such a mother, the child, who has inherited her 
constitution, will be the more likely to fall a victim to her disease. 

Passions of a Nursing Woman. — Let the woman who nurses a 
young child be careful of her passions. An irritable disposition, giv- 
ing rise to gusts of violent passion, may so alter the character of the 
milk as to throw the child into convulsions. Grief, envy, hatred, fear, 
jealousy, and peevishness, unfit the milk for nourishing the child, and 
often cause the child's stomach to be much disordered. 

The Diet of the Nurse should receive strict attention. It should 
be plain and wholesome, and the amount should never be excessive. 
Her drink should be simply water and non-stimulating and nourish- 
ing drinks such as the various preparations of cocoa, etc. She should 
take gentle daily exercise in the open air. 

Wet Nurses. — If for any reason it should be necessary to wean 
the baby, or the mother cannot nurse the child, then we must select 
a food the most like that of the mother. 

Wet-nurses formerly were quite popular among the well-to-do to 
supply this food ; but as in her selection there are so many exacting 
requirements, she is fast becoming obsolete. There are three requi- 
sites for a good wet-nurse : she must be of good health, of good moral 
character, and be able to supply plenty of good healthy milk. 

If she has any tubercular, scrofulous, syphilitic, insane or osseous 
history; if she is menstruating, or pregnant, or is in anywise below par 
in health, she is necessarily disqualified as a nurse for any child ; 
only your physician may be able to detect these evidences and per- 
haps not even he. If, on the other hand, she is occasionally given 
to blues, has a violent temper, is jealous, or fretful, or worries about 
her own child, or goes into dangerous company when away from the 
house, then you have added a second disqualification. Again, her 
supply of milk must be good as shown by an analysis and the health 
and growth of her own child. A nurse may pass muster to-day in 
reference to this third requisite, but perhaps not in a week from to- 
day. 

Seeing that the average wet-nurse comes from a lower stratum of 
society, even if not from the criminal class, that she is in consequence 
more liable to acquired disease and contagion, that she is more than 
likely to bring trouble into the household rather than to relieve the 
household of it, it will be extremely difficult for you to find such a 
person as can furnish all the required conditions of a safe wet-nurse. 



CARE OF CHILDREN AND THEIR DISEASES. 



447 



It has been found, therefore, that artificial feeding gives better satis- 
faction and is quite as safe. 

Nursing Bottles. — There are nursing bottles innumerable, few of 
which are of practical value. A simple bottle with plain black nip- 
ple is all that is requisite for successful feeding at the hands of a 
careful and cleanly mother or nurse. There should be several bottles 
and several nipples, the latter to be kept in soda water or other sim- 
ple alkaline solution when not in use. A pinch of soda to a cup of 
water is of sufficient strength. After a bottle has been used it should 
be thoroughly scalded with hot water and soda and finally set away 
filled to the brim with this same solution, till later in the day. 
Meanwhile, a fresh bottle and a fresh nipple is used, they having 
first been cleansed with the above solution. The best bottle, how- 
ever, for nursing in those cases, where for want of time and means 
the bottle cannot be held by mother or nurse, is one called " The 
Best." See Figs. 147 and 148, This bottle, like many others, al- 





FiG. 148. 



Fig. 147. 

lows of its resting on the bed$ but, unlike many others, it is very 
readily cleansed, is of easy suction and has a nipple which does not 
collapse. The accompanying cuts and description are worthy of at- 
tention. The peculiar feature of the bottle is a valve or air-inlet 
in the end admitting air back of the food, thus rendering suction 
easy. This valve does not leak and cannot be pulled off by the baby, 
but is easily cleansed and adjusted. Whatever else you may do with 
the bottle, above all things keep it clean, not only to outward ap- 
pearances, but by actually scalding and soaking in soda solution up 
to the very time of its use. 

Food for Infants. — It has been found that mother's milk, which 
of course is the best food for babies, is composed on the average of 
the following ingredients : water 87, fat, 4, casein 1, sugar 7, ash 1, 
and slightly alkaline in reaction. 

Now, ordinary cow's milk has the following composition: water 
87, fat 3.7, casein 2.9, sugar 4.9, ash .4 ; it is slightly acid. 



448 



CARE OF CHILDREN AND THEIR DISEASES. 



We can therefore see that if we take cow's milk and dilute it with 
water sufficiently, we diminish the amount of casein to that of 
mother's milk, and by the addition of cream, milk, sugar and lime- 
water, we raise these constituents to the standard found in human 
milk. This mixture, known among medical men as the " Meigs' 
Cream Mixture," is the basis of all modern compounds for artificial 
feeding. 

Milk, as ordinarily received from the milkman, swarms with bac- 
teria and germ-life which, under favorable conditions, quickly changes 
the milk and renders it unfit for easy and proper digestion. Milk 
from the mother is devoid of these germs, or, as medical men say, 
it is sterile. This attribute then is in reality quite as important as 
the proper constituency of milk. The process of making cow's milk 
sterile is called sterilization, of which we will speak shortly. 

Temperature of Milk. — Mother's milk is of the same heat as the 
body, or nearly so ; hence common sense dictates that the artificial 
food must be of that degree of heat, or, about 98° Farenheit. 

Quantity and Interval of Feedings. — The capacity of a baby's 
stomach and the length of time food remains in it are matters of ex- 
perience. Herewith is appended a table covering the general rules 
of feeding infants and especially adapted to milk and cream mixture 
of which we will now speak. 



GENERAL EULES 


FOR FEEDING. 




AGE. 


Interval. 
Hours. 


Feedings in 
24 Hours. 


Amount at 

each Feeding. 

Ounces. 


Amount in 

24 Hours. 

Ounces. 


1st week 

1st to 6th week .... 
6th week to 6th month . . 

At 6 months 

At 10 months 


2 

2^ 

3 

3 

3 


10 
8 
6 
6 
5 


1 
Hto2 
3 to 4 

6 

8 


10 
12 to 16 
18 to 24 

36 

40 



— Dr. F. M. Rotch, Keating's Cyc. Dis. Children. 

Based on the average analysis of mother's milk, i. e., 7 parts 
sugar, 4 of fat, and 1 of albuminoids, we must take : cream 1 J ounces, 
milk 1 ounce, water 5 ounces, lime-water J ounce, sugar of milk 3 
to 34 drachms. 

The milk-sugar is to be obtained at the druggist's. This gives an 
eight-ounce mixture, so that for a baby four weeks old (see table) 
we need to take about one-half or three-fourths more of this mixture ; 
for a baby six months three times this amount, and so on. For a 
child newly born, after the first few days, when only a little should 
be -given, only slightly more of these ingredients should be used than 
in above formula. 

Of course, plain cow's milk one-third part, with boiled wal 
thirds, will answer well for many babies, if the milk is sterili 



CARE OF CHILDREN AND THEIR DISEASES. 449 

a little sugar of milk and lime-water be added just before feeding ; 
but this simple mixture, while quite sufficient for the average baby, 
will not answer for all, nor is it as good for any as the cream mixture 
given above. Should the former cause green stools or curdy masses, 
the latter must be substituted. This mixture is very easy to prepare, 
as the process of making it sterile is very simple, and any woman of 
ordinary care and intelligence can successfully carry on this kind of 
feeding till the eruption of the second or fourth tooth, when plain 
cow's milk diluted with an equal quantity of oatmeal jelly and 
sweetened, may be substituted. This food should be given at first 
once daily ; and later, twice, thrice, and finally it may be fed alto- 
gether on milk and oatmeal. 

When the back teeth, or molars, have come through, then, for the 
first time, bread, rice, and soft-boiled egg may be added. 

Oatmeal jelly may be prepared by boiling a quarter of a pound of 
oatmeal, in a quart of water, down to one pint. This mixture is then 
to be diluted with an equal quantity of boiled water and strained 
through a cloth. Should the oatmeal prove too laxative for the 
child, barley jelly may be made in the same way. 

Sterilization of Milk. — We have seen how much more important 
than the kind of nursing-bottle that may be selected is the kind and 
quality of food put into that bottle. To complete our consideration 
of the best artificial food, we must know how to render the milk free 
from bacterial life ; this process is called sterilization, and may be 
accomplished in a simple way as follows : into as many bottles, which 
have been previously scalded and cleansed, as there are to be feed- 
ings in the twenty-four hours, pour that quantity of the milk mixture 
which is to be given at a feeding; place these bottles, with absorbent 
cotton in the mouths, into a kettle filled with water up to the level 
of the milk in the bottles, and allow the water to rise to 170° Faren- 
heit, when the kettle is removed to a warm part of the stove and 
covered for about half an hour. The bottles should then be kept in 
a cold place till used, when they are to be heated just sufficiently to 
correspond to the body heat. These bottles come ready made, 
also a rack in which to rest them in the kettle. They should be, in 
reality, specially made bottles, and are to be obtained at any drug- 
store. They are ready for the baby's use after removing the cotton and 
attaching the nipple. One may, however, sterilize the entire feeding 
of the twenty-four hours, or for twelve hours, as thought best, in any 
clean, thin bottle or jar, and pour out the given amount required at 
each feeding ; but there is some danger of spoiling the sterilization by 
so much handling. Should it be desirable to prepare milk to keep for a 
longer time, it will then be necessary to sterilize at a greater heat 
(212°), and to repeat the process two or three times. Such milk is 
supplied nowadays in the larger cities by companies who will express 
it daily to one's address. By giving the age, quantity and kind of 
feeding the baby needs, these companies send to you in neat straw 



450 CARE OF CHILDREN AND THEIR DISEASES. 

baskets the number of bottles the baby will use in the next twenty- 
four hours, containing the quantity required, and of the composition 
found to agree best with the baby. The Walker-Gordon Laboratory, 
203 Clarendon St., Boston, perhaps is the best known of these insti- 
tutions, as it sends milk even to remote parts of the country, and in 
sufficient quantities to last for a voyage to Europe, and even further 
if needed. 

To summarize, then, in reference to infant feeding, first in impor- 
tance is the mother's milk ; second, the sterilized cream mixture ; 
third, the sterilized milk and water ; and in later months, the addition 
of oatmeal jelly. 

Weaning. — At the end of twelve months, the first set of teeth are 
generally so far cut that the child can manage most kinds of plain 
food; and it may now be taken from the breast. Should the teeth 
appear earlier, and the infant be healthy, it may be weaned even at 
the end of the tenth month. Never take the child from the breast in 
the midst of summer heat. A disordered state of the bowels, or 
cholera infantum, would be likely to be the result. The spring and 
the autumn are the proper periods for weaning. 

If for some months it has been accustomed to other food besides 
the milk of the mother, it may be taken suddenly from the breast. 
It must not have any amount of solid food it may crave immediately 
after weaning. It should still be kept, for some time, upon a simple, 
bland, half-fluid aliment, taken in moderate quantities, and at proper 
intervals. At first, the food should be bread and milk, boiled rice and 
milk, soft-boiled eggs, oatmeal gruel, plain rice-pudding, preparations 
of arrowroot, tapioca and sago, simple meat-broths, mixed with 
crumbs of bread or grated crackers, or in which rice or barley has been 
well boiled. From this it may pass gradually to a more solid diet ; 
though, until the age of puberty, the principal part of the diet should 
be milk, the farinaceous articles, and vegetables. Sugar has been 
thought to be injurious to children. It is not so. If taken moder- 
ately, at meal-times, it is wholesome. Lately a new form of choco- 
late has come into use, called Kraft-chocolate, made in Germany. It 
is prepared with cocoa-butter and comes in small cakes, is easily di- 
gested, nourishing, and supplies sweets in a very acceptable and 
strengthening form. 

Whatever be the food allowed to children, it should never be taken 
in excess ; and to prevent this, they ought not to take their meals 
alone ; for they have very keen appetites, and if permitted to do so, 
they will generally form habits of gluttony. Three or four light 
meals a day is enough. 

Their drink should be water simply, — nothing else. 

If parents would observe these rules, and enforce them strictly, they 
would confer blessings upon their children greater than riches. They 
would send them into the world with health and good constitutions, 
and would save them from untold misery and an early death. Such 



CARE OF CHILDREN AND THEIR DISEASES. 451 

a course would evince more love for their children than those weak 
concessions which allow tea and coffee, and all sorts of food, in quan- 
tities to suit, which occasion early disorders of the stomach and 
bowels, and bring later derangements of the nervous system, with 
all its regrets and horrors. 

Sleep of Children. — During the first period of its existence, an 
infant sleeps a large portion of the time. This is a wise provision of 
nature. It withdraws the young child, for a time, from those outward 
exciting agents, which would too much disturb the nervous system 
of so tender a being. Whenever a young infant is restless or wakeful 
much of the time, we may feel sure it has had too much food, or is 
in some way disturbed by it, or by tight clothes, or that some other 
cause is giving it uneasy sensations. Do not make the mistake of 
thinking the child is hungry because it cries. 

Its sleep should be the promptings of nature, and should never, 
except in rare instances, be brought about by opiates. It is wrong 
and sinful for a mother or nurse to put an infant to sleep with an 
opiate, merely that she may gain time for pleasure, or even for other 
duties. 

The Infant should be kept Warm while Sleeping.— During the 
first few weeks it should sleep with its mother, especially if the 
weather be cold. After that, it may be in a cradle or cot. The 
covering should be warm, but light, so as not to press heavily upon 
its tender limbs. If laid upon its back, the fluid of its mouth and 
throat may get into the windpipe, and obstruct the breathing, or 
produce coughing. It is better, therefore, to lay the infant upon its 
side, — taking care not to produce distortion of the spine or limbs 
by always laying it upon the same side. 

Children should not be allowed to sleep either with the aged, or 
with sick persons. It is not healthful for them to breathe the exhala- 
tions from the bodies of such. For a somewhat similar reason, some 
kinds of plants, and flowers generally, should be excluded from their 
sleeping-rooms. Their beds should be so placed as to turn their 
faces away both from the sunlight which comes in at the windows, 
and from the artificial light in the room. 

They should be taught to retire early at night, and to rise imme- 
diately after waking in the morning. This habit will be worth much 
to them through life. Do not form the habit of rocking the child to 
sleep. After the meconeum has passed, the bowels of an infant 
should be opened from two to four times in twenty-four hours. If 
the stools are less frequent than twice a day, or, if they are lumpy, 
some gentle cathartic is called for. From one-quarter to one-half 
teaspoonful of castoria, or a dessert-spoonful of mixture (24), an- 
swers a good purpose. During childhood, the bowels should be 
moved once or twice a day. When a cathartic is required, a table- 
spoonful, of mixture (25), or a teaspoonful of (17), will be found 
excellent. 



452 CAKE OF CHILDREN AND THEIR DISEASES. 

Exercise. — During the first few weeks of an infant's life it requires 
but little exercise ; indeed its organization is not sufficiently settled 
and compacted to permit much without injury. A little gentle rub- 
bing with the hand over the whole body is about all it needs or will 
bear. To dandle and toss it about, and especially to set it upright, 
is injurious and wrong. Its bones are all soft, and will not endure 
to be much twisted about, and its spine is not stiff enough to bear 
up the weight of its head. 

After a few months, riding in a carriage, by a careful and trusty 
nurse, is both a healthful and pleasurable exercise for children. 

Learning to Walk. — At the end of the ninth or tenth month, a 
child may begin to learn to walk. It is not safe to teach it this 
exercise much earlier than this, as the bones, being soft, may be 
bent by the weight of the body, and the limbs be permanently 
deformed. 

As soon as the child has learned to walk alone, it should be allowed 
perfect freedom of exercise. Thenceforward, the open air is its proper 
place during the day; and such an unrestrained use of its limbs as 
its own instincts may dictate, is its proper calling. For five years 
after it has learned to walk, it should do little else than to use its 
limbs out of doors, as it pleases. The books and the school-room 
will be in season after that. First compact the body, then bring out 
the mind. The mind is of no use without the body, — the body must 
be developed first, or never. 

Moral Treatment. — We charge upon nature many of the bad 
passions whicb we ourselves implant in children. The moral treat- 
ment of children is generally bad. We are apt to begin by either 
making them our masters or our slaves. Sometimes we do both, — 
allowing them to govern us for a time, and then, getting into a pas- 
sion, or a mood for playing the tyrant, we turn upon, and govern 
them as if we were autocrats. We submit to their whims until we 
grow irritable, and then, by way of retaliation, we compel them to 
submit to ours. 

This is all wrong. Children should be governed always, but with 
an even, a gentle, and a loving hand. They should early be sub- 
jected to habits of self-control, and of regularity in eating and sleep- 
ing ; and should be taught absolute and continued obedience. All 
this can be brought about only by firmness, self-control, and great 
gentleness on the part of the parents.. If they would make a child 
cheerful and happy in its disposition, they must themselves be cheer- 
ful, and never let it see anger, passion, and fretfulness, marring their 
conduct. Nothing is more injurious to the health of a child than a 
peevish, complaining, and soured disposition ; and these vices are 
seldom acquired, unless seen in the lives of parents. 



CARE OF CHILDREN AND THEIR DISEASES. 453 



How to Nurse Sick Children. 

As the education of the young, whether religious, moral, or intel- 
lectual, is more important than that of adults, so is the care of their 
physical life of more importance. Death aims to " out-Herod Herod," 
and seeks the life of all infants, male and female, and in fact destroys 
one-half of all below the age of five years. 

But few know how to train and take care of children. It is a still 
more rare gift to know how to nurse them when sick. No person 
can properly nurse sick children who is in feeble health, or has a 
fretful temper, or is low-spirited: for she can neither endure the 
fatigue, nor bear the trials, nor hear the prattle which such a respon- 
sibility would bring. Somte will manage a well child very well, who 
are not fit to have the care of a sick one ; for there is a great differ- 
ence between a child when well, and the same child when sick. 
When well, and full of fun and frolic and life, laughing and jump- 
ing and shouting aloud for very joy at being alive, it is an easy thing 
for a person of even a morose temper to attend upon them. But 
when sickness comes, and the child's playfulness is all laid aside ; 
when it becomes so fretful that nothing goes right with it ; when it 
cries to be laid down, and then cries to be taken up ; stretches out its 
hand for drink, and pushes away the cup when it is presented, — 
apparently made more angry by your attempts to serve it; — when 
these things are repeated day and night, until the nurse is weary and 
exhausted, and even a change of disease and amendment only brings 
a cross and fractious temper, it is only by possessing peculiar qualifica- 
tions that the nurse can maintain an even and unruffled disposition. 

While passing through such scenes, it is hard for the nurse to re- 
member that sickness does not destroy the little loving heart, but only 
hides its affection for a short time. 

Signs of Disease in Children. — It is important that the nurse of 
sick children should know what to observe, and the meaning of the 
signs of disease. A baby has only cries to express its sick feelings. 
To one person, these cries mean no more than that the baby has some 
sort of illness. To another, with more experience and better powers 
of observation, they point to the head, or chest, or stomach as the dis- 
order. A baby with the stomach-ache utters long, loud, and passion- 
ate cries, and sheds tears plentifully. Suddenly it stops for a moment, 
and then begins again, drawing up its legs to the stomach, and as the 
pain passes off, stretching them out again, and with many sobs, pass- 
ing off into a gentle sleep. 

If there be inflammation in the chest, it neither cries loud, nor sheds 
tears, but after every long breath or hacking cough, it utters a short 
cry, which is cut off before it is half finished, — apparently because 
crying is painful. 

If the disease be in the head, the cries will be sharp, piercing shrieks, 



454 CARE OF CHILDREN AND THEIR DISEASES. 

with low moans and wails between. Or, there will be quiet dozing, 
interrupted by startling pains. 

When a child is taken ill, whatever the disease which is impending, 
there is always a change of some sort, which soon attracts attention. 
It either loses its appetite, or is fretful, or soon tired, or sleepy, or 
restless, or thirsty, or has a hot skin, or, rather, has a number of these 
symptoms. It vomits, or is purged or bound in its bowels. It loses 
its merry laugh and cheerful look ; it no longer watches its mother's 
or its nurse's eye, as before, but clings to her more closely, and will 
not be out of her arms a moment. If lulled to sleep in her arms, it 
wakes immediately on being placed in its cot. 

Such symptoms often continue a day or two before it can be de- 
termined what disease is impending. An intelligent nurse may do 
much towards solving*the question. It is frequently proper at such 
times to place the child in a warm bath. When stripped for the 
bath, it should be carefully examined to see if there is any rash upon 
its body. If it be a rash from which it is about to suffer, the bath 
will help bring it out. The rash should be looked for at least every 
twelve hours, until the nature of the disease is determined. 

The Appearance of the Different Rashes may be distinguished 
with a little care and experience. Measles has a number of dark-red 
spots, in many places running into each other, and is generally seen 
first about the face and on the forehead, near the roots of the hair, 
and is preceded by running at the eyes and nose, and all the signs of 
a severe cold. Scarlet fever does not show separate spots, but pre- 
sents a general bright red color of the skin, much like a boiled lobster. 
At first there is more of it about the neck and chest than on the face, 
and it is preceded by a sore throat. Chicken-pox is .attended by 
fever, but not so much running at the nose and eyes as in measles, 
nor is there so much cough. The spots, too, are smaller, and are not 
so much run together ; and they come out more over the whole body. 
They appear a few hours earlier on the body than elsewhere ; and in 
a day or two they are found to be enlarged, and turn into little blad- 
ders of water as big as the head of a shawl-pin. (See table of com- 
parison of these diseases.) 

And now a few Words as to what should be Done in the sick- 
room of a child. The room should be kept cool, and its temperature 
should be measured by a thermometer. This instrument, when hung 
away from the fire, should show a temperature of about 60°. That 
is about the right degree of warmth. Sick-rooms are generally kept 
too hot. The room should be darkened ; not made totally dark, but 
its light shaded down by closing the outside blinds, or by dropping 
the curtains, so as to give a kind of twilight ; and the cot should 
always be so placed as to turn the little one's face away from the 
light. The room should be kept quiet; and this requires attention 
in the whole house, as well as among the persons in the room. Those 



CARE OF CHILDREN AND THEIR DISEASES. 455 

present should never whisper, but speak in low and gentle tones, — 
should not walk on tip-toe, but move about carefully. There is a 
fussy quietness which disturbs the sick far more than noise. The 
child must be spoken to, and roused from its slumbers, and turned 
from side to side, and raised for its food or medicine, with a soothing 
tenderness, and a delicacy which never forgets itself. 

In applying leeches or cold to a child, judgment is needed to suc- 
ceed well. The leeches should be put either behind the ear or on top 
of the head, so that the child cannot see them. Cold is best applied 
by means of a couple of ice-bags, half filled with powdered ice, and 
wrapped in two large napkins ; one of them should be placed under 
the child's head, the corner of the napkin being pinned to the pillow- 
case to prevent its being disturbed, while the other is allowed to rest 
upon the head, with the corner of the napkin again pinned to the 
pillow, to take off the greater part of its weight. In this way the child 
will not be wetted, or irritated, as by the changing of wet cloths, 
nor will the cold applications get displaced by its movements. 

A word should be said respecting the nursing of children in cases 
of lung-inflammation, — an affection from which they often suffer. 
The lungs are much like two large sponges, and the air enters them 
through the windpipe ; and passing through smaller and yet smaller 
tubes, it comes at last into tiny cells, so small that they can only be 
seen by a magnifying glass. When the lungs are inflamed, some of 
the tubes become stopped up; and the very small cells are pressed 
on by the flow of more blood than natural to the part ; and so the 
air enters less easily, and in smaller quantities, than it should. If 
now you let the child lie flat, it is not only less able to draw a deep 
breath, and fill the lungs, but the blood also flowing to the inflamed 
portion of the lung, returns less easily than if the child were propped 
up in bed. When a whitlow is on the finger, if the hand be hung 
down, the inflamed finger will become redder, and will beat and 
throb so as hardly to be endured, while, if the hand be raised, the 
pain will abate. The same increase of pain does not follow an accu- 
mulation of blood in an inflamed lung, because the lung is not as 
sensitive as the finger ; but the consequences are very serious. The 
air-cells being more and more pressed upon, the admission of air is 
more and more difficult, until, at length, a large part of the lungs is 
rendered useless, and the child dies. 

In this disease, the temperature of the room needs attention. The 
air should not be quite so cool as in other diseases. From 60° to 65° 
is about right. 

Of course crying will irritate inflamed lungs, and it is all important 
that a child sick with this disease should be soothed and quieted as 
much as possible. Every good nurse knows how to do this better 
than any rules can teach her. 

Sometimes sickness and vomiting, from which a child may suffer, 
are increased by want of judgment in giving food and drink. When 



456 CARE OF CHILDREN AND THEIR DISEASES. 

there is nausea, the stomach will bear only very small quantities of 
food at a time, while cold drinks are almost always borne much bet- 
ter than warm. When there is nausea, it is best, for an hour or two, 
not to attempt to give any food or drink. After the stomach has been 
thus completely rested, give a single teaspoonful of cold water. If 
this is not thrown up, it may be succeeded, in ten or fifteen minutes, 
by a second or a third. If this is borne, give a little water thickened 
with isinglass, or cold barley-water, or cold milk and water; and 
then, with the same precautions, and in very small quantities, beef 
tea, or chicken broth, or whatever else the doctor in attendance may 
direct. The smallness of quantity, the coldness of the articles, and 
the giving it without moving or disturbing the child, if possible, are 
the important points to be attended to. 

It is of great consequence that children suffering from diarrhoea 
should have their skin kept very clean. The pores should be kept 
well open, so that the fluid matter which is passing off by the bowels, 
and through the mucous membrane or inner skin, may be diverted to 
the outer skin. In this disease, the skin of children is apt to become 
irritable, or even sore. In these cases, soap and water are quite apt 
to increase the soreness, while a little starch, made as for use upon 
clean clothes, though much thinner, will, if used in place of soap, 
very much soothe the inflamed skin. 

A child much exhausted by diarrhoea, or other disease, should be 
moved or lifted out of its cot or cradle as little as possible. Sud- 
denly, moving it when very weak may cause fainting, or even con- 
vulsions. Let it be sponged and cleaned by merely turning it, with 
great gentleness, from side to side. 

In such cases, too, the child should be supported with proper nour- 
ishment. When worn down by diarrhoea, its desire for food may be 
nearly lost. Though at one time it cried much, and seemed to suffer, 
it will, in this condition, grow quieter, and doze, and even sleep on 
for hours, appearing fretful only when roused. If, in such cases, the 
child be allowed to go without food because it does not seek it, or 
declines it when offered, it will sink into a deeper and deeper sleep, 
and finally into a stupor which will end in death. To give a little 
arrow-root, or broth, may now require trouble and perseverance ; but 
it must be done, for upon it depends the child's life. The effort to 
administer food must not be abandoned because once or twice, or 
several times unsuccessful, for the food which is refused one minute 
may be accepted five minutes after. 

In the various rashes from which children suffer, there is a very 
general fear of washing the surface lest the rash be driven in. There 
is no ground for this fear, unless it be in measles ; and even in this 
complaint there is no danger if lukewarm water be used. If only a 
small part of the body be sponged at a time, there is nothing to fear 
even from frequent washing ; and the passing of a wet sponge fre- 
quently over the surface is a great comfort when the skin is burning 



CARE OF CHILDREN AND THEIR DISEASES. 457 

with fever. The same remark applies to the changing of the linen. 
The same kind of objection, and with no better reason, is often urged 
against cold water in fevers, though it is most refreshing, and if 
taken in small quantities, and often, never does harm, but often much 
good. 

The Warm Bath. — The best method of giving a child a warm 
bath is a matter of importance. There should be as little parade 
about it as possible. If the child sees the bath prepared, is taken out 
of bed, undressed and put into it smoking before its eyes, it may be 
much alarmed, and cry so passionately as to be really injured by it. 
The bath should be prepared out of its sight, and brought to the bed- 
side with a blanket spread over it to hide the steam. The child 
should then be laid upon the blanket, and gently let down into the 
water, and then set to play with a couple of corks with feathers stuck 
in them. 

Inflammation of the Mouth. — Ery thematic Stomatitis. 

This is a simple inflammation of the mucous membrane of the 
mouth, and is very common during infancy. It may be confined to 
the tongue, or spread over the whole mouth. It is sometimes very 
severe, going down into the gullet and stomach, and into the wind- 
pipe. It occasions redness and pain in the mouth and fretfulness of 
the infant, causing it to quit the nipple suddenly when nursing. A 
frequent result of this inflammation is the secretion and exudation 
upon the surface of a white, matter-like curd. It appears in small 
points and patches. This is the thrush, or what nurses call children's 
sore mouth. It is commonly confined to the period of suckling. 

Treatment. — For the simple inflammation of the mouth, a wash 
made by infusing the inner bark of slippery elm in water answers a 
good purpose ; and in more severe cases, a wash made of sugar of 
lead (227) will be found useful. 

In some mild cases of curdy exudation, this last wash will do well, 
if united with the daily use of the warm bath, and proper care of the 
diet. But in the more severe cases, a little pulverized borax and 
white sugar or honey (274), (275), placed occasionally on the in- 
fant's tongue, will do good service. A decoction of equal parts of 
blue cohosh and golden seal is a good remedy. When the curdy 
patches are large, touch them with a mixture of hydrochloric acid 
and honey (276). If the exudation have a look as if mortification 
were taking place, use a wash of chloride of lime (228), or chloride 
of soda, etc. (229), or creosote and mucilage (230), or alcohol and 
vinegar (231), or nitrate of silver (211). When diarrhoea is present, 
with acidity, give (26). In the more severe cases, when appearances 
of mortification are seen, quinine (69) should be administered. 



458 CARE OF CHILDREN AND THEIR DISEASES. 

Follicular Inflammation of the Mouth. — Apthae. 

This disease attacks the little glands of the mouth, called follicles, 
and appears about the time of cutting teeth. Small white specks, a 
little elevated, first show themselves on the lips, insides of the cheeks, 
and under side of the tongue, etc. The specks enlarge, a whitish, 
curdy matter flows out from their centre, and ulcers are formed, with 
elevated edges, surrounded by a red, inflamed circle. Sometimes, 
instead of curdy matter, a bloody exudation takes place, and dark- 
colored crusts are formed which are mistaken for mortification. In 
bad cases, there is great restlessness, with hot mouth, dry skin, thirst, 
and diarrhoea, with green stools, and sometimes salivation. 

Treatment. — The milder forms of this disease are treated like 
simple inflammation of the mouth. If there is thirst, give several 
times a day, a spoonful of cold water, with a little gum arabic dis- 
solved in it. If the child be weaned at this time, its food should be 
barley or rice-water, sweetened with white sugar. An occasional 
dose of magnesia, with or without a little rhubarb, will remove the 
acid which abounds in the bowels. After ulceration has taken place, 
borax (274) will do well. When watery discharges from the bowels 
and griping pains appear, preparation (28) should be used. If the 
strength be reduced, give (69). 

Inflammation of the Gums. — Gengivitis. 

During the cutting of teeth, the gums are apt to be inflamed, red 
or livid, swelled and painful. The child is languid, with a hot and 
dry skin, small and quick pulse, little appetite, much thirst, and a 
tongue covered with a thick, yellowish fur. When ulceration takes 
place, and is allowed to go on, the teeth become loose, black, and 
rotten, and often soft and pulpy; a flow of fetid spittle takes place, 
the breath of the child becomes offensive, and its countenance pale 
and sallow. The gums bleed under the least pressure, and a profuse 
diarrhoea fills up the list of ills. 

Treatment. — In the first stages, mild washes to the gums, such as 
(227), will do well. Clear out the bowels at once with magnesia and 
rhubarb (26). After ulceration has taken place, use oak-bark (232), 
or chloride of lime (227), or diluted hydrochloric acid (233). A 
daily tepid bath. If the strength be reduced, use an infusion of 
Peruvian bark, or quinine (69). 

Gangrene of the Mouth. — Canker. — Cancrum Oris, 

This disease attacks weakly children, of a lymphatic temperament, 
and having inflamed gums. It often follows intermittent, remittent, 
or bilious fever, and is also frequently connected with disease of the 
stomach and bowels. 



CARE OF CHILDREN AND THEIR DISEASES. 459 

Symptoms. — It is attended with languor, listlessness, indisposition 
to play or move about, thirst, loss of appetite, peevishness, and ina- 
bility to sleep. The countenance is pale and sunken, and there is a 
peculiar puckering of the cheeks about the corners of the mouth. 
The breath is bad, the gums have the appearance of salivation, the 
teeth become loose and fall from their sockets, or, if they remain, they 
become covered with a thick coating of a dirty white or ash color. 
A few ash-colored water-pimples appear upon the gums, which en- 
large, *un together, and finally break, — presenting a black appearance 
of mortification. The gangrene, sooner or later, goes to the lips and 
cheeks. 

Treatment. — When bowel complaints exist, they are to be treated 
with the usual remedies, such as (70) or (156). If there be active 
inflammation of the gums, at first, leeches may be applied, after 
which, the inflammation being subdued, a wash of oak-bark (232) 
will be in place, with quinine given internally (69) to ward off the 
mortification. As a wash, too, a strong solution of sulphate of cop- 
per (234) is excellent; so is white vitriol (235), and nitrate of sil- 
ver (219), and creosote (236). 

The diet should be beef-tea, plain beef or mutton broth, with rice, 
milk and rice, tapioca, sago, and the like. 

Difficult Teeth-Cutting. 

Teeth-cutting generally begins between the ages of five and 
seven months. It is indicated by redness, heat, and tenderness of 
the gums, an increase of saliva, and, occasionally, redness of the 
cheeks, watering of the eyes, thirst and fever, with fretfulness, dis- 
turbed sleep, and more frequent motions of the bowels, a little more 
fluid than usual, and sometimes of a greenish hue. As the tooth 
comes near the surface, the child holds its fingers in its mouth and 
presses the gums harder upon the nipple when nursing. Beside 
these milder symptoms, there are sometimes ulceration of the mouth, 
gangrene, extensive and long-continued diseases of the bowels, and 
even disorders of the brain, convulsions, and palsy. 

Treatment. — Watch the gums, and the moment they are swollen 
by the teeth pushing them up, lance them at the elevated points, cut- 
ting entirely down to the advancing teeth, — so that no tough mem- 
brane shall cause pain by impeding their growth. These incisions 
often prevent fatal disease of the brain, and sometimes almost in- 
stantly relieve the most threatening symptoms. Before the teeth 
are far enough advanced for lancing, some soothing wash may be 
applied to the gums, or a leech or two to the angle of the jaw. For 
obstinate diarrhoea, with watery stools and griping, use prescription 
(157). If the child be drowsy and starts from sleep, and has heat 
and redness, with enlargement of the blood-vessels about the head, 



460 CARE OF CHILDREN AND THEIR DISEASES. 

put three or four leeches behind the ears, and make cold applications 
to the head. At the same time, open the bowels with castor-oil (17). 
When there is difficulty of passing the water, give flax-seed tea ; and 
if the pain be considerable, a sedative (351) ; one half teaspoonful 
in as much water, every hour till quiet. 

Croup. 

This is one of the scourges of childhood. Croup is an inflamma- 
tion of the mucous membrane of the larynx and windpipe. It causes 
a peculiar fluid to flow out upon the surface of the membrane, which 
stiffens into a membrane, or skin-like substance and adheres to the 
inner surface of the windpipe, and sometimes extends through the 
whole of the bronchial tubes. This is membranous croup, — the worst 
and most fatal form of the disease. The ordinary form of croup con- 
sists in a congestion of the vocal chords with oedema and swelling, so 
that the voice is very husky and the cough very much like a hoarse, 
tight bark. This form is the result of cold, and is usually quickly 
amenable to treatment, although it is really quite frightful for 
parents to hear. 

The Symptoms of croup are, difficulty of breathing, hoarseness, 
and a peculiarly loud and ringing cough, with fever. In fc the mem- 
branous and worst form of the disease, the breathing is not, at first, 
so laborious, and the symptoms generally not so violent and alarm- 
ing as in the less fatal but more inflammatory type. This latter kind, 
though generally causing great alarm, like a highway robber, by the 
sudden fierceness with which they seize the throat, are yet much 
less fatal, and of course less to be feared, than the membranous form. 
The disease is pretty much confined to children between the ages of 
one and eight years. 

Treatment. — The mild and ordinary form of croup, so frequently 
experienced by young children at night time, is usually much allevi- 
ated by small, oft-repeated doses either of the syrup or of the wine 
of ipecac, say five drops (for a child two years old) every fifteen 
minutes, till nausea, and even vomiting ensue, then much less often. 
The inhalation of steam, and of many of the medicated vapors, is an 
excellent method of treatment for the older children. One tea- 
spoonful of the compound tincture of benzoin in a bowl of boiling 
water inhaled through a tin funnel is a very simple thing and a very 
efficacious one ; this is to be repeated every twenty minutes. In 
cases which do not yield to this treatment at once, the employment 
of turpeth mineral, in one-half to one-grain doses every half-hour till 
the child vomits,. will clear up almost any severe case. The accom- 
panying bronchitis which often follows is to be treated as laid down 
for that disease. Membranous croup is in reality diphtheria, and is 
to be so treated, the exudation being in the windpipe rather than in 






CARE OF CHILDREN AND THEIR DISEASES. 461 

the throat. As soon as the case is diagnosed, the child is to be quar- 
antined in a room by itself, and all the precautions taken against 
spreading the disease that would be employed in diphtheria proper. 
The newly-discovered antitoxin, with which the world has now been 
blessed for a year or two, has already saved hundreds and thousands 
of lives by its timely use. Nothing is simpler, nothing more effica- 
cious, and nothing less deleterious. (See Diphtheria, page 485.) 

The inhalation of the vapor of water-slacked lime softens the 
membrane and causes the little one to breathe with more ease. 
Place a bucket under a tent made with a sheet spread over the crib, 
into this bucket put a piece of lime the size of a turnip, and gradu- 
ally add a little water. The fumes produced are not hard to bear, 
but an adult should also get under the tent, so that the little one 
will not be frightened. Keep the room warm, with plenty of moisture 
in the air. Liquid diet which is very concentrated, like beef-extracts, 
milk and egg, etc., with stimulants, should be given every two hours. 
Support the strength and heart by simple tonics like quinine, one- 
half grain in powdered sugar, or in a tiny pill, every two hours. 

Spasm of the Glottis. — Laryngismus Stridulus. 

This disease consists in a sudden shutting up of the glottis, or 
passage to the windpipe, which creates a feeling of strangulation, 
and a difficulty of breathing so great that the drawing in of the 
breath causes a peculiar crowing sound. There is no fever. The 
child, upon taking food or drink, or upon being irritated or teased, is 
taken suddenly with an impossibility of drawing in its breath. After 
struggling convulsively for a time, its head thrown back, its nostrils 
dilated, its mouth open, its eyes rolled up, its face pale, its legs and 
arms stiff, it begins to breathe with a shrill crowing sound. The 
disease is sometimes mistaken for croup, and for hooping-cough. It 
is strictly spasmodic in its nature. 

Treatment. — During the paroxysm, set the child in an upright 
posture, with the head leaning forward, exposed to a full draft of 
cool, fresh air, and sprinkle cool water upon the face. Let nothing 
be tight about the neck. Slap the child slightly on the back, and 
apply friction along the spine. If these means do not succeed, place 
it in a warm bath ; while in the bath, sprinkle cold water on the face. 

When the fit is over, examine the gums. If they are swollen, lance 
them down to the coming teeth. The bowels should be moved daily 
with some gentle physic, but not irritated by severe purging. If the 
stools are light-colored, use the following prescription : Podophyllin, 
one-half grain, alcohol, one ounce, elixir, one ounce, and take a tea- 
spoonful in a teaspoonful of water, three times daily. 



462 CARE OF CHILDREN AND THEIR DISEASES. 



Whooping Cough. — Purtussis. 

This is a contagious disease, peculiar to childhood, and occurring 
but once in the same individual. It is characterized by a convulsive, 
paroxysmal cough, which is attended by long-continued hissing, con- 
vulsive breathing, with rattling in the windpipe, which is succeeded 
by several short efforts to expel the breath, following each other in 
quick succession. The long, convulsive breathing, attended by the 
whooping sound, is immediately repeated ; and these paroxysms con- 
tinue until a quantity of thick, slimy, ropy mucous is thrown up, by 
expectoration or vomiting, when the breathing is again free. These 
paroxysms have all the appearance of impending suffocation, redness 
of the face, shedding of tears, sweating about the head and forehead, 
and such agitation of the whole body that the child lays hold of 
something for support. Blood sometimes starts from the nostrils, 
and the child involuntarily passes water or evacuates the bowels. In 
spring and autumn the disease most prevails. It is not generally 
dangerous. 

Treatment. — First give an emetic, — say, two drams of wine of 
ipecac. Afterwards, give small doses of ipecac and sulphur (277). 
From six to fifteen grains of sulphur alone, three times a day, is an 
excellent remedy. A liniment of olive oil, oil of amber, etc. (193), 
applied to the spine, is useful. Belladonna (278) is a good remedy. 
Prussic acid (96) is strongly recommended by many, and is worthy 
of a trial. Lobelia (106) is a valuable remedy. Alum (279) is well 
recommended. Sulphuric ether, a little being spilled in the nurse's 
hand and held to the child's nose, generally shortens the paroxysm, 
and frequently abridges the disease. A solution of nitric acid in 
water, as strong as lemon-juice, and sweetened, is a very valuable 
remedy, breaking up the disease in two or three weeks. The 
child may drink it freely, a little further reduced with water. In- 
halations of cresoline are the most useful to abridge and soften the 
paroxysms. 

There are remedies by the legion that have from time to time been 
used against whooping cough, but few of them have survived their 
infancy. Among the more modern drugs bromoform still holds a 
prominent place. Given in one to six-drop doses in a tablespoonful 
of water, three times a day, and gradually increased to five and ten 
drops, respectively, the drug exerts a marked impression on the 
duration and severity of the disease. Antipyrin, in five- to ten-grain 
doses, according to age of child, given three or four times daily, 
mitigates the paroxysm and shortens the disease. The burning of 
cresoline, a coal-tar product obtainable at all drug-stores, is a most 
valuable means of cutting short the 1 disease. This liquid should be 
put in a tin box-cover and set over a lamp with very small blaze, — 
just sufficient, in fact, to evaporate the cresoline. A lamp for the 



CARE OF CHILDEEN AND THEIR DISEASES. 463 

purpose comes with the cresoline, but any ordinary lamp with ser- 
rated lamp-chimney may just as conveniently be used. The odor 
is strongly tarry. The vapor should be confined in the sleeping 
chamber at night, but may also be burned both night and day. 

Looseness of the Bowels. — Diarrhoea. 

Infants and children are more liable to diarrhoea than adults, and 
this is the reason for speaking of the disease here as well as else- 
where. It may be caused by inflammation of the stomach and 
bowels, by irritation produced by too much or improper food, by cold 
and damp weather, or by teething. The discharges from the bowels 
may be more or less thin, of a dirty white color, of a curdled appear- 
ance and acid smell, or they may be watery, yellow or green in color, 
and often mixed with blood. Sometimes they are mixed with por- 
tions of undigested food, are very acid, and when the looseness has 
been caused by unripe vegetables and fruit, in a state of fermentation, 
like yeast. At other times, especially while teething, they are a kind 
of thick mucus, like jelly. 

If pressure on the bowels causes pain, the diarrhoea is the result of 
inflammation. When the disease has become chronic, the skin is dry, 
harsh, and discolored, the face wrinkled, looking yellowish, dirty, 
and old. 

Treatment. — First, regulate the diet. This is very important. 
In the case of older children, take away every kind of solid food, as 
well as pastry, confectionery, sweetmeats, and fresh vegetables. Give 
plain boiled rice and milk, — sometimes boiled milk, — water gruel, 
crackers and milk, tapioca, etc. At the beginning of the attack, give 
some mild physic, as castor oil, or syrup of rhubarb. A warm bath 
at this period is excellent. If the discharges are very sour, dissolve 
a teaspoonful of bicarbonate of soda in half a tu'mbler of water, and 
give a teaspoonful every hour, or the same amount of lime-water, 
mixed with an equal quantity of new milk, or prepared chalk and 
ipecac (158), some slight astringent being used also (159). But 
better than all other astringents for this complaint is a decoction of 
the cranesbill or spotted geranium with milk, or of the bark from 
the root of the common blackberry, which is armed with strong 
prickles. 

The Summer Complaint of Infants. — Cholera Infantum. 

This is confined to the North American continent. It occurs in 
large cities during the hot season. Its subjects are infants between 
the ages of four and twenty months, — occurring most frequently 
about the time of cutting the first teeth. It is one of the most fatal 
diseases of infants. 

Symptoms. — It begins with a profuse diarrhoea, — the stools being 



464 CARE OF CHILDREN AND THEIR DISEASES. 

green or yellow, or more often light colored, and very thin. The 
stomach soon becomes very irritable, ^— rejecting everything with 
violence. In some cases, vomiting and purging set in, — the dis- 
charges from the bowels being without color or smell. The infant 
rapidly loses flesh, and is soon reduced to great languor and prostra- 
tion. The pulse in the beginning is quick, small, and often tense. 
The tongue is covered with a white, slimy mucus. The skin is dry 
and harsh. The head and belly are hot. The feet and hands are 
either of the natural temperature, or cold. There is great thirst, and 
towards evening, fever. The belly is often a little swollen, and 
tender to the touch. Occasionally there is delirium, as indicated by 
wild and bloodshot eyes, violent tossing of the head, and attempts to 
bite and scratch the nurse. 

Treatment. — If possible, remove the child at once from the im- 
pure and heated air of the city to the cooler and purer air of the 
country. Or better, take it to the seashore or a short trip on the salt 
water. This will often give immediate relief. Be careful the child 
does not take cold. If this cannot be done, keep it in as large and 
dry a room as can be had, and take it often into the open air in clear 
weather. Confine the infant entirely to the breast, or, if weaned, let 
its food be tapioca, pure arrow-root, rice flour and milk, and put it 
daily in a warm or tepid bath, according as the skin is hot or cold. 
Give it gum-water, or rennet whey, with a little gum-arabic added 
to it. 

These measures, if used early, will often cure the disease, without 
medicine. If the vomiting be obstinate, camphor and sulphuric 
ether (280) will generally give relief. When everything else fails, 
in relieving the sickness, sugar of lead (160) is generally successful. 
When the vomiting is stopped, the most prompt remedy for the dis- 
ordered bowels is the compound syrup of rhubarb and potassa. 
When the disease has become chronic, treat it the same as children's 
diarrhoea. But if the discharges are sour, offensive and dark colored, 
pulverized charcoal (42), with tartrate of iron (71), will be suitable 
remedies. Rhubarb, leptandrin, etc. (28), will often answer a good 
purpose. B 

Colic, 

Infants are very much subject to colic, from over-feeding and 
consequent acidity of the stomach, from giving them solid food at 
too tender an age, and from some improper thing eaten or drunk by 
the mother or nurse. They often suffer intensely from these pains, 
tossing their legs up and down, and screaming vehemently. When 
it arises from costiveness, the bowels are often hard and swollen. 

Treatment. — When it arises from costiveness, give an injection 
of a tablespoonful of castor-oil, and a half-ounce of warm infusion of 
peppermint or spearmint. At the same time, administer internally 
an infusion of one of the same herbs, with a small portion of bicar- 



CARE OF CHILDREN AND THEIR DISEASES. 465 

bonate of soda dissolved in it, and sweetened with loaf sugar. Or, 
if the bowels need to be acted upon, the syrup of rhubarb, or the 
sweet tincture of rhubarb, with a little soda in it, will do well. Para- 
goric generally brings relief, but should not be used, if simple car- 
minatives will answer the purpose. Children are often relieved by 
covering them with a hot flannel, laying them upon the belly on the 
knee, and trotting them, at the same time tapping them gently upon 
the back. This should be done cautiously ; for if unsuccessful, it 
might increase the suffering ; and the infant has no language but 
screams to tell its distress. Five drops of aromatic spirits of ammo- 
nia, with same amount of spirits of lavender, in warm water, relieve, 
if often repeated, most cases. 

Falling of the Bowel. — Prolapsis Ani. 

In cases of long-continued looseness, the lower bowel of children 
sometimes gets so weakened that it drops down, and projects through 
the fundament. Occasionally, only the mucous membrane which 
lines it comes down, in the shape of a small tumor, causing a sense 
of bearing down and smarting. These fallings-down occur when the 
child goes to stool. Whether it be the bowel or the lining membrane 
which has come down, if it be allowed to remain long down, inflam- 
mation will take place, and to return it will then be very difficult. 

Treatment. — Place the child upon his back, and, having smeared 
the thumbs, or forefingers, with lard or sweet oil, press them gently 
upon the tumor in such direction as shall tend to return it within the 
body. If this does not succeed, push the forefinger into the gut, so 
as to relax the circular muscle which contracts upon and holds it. If 
the falling is caused by straining at stool, made necessary by costive- 
ness, some ripe fruit stewed in molasses, or rye hastj^-pudding and 
molasses, should be given to the child daily, and it should be caused 
to empty the bowels while standing up. To strengthen the bowel, 
few things are better than cold water, applied to the fundament 
several times a day. An astringent wash of oak-bark (232) is also 
valuable. Should the bowel become so much relaxed that these 
means fail, a tight bandage must be applied to support the funda- 
ment. Be careful that some ignorant pretender does not — as has 
happened — apply the ligature or the knife, and cut off the tumor, 
instead of returning it into the body. Feed upon the simplest of 
liquid food. 

Gastric Fever of Infancy. 

The inflammatory affections of the bowels, which happen after 
teeth-cutting, are frequently accompanied by remittent fever, — the 
fever showing itself very distinctly towards evening, and subsiding, 
or nearly disappearing, in the morning. It is a sympathetic fever, 



466 CARE OF CHILDREN AND THEIR DISEASES. 

and is generally the result of a reaction produced by inflammation of 
the stomach, or ileum, or colon. The attack is sometimes sudden, 
though generally gradual. 

Symptoms. — For several days, the child will be languid and 
fretful, with loss of appetite, increased thirst, and some heat of skin. 
Towards night these symptoms are more intense ; the skin is more 
hot, the thirst and restlessness are greater, the pulse more rapid. In 
the morning, the skin is more moist and cool, and the child falls into 
a short, disturbed sleep. Early in the attack, the bowels are consti- 
pated, — though there is sometimes diarrhoea, or a frequent desire to 
go to stool without much being passed. The evacuations are always 
unnatural and very offensive. They are dark-colored, or clay-like, or 
of the consistency of tar, — sometimes mixed with mucus, and occa- 
sionally with blood. There is tenderness of the belly, and pressure 
upon it causes pain. It is also hot to the touch, while the feet are 
cold. The face is flushed, and the breath has a decidedly sickly 
smell. The stomach is irritable, and vomiting is frequent. The 
tongue, after a time, becomes coated, dry, and pointed. 

In the chronic form of the disease, there is, frequently, diarrhoea, 
the passages being unhealthy and fetid ; the tongue is covered with 
a brownish-yellow mucus, the gums with sores ; the lips are parched 
and cracked; the urine is scanty and high-colored, with a white sedi- 
ment; the skin, dry, harsh, and dirty-looking; the countenance con- 
tracted and wrinkled ; and there is, frequently, a dry, hacking cough. 

Treatment. — Regulate the diet. This is important. In recent 
and acute cases, withhold all food, except some cold mucilaginous 
fluid to drink, as rice-water, gum-water, infusion of slippery-elm bark, 
or milk diluted with barley-water. Give a warm or tepid bath daily. 
Purgatives should be used sparingly. The bowels, when costive, had 
better, generally, be opened by injections of tepid water, or thin 
gruel. If any laxative be used, let it be the compound rhubarb 
powder, or either of the following (28), (281). When the discharges 
have become healthy, and the tongue clean and moist, some light 
bitter, as the infusion of Peruvian bark, or calumba, in combination 
with diluted sulphuric or hydrochloric acid, may be given. These, 
carefully given, with the daily tepid bath, and exercise in the open 
air will soon restore the strength. 

Mesenteric Disease. 

This attacks scrofulous children between the ages of three and 
ten years. Its symptoms are a prominent belly and loss of flesh, — 
particularly upon the arms and legs. To be able to feel the enlarged 
and hardened glands through the walls of the belly is the surest 
sign of this disease. When the complaint is long-continued, the 
child loses all its flesh, and dies in almost a complete skeleton state. 



CARE OF CHILDREN AND THEIR DISEASES. 467 

Treatment. — If there is inflammation or other disorder in the 
stomach or bowels, attend to this first. Then put the patient on a 
generous diet,.such as meat-broths, etc. Give bicarbonate of potassa, 
dissolved in the infusion of calumba or quassia, and when there is 
costiveness, add rhubarb to the preparation. For the enlargement 
of the glands, apply, externally, an ointment (184) of the iodide of 
lead, or of the iodide of potassium (185). Give an ioduretted bath, 
daily, which is formed by adding one grain of iodine and two grains 
of iodide of potassium to each gallon of warm water. 

The syrup of iodide of iron should be given, internally, three times 
a day, in a little water, or the iodide of potassium, and compound 
infusion of gentian. Daily sponging the body in salt and water, and 
exercise in the open air, are important. 



Rickets. 

This is also a disease of scrofulous children. By some defective 
process of nutrition in such children, there does not enter into the 
bones enough phosphate of lime to harden them, and the weight of 
the body, or the pulling of the muscles, o1? the pressure of the 
clothing, bends and distorts them in all manner of ways. The heads 
of the thigh-bones are pushed nearer together, making the lower belly 
narrow; the backbone is so curved as to lessen the height; the 
shoulder-blades stand up like wings when flying is contemplated j 
and the shoulders are so lifted up that the head seems only a little 
higher than the elevations on each side. 

Treatment. — A good, generous, wholesome diet, properly regu- 
lated; out-door exercise; the tepid or cold salt-water sponge-bath, 
with friction, and but little medicine. The hypophosphite of lime, 
in two-grain doses, given in a little sweetened water, three times a 
day, or the syrup of the hypophosphites, in half-teaspoonful doses, 
three times a day, may be given with advantage. The pyrophosphate 
of iron, combined with the lime, makes a good tonic for scrofulous 
children. 

The Blue Disease. — Cyanosis. 

This disease is known by a blue, purple, -or leaden tinge over the 
whole body. The warmth of the body is reduced, there is difficult 
breathing, which is increased by quick motion or by crying. The 
disease is generally fatal. The blueness is occasioned either by the 
passage between the right and left side of the heart remaining open 
after birth, so as to let the blue, venous blood run through and mix 
with the red arterial blood, thus making the whole blue, or by the 
obstruction of the pulmonary artery, which withholds the blood from 
the lungs, and does not allow it to be arterialized and reddened. This 
latter opinion is the more general one now. 



468 CARE OF CHILDREN AND THEIR DISEASES. 

Treatment. — Keep the patient, as much as possible, in a state of 
rest, so that the circulation may not be hurried. Allow pure, fresh 
air, easily-digested food, and protect the body from cold and damp- 
ness. Hold the infant near the fire, and apply gentle friction over 
the head and body with a warm, soft cloth. 

Fits. 

Most persons have seen a baby in fits; and it is a sad sight, — its 
little face all distorted and livid, its eyes rolling and squinting fright- 
fully ; its hands clenched, arms bent, legs drawn up, body arched 
backward, and limbs twitching violently, — itself insensible and un- 
able to see or swallow or move. After a time, the fit ceases, some- 
times by degrees, at other times suddenly, the child fetching a deep 
sigh, and then lying quiet and pale, as if it had fainted. From this 
state it passes into a sleep, and, on waking, some hours after, seems 
quite well. 

Fits may attack a child which is apparently well, occurring daily, 
or even several times a day, and it may linger on for weeks. A 
child may have fits from a great variety of causes ; they therefore, 
have a different meamng in different cases. But they alivays show 
that the brain has in some way been disturbed. 

Treatment. — As fits are not a disease in themselves, but only a 
symptom of some disease, the treatment must have reference to the 
cause. Sometimes, while the fit lasts, it is wise to do nothing. But, 
if a fit come suddenly, in the case of a child previously healthy, it is 
generally safe to place it in a hot bath, and at the same time to dash 
cold water on its face, or to pour cold water on its head, or hold on 
it a large sponge dipped in cold water. The hot bath will draw the 
blood to the skin, and away from the overloaded brain. It will quiet 
the disturbance of the system, and if scarlet-fever or measles are 
about to appear, it will bring them out. 



DISEASES OF THE GENERAL SYSTEM 

AND MISCELLANEOUS DISEASES. 



Having now treated of those disorders which affect the skin, the 
brain and nerves, the throat, the lungs and their appendages, the 
heart and its covering, the abdominal cavity and its lining membrane, 
the sexual organs, and those complaints peculiar to females and chil- 
dren, it remains to speak of those others — fewer in number — which 
are not specially developed in any particular part, but disturb the 
whole system. 

Fever. 

Fever is a disease which affects the system generally, and is char- 
acterized by more or less excitement of the circulation, increased 
heat, diminished strength, and, oftentimes, unnatural thirst. The de- 
gree of excitement is measured by the state of the pulse. Of this 
state, there are two characteristic indications : namely, frequency and 
hardness. A pulse is frequent when its rapidity exceeds that of 
health ; it is hard when its stroke resists the pressure of the ringer 
with unusual force. 

In health, the pulse of an adult beats from sixty to eighty times in 
a minute ; that of children is more frequent. The pulsations of the 
heart of the unborn infant, as heard through the body of the mother, 
are one hundred and fifty in a minute. After birth, the pulse varies 
from one hundred and forty down to the standard of adult age. To 
appreciate hardness of pulse, experience is absolutely necessary. 

The great activity of the circulation, in fever, is intimately con- 
nected with the heat and thirst, and tends directly to waste the ener- 
gies and consume the strength of the patient. The heat of fever 
lessens or dries up the secretions, or different fluids of the body, 
which, in a state of health, are separated from the blood for various 
purposes. This is the cause of the dry skin, scanty urine, etc. 

A crisis of fever is that period in its course when unfavorable 
symptoms give place to those of returning health. 

A course of fever, or, in common language, a run of fever, is dis- 
tinguished by a great variety of symptoms, which will be more par- 
ticularly spoken of in the pages which follow. 

469 



470 DISEASES OE THE GENERAL SYSTEM. 



Typhoid Fever. 

Of the different kinds of fever, this is one of the most common 
and Widely prevalent. The name typhoid is from two Greek words 
which mean like typhus, or s'milar to typhus. The word typhus, from 
a Greek word signifying stupor, means stupid, dull or low ; and, when 
applied to a fever, implies that is low, or characterized by great nerv- 
ous depression. 

Typhus and typhoid fevers, if not identical, are so similar in his- 
tory and treatment as to make unnecessary their consideration under 
separate heads. The following is one of the differences claimed to 
exist between the two : namely, in typhus fever, the belly is flat ; 
there is no marked disease of the bowels, and generally no diarrhoea 
until the second or third week. In typhoid fever, on the contrary, 
some small glands, called Peyers glands, situated in the lower part 
of the small intestines, are always inflamed, and sometimes ulcer- 
ated ; and consequently, among the symptoms most frequently no- 
ticed, are diarrhoea, and drum-like swelling of the belly, called tym- 
panites. 

Symptoms. — The disease often has precursory symptoms. For 
several days before its actual beginning, the patient droops. He may 
attend to his various duties, but does not seem well ; he is low-spir- 
ited and languid ; is indisposed to any exertion of body or mind ; has 
pains in the head, back, and extremities ; loses his appetite ; and 
although dull and perhaps drowsy in the daytime, his sleep is inter- 
rupted and unrefreshing at night. The immediate harbinger of the 
fever is a chill, often so marked as to cause violent shivering. 

The history of the first week shows increased heat of the surface ; 
frequent pulse ranging from eighty to one hundred and twenty ; 
furred tongue ; restlessness and sleeplessness ; headache and pain in 
the back ; sometimes diarrhoea and swelling of the belly ; and some- 
times nausea and vomiting. 

The second week is frequently distinguished by an eruption of 
small, rose-colored spots upon the belly, and by a crop of little watery 
pimples upon the neck and chest, having the appearance of minute 
drops of sweat standing on the skin, and hence called sudamina, or 
sweat-drops ; the tongue is dry and black, or red and sore, the teeth 
are foul ; there may be delirium and dullness of hearing ; and the 
symptoms generally are more serious than during the first week. 
Occasionally, at this period, the bowels are perforated or eaten 
through by ulceration, and the patient suddenly sinks. 

If the disease proceeds unfavorably into the third week, there is 
low muttering and delirium; great exhaustion; sliding down of the 
patient towards the foot of the bed ; twitching of the muscles ; bleed- 
ing from the bowels ; and red or purple spots upon the skin. 

If, on the other hand, recovery takes place, the countenance bright- 



DISEASES OF THE GENERAL SYSTEM. 471 

ens ; the pulse moderates ; the tongue cleans, and the discharges 
assume the appearance they have in health. 

Treatment. — Give the patient good air, and frequent spongings 
with water, cold or tepid, as shall be most agreeable to his feelings. 
Keep the bowels in order ; by which is meant, be more afraid of 
diarrhoea than of costiveness. Diarrhoea should be restrained by a 
little brandy. 

For costiveness, give injections, or the mildest aperients (7), 
(10), (12). 

To lessen the frequency of the pulse, reduce the fever, and pro- 
duce perspiration, give from three- to ten-drop doses of the tincture or 
fluid extract of veratrum viride every hour. This remedy has great 
power in fever. 

Great wind-swelling of the bowels may be relieved by fomenta- 
tions, or hot, steaming applications. Sometimes the wind may be 
let off by introducing into the bowels a long India-rubber tube, — 
thus reducing the swelling, and greatly promoting the patient's com- 
fort. 

If pain in the head be severe and constant, let the hair be cut 
short, and the head be frequently bathed with cold water. 

Let the strength be supported by light nourishment ; and in case 
of bleeding from the bowels, or great debility, by broth and wine. 

For foul mouth, the weakest possible infusion of old hyson tea is 
valuable. Good nursing is eminently desirable. 

If the fever runs a low course, the patient being much prostrated, 
quinine, even in large doses, may be given from the beginning. 

Be very sure the patient has absolutely no solid food during the 
fever and for five days after. There is nothing so good as milk for 
typhoid fever, — a glassful every two to three hours will be all the 
food required. 

Bilious Remittent Fever. 

There are three principal varieties of periodical fever, which, 
though varying considerably from each other in several particulars, 
are yet essentially, in their substance, but one disease. These are 
Bilious Remittent Fever, Pernicious Intermittent or Congestive Fever, 
and Intermittent Fever or Fever and Ague. According to the custom 
of most writers, I shall treat them separately, beginning with Bilious 
Remittent Fever. 

Symptoms. — The attack is generally sudden and well marked. 
Some writers say it has no premonitory symptoms ; others that it 
has. The more general understanding is, that for a day or two, or 
even longer, before the onset, there is a sense of languor and debility, 
slight headache, lack of appetite, furred tongue, bitter taste in the 
mouth in the morning, pains in the joints, and general uneasiness. 

The formal onset is nearly always marked by a distinct chill or 



472 DISEASES OF THE GENERAL SYSTEM. 

rigor, — sometimes slight and brief ; at other times severe and pro- 
longed. The chill may begin at the feet, or about the shoulder- 
blades, or in the back, and thence run like small streams of cold 
water poured in every direction through the whole body. There is 
generally but one well-marked chill, the returns of the paroxysms of 
fever being seldom, after the first, preceded by the cold stage. 

At certain periods of the day there is an increased intensity in the 
symptoms of the disease, occasionally preceded, though generally 
not, by the chill. Between this period of severity in the feverish 
symptoms, and a similar period which follows it, there is generally a 
decrease in the violence of the symptoms, during which the fever 
moderates, but does not, as in fever and ague, entirely go off ; has 
distinct remissions, but not complete intermissions. 

During the hot stage, the pulse is up to one hundred and twenty, 
or one hundred and thirty. There are pains in the head, back, and 
limbs, of a most distressing kind. 

The tongue is generally covered with a yellowish or a dirty-white 
fur ; and in bad cases in the advanced stage is frequently parched, 
brown or nearly black in the centre, and red at the edges. There is 
no appetite for food, and generally nausea and vomiting ; and usu- 
ally there is pain and tenderness in the epigastrium. The bowels are 
at first costive, but afterwards become loose, and there are frequent 
evacuations of dark, offensive matter. 

Causes. — This disease is produced by malarial exhalations from 
the decomposition of vegetable matter. It is most prevalent in hot 
climates, and in the summer and autumn. 

Treatment. — If the fever be in the formative stage, and have not 
fully developed itself, give an emetic (1), (2), and follow it with a 
mild cathartic (7), (13). 

If the disease be already developed, sponge the body all over sev- 
eral times a day, with cold or tepid water, according to the feelings 
of the patient, and give cooling drinks (132), (133), (298), (299). 
To moderate the fever, give three- to ten-drop doses of tincture, or 
fluid extract of veratrum viride. The compound powder of ipecac and 
opium is a valuable preparation for the same purpose. Give cold 
water as drink if desired by the patient, or let him eat ice. 

When t'he headache is very severe, let wet cups be applied upon 
the temples or behind the ears ; and the same remedy to the pit of 
the stomach, when there is great tenderness, is often desirable ; though 
a mustard poultice will sometimes do better. 

During the remissions of the fever, quinine and other tonics are to 
be given, as in fever and ague. Quinine, in large doses, acts almost 
as a specific for these diseases. 



DISEASES OF THE GENERAL SYSTEM. 473 



Malarial or Congestive Fever. 

This is the pernicious or malignant form of malarial fever. It is 
marked, either in the earlier or later stage, by a rush of blood towards 
one or more organs, by which they are crowded full and congested, — 
hence its title of congestive fever. 

Symptoms. — It may be intermittent or remittent, — more com- 
monly, it is the former. It may assume any of the types of period- 
ical fever, but it is most frequently quotidian or tertian. 

The. first attack does not differ very materially from a common 
attack of simple intermittent. The first paroxysm is simple, exciting 
but little attention. The second is always severe, producing great 
coldness, and a death-like hue of the face and extremities. The ad- 
vancement of the disease brings dry, husky, parched, and pungently 
hot skin, followed, after a time, by a cold clammy sensation. The 
eyes are dull, watery and sometimes glassy ; the countenance dull, 
sleepy, distressed; the tongue, at first white, changes to brown or 
black, and is usually tremulous; the breathing is hurried and diffi- 
cult. Pressure over the liver, stomach or bowels produces pain. 
The mind is often disturbed, and falls into lethargy and stupor, or is 
delirious. 

Treatment. — This should be very much like the treatment of the 
bilious remittent fever. 

While getting up from the fever, the diet must be light and nutri- 
tious at first, but may be increased in quantity as the strength re- 
turns. Exercise out of doors must not be omitted. If recovery be 
slow, some mild tonic, or a little wine, or ale, or brandy may be taken 
two or three times a day. Ten grains of quinine, taken four hours 
before the expected chill, will put a stop to these attacks like magic. 
After a day or two the dose may be diminished. 



Fever and Ague. — Intermittent Fever. 

This is a kind of fever in which there is a succession of attacks 
with equal intervals and intermissions that are complete but unequal, 
on account of the uncertain duration of each fit. 

An interval is the period of time between the beginning of one fit 
and the beginning of the next. 

An intermission is the period of time between the close of one fit 
and the beginning of the next. 

The different varieties of ague take their designation from the 
length of the interval in each case. 

The interval of a quotidian, or daily ague, is twenty-four hours. 

The interval of a tertian, or third-day ague, is forty-eight hours. 

The interval of a quartan, on fourth-day ague, is seventy-two hours. 



474 DISEASES OF THE GENERAL SYSTEM. 

Symptoms. — The disease first develops itself by an ague-fit. This 
has three stages, the cold, the hot, and the sweating. The cold 
stage is very marked. The patient has a sense of debility, yawns, 
stretches, has no appetite, and does not wish to move. The face and 
extremities become pale, the skin shrinks, causing universal horripi- 
lation, or goose-flesh ; the patient shakes, and his teeth chatter. 

After a time, these symptoms decline, and the hot stage comes on, 
which is characterized by high fever, with its various uncomfortable 
sensations. 

When this fever passes off, it is followed by the sweating stage, 
during which a moisture breaks out, which increases, frequently, to a 
profuse sweat ; the body returns to its natural temperature, the pains 
and aches disappear, and a feeling of health comes back. 

During the cold stage, the blood is driven inward from the sur- 
face, and particularly oppresses the spleen, which, in cases of long 
standing, becomes swelled and permanently enlarged. This swelling 
may be plainly felt, and is often quite perceptible to the eye. It is 
called ague-cake. 

Ague-fits begin at different hours of the day, and generally termi- 
nate in the evening. 

A quotidian usually begins in the morning; a tertian at noon; and 
a quartan in the afternoon. 

The cold stage is shortest in the quotidian, and longest in the 
quartan. 

Thus the longest fit has the shortest interval, and the shortest cold 
stage ; while the shortest fit has the longest interval, and the longest 
cold stage. 

There are also double tertians and double quartans, wherein the 
fits repeat themselves, — sometimes the same day, at other times on 
alternate days. 

To these varieties, the terms postponing and anticipating are ap- 
plied, according as the intervals are growing longer or shorter. 
When a person is recovering from ague, the interval may gradually 
grow longer, the attack being put off, or postponed. But if the dis- 
ease be increasing in severity, the attack may anticipate its usual pe- 
riod, making the interval shorter. 

Tertians are more common than either qrfotidians or quartans. 

Agues are more prevalent in spring and autumn. Fall agues are 
most severe and dangerous. 

Causes. — Exhalations from the soil, called malaria, arising from 
decomposition of vegetable matter in new countries, or from low and 
marshy districts in which the land is alternately covered with water, 
and again left dry and exposed to the sun. 

In districts where it prevails, high hills are exempt, and even the 
upper stories of houses are more healthy than the lower. 

Treatment. — First clear the bowels with the fluid extract of 



DISEASES OF THE GENERAL SYSTEM. 475 

senna (15), or the preparation (21). Then, in the cold stage, give 
hot, and in some cases, stimulating drinks. Administer hot foot- 
baths, and putting the patient in bed, apply bottles filled with hot 
water to the feet, sides, and back, and in every way try to excite 
warmth and comfort. 

In the hot stage, give cooling drinks, and camphor (117), (118) 
in decided doses; or, what is better, quinine (67) in two-teaspoon- 
ful doses every half hour, at the same time giving five-drop doses of 
tincture or fluid extract of veratrum viride every hour. 

During the sweating stage, stop the veratrum, and rub the patient 
with dry towels. 

In the intermission, give quinine (62), in three-grain doses once in 
three or four hours, and continue it, gradually decreasing the dose, a 
fortnight after the cessation of the attacks. The following is a good 
preparation : quinine, one scruple ; elixir of vitriol, one dram ; dis- 
solve the quinine in the elixir, and add tincture of black cohosh, 
fourteen drams. Twenty drops are to be given, in a little water, once 
an hour. 

Quinine is the one medicine which surely relieves and cures this 
disease. 

It is important, in fever and ague districts, to avoid the hot sun, 
and the damp evening and morning air. 

Yellow Fever. 

This disease belongs to warm climates, being most prevalent in 
Southern cities. It makes its appearance chiefly in the latter part of 
summer, and disappears upon the approach of frosty weather. 

Symptoms. — The complaint begins, generally, with a chill, which 
is sometimes severe, though commonly moderate, of short duration, 
and rarely repeated. 

Following this chill, there is moderate fever and a little heat of 
surface; but this rarely rises to any considerable height, and only 
continues to the second or third day, when, in fatal cases, it gives 
place to coldness of surface, etc. In many cases there is sweating. 

The pulse is peculiar, — not easily described, — generally not rising 
above one hundred in a minute, — a kind of bubble under the finger, 
which breaks and vanishes before it can be fairly felt. 

The tongue is moist and white in the first and second days, but 
red, smooth, shining, and dry, as the disease advances towards the 
close, having a dry, black streak in the middle. 

The most striking symptoms are nausea and vomiting. The 
vomiting, in fatal cases, is generally very persistent, and towards the 
termination, the yellowish or greenish matters thrown up give place to 
a thin and black fluid, having a sediment looking like coffee-grounds. 
This is called the black vomit. 

The bowels are generally costive, with frequent epigastric tender- 



476 DISEASES OF THE GENERAL SYSTEM. 

ness and distress. There is generally severe headache, and a peculiar 
expression of countenance, in which the lips smile, but the rest of the 
face is fixed and sad, sometimes wild. The patient continues wake- 
ful night and day. There are discharges of blood, often, from the 
nose, the gums, the ears, the stomach, the bowels, and the urinary 
passages. 

Treatment. — First, move the bowels with some mild physic (40), 
(18), (19), (41), (3T). 

During the chill, put the feet in. a mustard bath (242), give warm 
cordial drinks, and apply hot bottles, etc., externally. 

Cups may be applied to the back of the neck, or over the stomach, 
according to circumstances. 

During the second stage, or stage of calm, nothing is to be done 
but give some light stimulants, and to promote sweating by warm 
drinks and tincture of veratrum viride; and also quinine (62). 

The third and severest stage is to be met by stimulants, as brandy, 
freely given, with a continuance of the quinine. 

During the fever stage, and for the vomiting, give creosote, twenty 
drops to six ounces of spirits of Mindererus, and alcohol enough to 
dissolve the creosote. The dose is half an ounce every two hours. 
Said to be excellent for putting a stop to the retching and vomiting. 

Cleanliness, temperance, and cheerfulness are essential in warding 
of! the disease when one is exposed to its causes. 

Rheumatism. 

This is an inflammation of a peculiar character, being caused by 
acid or poisonous matter in the blood, and having for its seat the 
fibrous tissue, or that thready texture which enters largely into the 
composition of the cords and muscles of the human body. The 
synovial, or lining membrane of joints, is also peculiarly subject 
to rheumatic inflammation. Hence the terms, muscular rheumatism, 
and synovial rheumatism. There are also acute and chronic rheu- 
matism. 

Acute Rheumatism 

Is a very painful affection. It is most frequently brought on by 
exposure to wet and cold after violent and fatiguing exercise of the 
muscles. 

Symptoms. — Its principal characteristics are, high fever, with a 
full, bounding pulse ; furred tongue ; profuse sweat, which has a 
sour smell, and seems to increase the weakness without relieving the 
pain; scanty and high-colored urine, with brick-dust settlings; and 
swelling of the joints, with slight redness, great tenderness, and 
severe pain, which is particularly agonizing when the patient attempts 
to move. 



DISEASES OF THE GENERAL SYSTEM. 477 

This affection often changes suddenly from one part of the body to 
another, or from one set of joints to another. This sudden shifting, 
termed metastasis, is peculiarly dangerous ; for sometimes the inflam- 
mation, seeming to regard the constantly moving heart as a large 
central point, suddenly seizes upon its lining membrane and occasion- 
ally proves speedily fatal. 

Treatment. — It is well first to open the bowels freely with the 
compound powder of leptandrin, or the compound powder jalap. 
Then give tincture of black cohosh and tincture of veratrum viride 
(124), and push the preparation to the extent of producing sweating. 
This, if no evil effects seem to result from it, that is, no prostration 
or bad feelings in the head, may be kept up till the violence of the 
disease abates. 

Sometimes opium, nitrate of potash, etc. (127), administered one 
or more times* will have a good effect. 

The tincture of black cohosh root, two parts, and the tincture of 
colchicum root, one part, and given in doses of forty drops, is a valu- 
able remedy. 

For articular rheumatism, some form of the salicylates must be 
used and continued till all pain and soreness have entirely ceased for 
several days. Omit all sweets, condiments, and much meat from the 
diet. 

It is a valuable treatment, after clearing the bowels with salts and 
senna, to give equal parts of wine of colchicum and spirits of turpen- 
tine in doses of ten drops every two or three hours ; and after a day 
or two to give, in connection with the above, at intervals of five 
hours, tincture of chloride of iron, ten drops, with ten to twenty drops 
of laudanum. 

Fomentations of hops and cicuta, or stramonium leaves, placed 
upon the inflamed and swollen joints, will have a good effect in re- 
lieving the pain. The recent leaves of stramonium pounded, mixed 
with a little water, and laid upon the joints, are said to act very 
favorably. 

Salicylic acid and its salts, or salicin, the active principle of the 
willow bark, when given at the commencement of an attack, often- 
times arrests the course of the malady as effectually as quinine 
arrests the intermittent fever, or as opium and ipecacuanha arrest 
dysentery. It exerts such a beneficial influence that it is recognized 
by the profession as a specific. From ten to fifteen grains of salicylic 
acid, or the salicylate of soda should be given every two hours until 
relief is obtained. This usually takes place in from twelve to thirty- 
six hours. In most cases the fever and swelling will abate within 
the above time. If not entirely arrested, the disease is very much 
shortened. 

When the specific effect is produced on the system, it causes ver- 
tigo, headache, ringing in the ears. These symptoms indicate that 



478 DISEASES OF THE GENERAL SYSTEM. 

the medicine should be given in smaller doses and with longer inter- 
vals. For chronic rheumatism, Seawright's Lithia Water, drunk 
in large quantities, is one of the best remedies. 

Chronic Rheumatism. 

The chronic form of rheumatism may follow the acute as its con- 
sequence, but is more often an independent disease. It is seldom 
attended by fever, and in this differs from the acute rheumatism. 
It often lasts a long time, and causes much suffering. 

Symptoms. — These are various, but are generally understood, 
even by the common people, to consist of pain, lameness, stiffness, 
etc., in the joints and other parts. The joints are often swollen, but 
not as much as in the acute disease. It is peculiar to this form of 
the complaint, that when the patient remains at rest for a time, he 
will have pain and stiffness in the affected part on beginning to move, 
but as he grows warm both will disappear. 

Treatment. — This complaint is often palliated, and sometimes 
cured, by passing a current of electro-magnetism through the affected 
part. The diet is all-important; no sweets nor fats should be allowed, 
nor spices and other rich condiments are to be taken; meat is to be- 
eaten but once a day, 

The tincture or the fluid extract of black cohosh, taken in full 
doses, is one of the best remedies. It may be taken alone or mixed 
with the tincture of poke-berries, and a tincture of prickly-ash bark, 
if convenient. 

Opium and nitre (127) form a valuable remedy. Colchicum is 
much used, and has a deservedly high reputation (292), (301) . 

Liniments often have a good effect (190), (195), (196), 198). It 
is well to wear a piece of oiled silk over the affected part. It keeps 
up a gentle perspiration from the rheumatic surface, and materially 
hastens a cure. Iodide of potash in ten- to thirty-grain doses, with 
one-third glass of water, after food, three times daily, is an old but 
very efficacious remedy. The salicylates in this form are not without 
their special value, but are not so useful as in the acute form. The 
" Wonderful Wintergreen," lodia, Tongalin, are a few of the well- 
known reliable preparations that may be found on the market, each 
of which well deserve a trial in chronic rheumatism. 

To bathe the affected joint at bed-time with hot sweet oil, and 
then envelop it in cotton batting, to be kept on through the night, 
will often give much relief. Oil of cajeput relieves a large propor- 
tion of cases. 

The bowels must be kept regular, and all exposure to wet feet or 
clothes, and to currents of cool air when sweating, must be carefully 
shunned. 



DISEASES OF THE GENERAL SYSTEM. 479 



Gout 

Gout is rheumatism's cousin ; the parentage of both belong to the 
brotherhood of the acids. 

A very acid state of the blood, or a state favorable to the forma- 
tion of acid, is supposed to be the cause of the inflammation peculiar 
to both these disorders. In rheumatism, an acid which exists in sour 
milk, and in cider, called lactic acid, is thought to be the disturbing 
element. In gout, lithic or uric acid is known to be uncommonly 
abundant, and to form a principal ingredient of those concretions 
found in gouty joints and familiarly called chalk-stones. 

The larger joints are most often affected by rheumatism ; while 
gout prefers the smaller ones. In rheumatism, the pain is excru- 
ciating ; in gout, it is intolerable. There is truth in the humorous 
Frenchman's description of the pains of these two complaints, which 
is, in substance, as follows : Place your joint in a vice ; turn the 
screw till you can bear it no longer ; that gives you an idea of rheu- 
matism ; now give the instrument one more turn, and you have gout. 

Symptoms. — A fit of the gout, as it is called, generally makes its 
attack in the night. Its unsuspecting victim is first awakened, per- 
haps an hour or two after midnight, by an intensely burning, wrench- 
ing pain in the ball of the great toe, or some other small joint. This 
pain, with its accompanying symptoms of fever, continues with little 
abatement for twenty-four hours. There is then a distinct remission, 
when the sufferer may get some sleep. He has a similar experience 
during several succeeding days and nights, when the disease, which 
has been growing milder, leaves him. 

After a considerable interval, there is likely to be another similar 
visitation. The length of this interval is inversely as the number of 
attacks, — that is, it diminishes in length as the attacks increase in 
number ; in yet plainer and more homely terms, the attacks come 
" thicker and faster " ; the space between them gradually shrinking 
from three or four years to one or two months. 

Recovery from the first attack maybe complete, — the skin peeling 
off from the red and swollen joint, and leaving it strong and supple 
as ever. But, after several repetitions of the in- 
flammation, the joint becomes stiff, its motions 
being obstructed by the deposit of lithic acid con- 
cretions, or chalk-stones, the limbs are sometimes 
actually frosted over with crystals of urate of soda 
(Fig. 149). This form of urate of soda crystals 
differs very materially from Fig. 124. When these 
crystals appear upon the surface, and deposits are 
made in the joints, uric acid is not secreted as 
usual by the kidneys, but accumulates in the blood. 

But gout is a disease by no means entirely local in its character, 




4<S0 DISEASES OF THE GENERAL SYSTEM. 

It vitiates the blood, affects the system generally, and is often be- 
trayed by general symptoms long before the local mischief is indi- 
cated by one of the attacks. Irritability of temper, unpleasant 
sensations in the stomach and head, and various uncomfortable feel- 
ings of body and mind, have been considered as premonitory of this 
disorder. Many other organs also, besides joints, are subject to the 
gouty inflammation. The stomach, heart, lungs, head, and even the 
eyes, are known to have been thus affected. 

Causes. — Luxury and indolence — particularly the former — are 
regarded as the principal causes of gout. But poverty and activity 
will not always keep the disease away. Probably an improper diet 
has more to do with the creation of gout than all else. Starchy food, 
sweets, etc., which cause an acid fermentation, are most likely to set 
up the trouble. 

Treatment. — Colchicum is the remedy for gout. It removes the 
disease by exciting the kidneys to action, so that the poison is con- 
veyed away in the urine. Perhaps it acts in some other unexplained 
way as an antidote to the disease. One teaspoonful of the wine of 
colchicum may be taken two or three times a day, until relief is ex- 
perienced. It should then be continued, in ten-drop doses, for a few 
days longer, to prevent a relapse. The colchicum may be taken in 
the form of prescription (301). 

Coffee, drunk freely every day, is said to be a sovereign remedy 
for gout. 

The bowels must be kept in order, but not actually purged (34), 
(40). The diet must be simple and unstimulating. 

Let the inflamed joint be bathed often in a saturated solution of 
bicarbonate of soda in soft, warm water. Cold applications should 
not be made, as there is danger of provoking a sudden change of the 
inflammation to some internal organ. 

A regulation of the diet and open air exercise are the best meth- 
ods of fighting the' disease. 

Scrofula. — King's Evil. 

This disease was once thought to be peculiar to swine, and hence 
derived its name from sc?'ofu, a sow. It shows itself in various forms, 
— as hip-disease, white swelling, rickets, salt-rheum, etc. Persons 
affected by it are subject to swelling of the glands, particularly those 
of the neck. 

Symptoms. — In the beginning of the disease, small, hard, movable 
kernels appear about the neck, just under the skin. These are lym- 
phatic glands, and the swelling generally takes place long before there 
is any soreness, or perceptible redness. They may be felt under the 
skin, and, in the course of six months or a year, may grow to the 
size of a filbert, or even a hen's egg. Sometimes they are much 



DISEASES OF THE GENERAL SYSTEM. 481 

larger even than this, and very hard. They may appear in many 
other parts besides the neck. 

After a time, though very slowly, they come to a head and break, 
— discharging a watery fluid, or a mixture like whey and curd. 
They are seldom very sore. When they heal, they are apt to leave 
a puckered condition of the skin, and ugly scars. 

The scrofulous humor may sometimes affect the eyes, when the 
lids will become red and thick, and discharge mucus and water ; — 
the under lid sometimes turning out, and presenting a shocking 
spectacle. 

The scrofulous condition is generally supposed to be indicated by 
a white, delicate skin, thick lips, light hair, and a delicate constitu- 
tion ; but these signs are not worthy of much confidence. 

The disease often attacks the cellular tissue, causing numerous 
suppurations and abscesses. It also affects the bones, producing 
caries, necrosis, and other affections. It shows itself in certain in- 
flammations of the eyes, in the formation of running sores in the 
ears, and in various other ways. 

Causes. — It is contended by some that scrofula is in all cases 
inherited; that we receive it from our progenitors, as we do their 
other constitutional peculiarities ; that the disease is everywhere, and 
in all time, one and the same, which shows it to come from within, 
and not from without ; that were it dependent on external causes for 
its existence, it would be greatly modified by temperature, climate, 
and the peculiarities of the races affected by it. 

They assert that though the causes which are usually assigned 
for scrofula, such as living in cold, damp, and impure air, and the 
lack of sufficient food, connected with filthy habits, often have a 
powerful effect in developing scrofula already existing in the con- 
stitution, and of aggravating it when already developed ; it never 
produces it. 

How far these statements are to be received, I will not undertake 
to judge. It is certain that the disease is often inherited ; and if we 
admit that the other causes named have some share in its production, 
it is possible we may not go entirely astray. Yet my own strong 
suspicion that scrofula arises from the animal poison of syphilis, fil- 
tered through the blood of many generations, inclines me to the adop- 
tion of the above views. 

Treatment. — In olden times of superstition, this disease was be- 
lieved to be cured by the patient coming into the presence of the 
king, and being touched by his royal hand. The ceremony was 
called the " sacred touch." It was from this that the disease took 
its name of "king's evil." This superstition reached its height in 
the reign of Charles II. After the Restoration, the numbers who 
flocked to Whitehall and Windsor to receive the " touch," are said to 
have been immense, — no less than ninety-two thousand in twelve 



482 DISEASES OF THE GENERAL SYSTEM. 

years ; and the writers of that day declare that none failed to receive 
benefit. 

In modern times, believing that the ceremony of the touch was 
best adapted to the period when kings were thought to have sacred 
persons, we rely for the cure of tins disease upon rational medicine 
and hygiene. 

The medical treatment of it is constitutional and local. 

Iodine is the great remedy for scrofula. Dissolve one scruple of 
iodine and two scruples of iodide of potassium in seven teaspoonfuls 
oi water. Of this, give ten drops three times a day, in a little water, 
gradually increasing the dose to one and a half or twice that amount. 
The iodide of potassium,, as in prescription (101), is a good remedy. 

Where there is considerable debility, the iodide of iron, in doses 
of twenty-five or thirty drops, in water, three times a day, is a good 
preparation. The syrup of the iodide is the most agreeable form. 

The compound syrup of yellow-dock root, and the compound 
syrup of stillingia, taken sometimes alone, and at other times with 
two to five grains of iodide of potassium in each dose, are both ex- 
cellent medicines for scrofula. 

The bowels must be kept open by laxative food, or in the failure 
of this, by some gentle physic (12). 

Medicinal springs, particularly those containing iodine, are ex- 
cellent. Cod-liver oil benefits most scrofulous people. 

Before the tumors become very sore, let them be bathed several 
times a day with a solution of muriate of lime, or ammonia, or soda, 
two drams to the ounce of water. When they are inflamed, apply 
poultices of ground slippery-elm and powdered bayberry, equal parts. 
Powdered poke-root, or blue-flag may be substituted for the bayberry. 
If these things are not at hand, use white bread and milk, or flax-seed 
poultices. 

When the tumors have opened, and ulcers have formed, the ulcers 
must be washed out with soapsuds, and dressed with salve made of 
beeswax and sweet-oil ; or, when the ulcers are indolent, with the 
red iodide of mercury ointment. Let the dressing be changed two 
or three times a day. 

Great attention should be paid to the improvement of the general 
health. The diet must be ample and nourishing, — consisting of 
fresh meat, poultry, broths, soups, milk, and wholesome vegetables in 
such variety as the season allows. 

The skin must be washed daily with cool water and spirit, or water 
and saleratus ; and rubbed to redness with a coarse towel or flesh- 
brush. Either flannel or silk should be worn next the skin, summer 
and winter. 

Exercise must be regular, and cheerfully performed, in the open 
air. If the residence be in a damp and unhealthy air, it should be 
changed at once, if possible. In any case, a change of residence, from 
time to time, when travelling is not possible, is much to be desired. 



DISEASES OF THE GENERAL SYSTEM. 



483 



Scurvy, — Scorbutus. 

Owing to a better knowledge of this disease, and of its proper 
treatment, it is much less common than in former years. It chiefly 
affects seamen who make long voyages ; but is not entirely unknown 
on land. 

Symptoms. — Languor, loss of strength, and great depression of 
mind, are among the first signs of scurvy. To one about being at- 
tacked, work and play are alike burdensome. There is no heart even 
to move. The face and the whole skin look pale and bloated, and 
the breath has a fetid smell. The gums are swelled, soft, red, and 
spongy ; and they bleed upon the slightest touch, — sometimes the 
blood oozes from them spontaneously. The teeth get loose, and 
often fall out. The skin becomes covered with bluish or purple 
spots, — looking precisely like bruises. These spread and run into 
each other, forming large patches of discoloration. 

These spots appear to be formed by the bursting of the small capil- 
laries of the veins and arteries, which have grown too weak and rot- 
ten to hold their contents, and the infiltration of dissolved blood into 
the cellular substance under the skin. 

Ulcerous sores break out in various parts of the body, which smell 
badly, and discharge a thin matter. These ulcers are covered with a 
crust. Various parts of the body, the bones included, are twinged 
with pains. The pulse is weak and soft. All the secretions, includ- 
ing the urine, have an offensive smell, — as though the whole body 
were approaching putridity. In truth, the whole man seems to be 
disintegrating, decaying ; the flesn becomes soft, and dwindles ; and 
the bones break easily, — being afflicted with a decay approaching to 
rottenness. 

In bad cases, blood is discharged from the bladder, bowels, womb, 
nose, and mouth ; and the smallest exertion is followed by fainting, 
and in many cases, by sudden death. 

Causes. — The disease is owing to the use of food and drink begin- 
ning to be decomposed, and to living long at sea without vegetables 
containing certain acids. Its attacks are likewise encouraged by 
whatever weakens and depresses the nervous system, as long expos- 
ure to a moist, damp air, particularly when this is connected with 
confinement on board a ship, unclean linens, occasional loss of the 
usual rest, and great fatigue, as in storms. The force of these causes 
is increased by the loneliness, the sadness, and the despondency of 
the sailor's life. 

Treatment. — Sailors are very much protected from the disease 
now, by frequent returns to land, during long voyages, to procure 
fresh meats, vegetables, and water. This practice is very generally 
adopted, particularly by whale-ships, which make long voyages; 



484 DISEASES OF THE GENEKAL SYSTEM. 

and the result is, very little scurvy, and general nealth among 
the men. 

One of the best medicines for the disease is quinine ; it may be 
given in from one to two-grain doses twice or three times a day. 
Gentian and quassia are also suitable remedies ; so is the muriatic 
tincture of iron (73). 

But the best of all remedies are fresh and succulent vegetables, and 
also fruits. Spinach, lettuce, dandelion, sorrel, cresses, and the like, 
are among the very best things when they can be had. Lemon or 
lime-juice produces the happiest effects. Potatoes are among the 
very best remedies, — particularly if scraped and eaten raw. They are 
also valuable when cooked. Spruce beer is a good antidote ; and 
may be made at sea from the essence. Many kinds of beer may be 
brewed at sea, which are valuable. 

When the bowels are costive, cream of tartar, dissolved in water, 
and drunk freely, will be found the best remedy. If there be loose- 
ness of the bowels, morphine, laudanum, a tea made of logwood, or 
geranium, or the tincture of catechu, will be suitable. 

For the spongy gums, a solution of alum applied to them will be 
proper, or a mixture of equal parts of tincture of myrrh, catechu, 
and Peruvian bark ; and ulcers may be washed with the same. 

Vinegar, which is an excellent preventive in this disease, may be 
made at sea from molasses and water exposed to the sun. Two 
ounces of nitre dissolved in a quart of vinegar, and given in table- 
spoonful doses, three times a day, is said to be an excellent remedy. 

Every ship, on going to sea, should be supplied with dried fruit, as 
raisins, currants, whortleberries, prunes, etc. ; and should have peas, 
beans, rice, flour, sugar and molasses. Beside these, ships should 
have essence of spruce and lemon, and dried balm, sage, pennyroyal, 
and other herbs. 

Seamen, when down with this disease, should be moved with care, 
as the spark of life may be easily extinguished. 

Purple Disease. — Purpura Hemorrhagica. 

This has been sometimes ranked as an affection of the skin ; but 
it is not such ; it is rather a disease of the general system. 

Symptoms. — The complaint is known by the appearance upon the 
skin of two kinds of spots ; the one kind are small, round, bright-red 
points even with the surface, and changing in a day or two to a pur- 
ple or livid color, which are yellowish brown when about to disap- 
pear. This variety of the purples is quite simple, attacking, gener- 
ally, young persons, and in warm weather. It is sometimes tedious in 
its course, but never dangerous. It requires little treatment — pure 
air, wholesome diet, with quinia and the mineral acids, make up the 
chief part of it. It may be known by the spots not disappearing 
when pressed upon by the finger. 



DISEASES OF THE GENERAL SYSTEM. 485 

The other and more dangerous variety of the disease is attended, 
generally, by faintness, wandering pains, great debility, and the ap- 
pearance upon the legs, arms, and body, of dark-red spots, and irreg- 
ular, livid patches, looking just like the marks of recent bruises. 
These marks are caused by the effusion of blood in patches under the 
skin; and in this respect they are just like bruises, only they are 
produced by different causes. 

In the rapid progress of the disease, dark venous blood frequently 
oozes from the tongue, mucous membrane of the mouth, nose, 
breathing tubes, ears, vagina, womb, stomach, etc. The other symp- 
toms vary in different cases very much, but generally indicate great 
disturbance of the system. 

It often runs a very rapid course, but sometimes remains for 
months. The disease, as seen in this country, is oftentimes associ- 
ated with rheumatism, it not infrequently being the forerunner of a 
long and tedious rheumatic outbreak. 

Treatment. — The bowels are to be kept regular by gentle physic 
(26), (21), (12), (15). 

Iron is a valuable remedy (73). 

Astringents generally have a good effect (156), (159), (279), 
(305). The best astringent in this complaint is gallic acid, taken 
in five-grain doses every three or four hours. 

The sponge bath, twice a day, with tepid or cool water, and fol- 
lowed with gentle rubbing with a coarse towel, will do much to 
restore and equalize the circulation in the skin. 

During the active stage of the disease, the diet should be very 
light, — simple toast-water, rice and arrow-root gruel, and either alum 
or wine whey. 

While getting well, the patient may have a more nourishing diet, 
consisting of tender fresh meat, broths, etc. ; and must take gentle 
exercise in the the open air. 

When associated with rheumatism, the latter disease should be 
treated on the same lines laid down elsewhere for rheumatism. 

Iron usually is the mainstay for building up the blood, and should 
be given in some mild, unstimulating form, such as Bland's pills, or 
pepto-mangan, peptonate or albuminate of iron, etc. 

Diphtheria. 

Diphtheria is an acute, contagious and infectious disease, whose 
characteristic feature is the formation of a pseudo-membrane upon 
a mucous surface. It is a comparatively recent disease in this 
country, and only lately well understood as to its origin and pathol- 
ogy. The excessive mortality of this disease within the last fifty 
years has been so great as to justly frighten all parents at its ap- 
proach, and lead them to regard it as the most terrible of all modern 
scourges. In New York city alone, over fifty thousand deaths have 



486 DISEASES OE THE GENERAL SYSTEM. 

occurred in twenty-five years. It is one of the most fatal, as well as 
one of the commonest of children's diseases. It is impossible to say 
at the outset whether the type will prove to be a mild or severe 
one. A case commencing with sudden, severe constitutional symp- 
toms and high fever may go on to recovery; while one with slow, 
gradual development, and little systemic disturbance, may progress 
gradually and end in death. Nor is the amount of membrane present 
in any case a guide as to the final outcome of the case. Many very 
mild cases may not at first be recognized as diphtheria until later, 
when some post-diphtheritic paralysis or other complication ensues. 
These mild cases are equally contagious, and often the origin of a 
severe and most malignant epidemic. 

Cause. — True diphtheria is caused by a germ known as the 
Klebs-Loefner bacillus, either alone or in company with other germs ; 
it is originally a local disease, becoming general as the poisons ema- 
nating from these germs are absorbed into the system. 

This bacillus is always present in diphtheria, and found only at the 
site of the local infection, and when injected into animals produces 
all the characteristic symptoms of the disease. 

In doubtful cases, recourse is now had to the finding of these germs 
by cultures made from little particles taken from the suspected mem- 
brane. 

There is, besides the true diphtheria, a pseudo-membranous inflam- 
mation which runs a mild course, but which cannot be distinguished 
clinically from the real disease, except by making these cultures in 
the laboratory ; in the latter disease, the Klebs-Lcefner bacillus is 
always absent. On the other hand, there are often seen cases of true 
diphtheria so mild in character, and showing so little membrane, as to 
pass unnoticed, but which on bacteriological examination prove to 
be the dreaded disease ; hence in all doubtful cases arises the neces- 
sity, in these modern times of refinement in diagnosis and treatment 
of disease, of having an examination made that the exact disease may 
be properly diagnosed, and the appropriate treatment be speedily in- 
stituted. The development of bacteriological science within the last 
few years renders this a very practical and sure test of the presence 
of the disease. Accepting the proven origin of the disease to be 
microbic, still there are many circumstances influencing the develop- 
ment or arrest of the germs when once introduced into the throat, 
since it is one of the most variable and uncertain of the contagious 
diseases. It is said that a normal throat will not be attacked by the 
bacillus, while one with some slight abrasion, inflammation, or other 
lesion, certainly offers a fertile field for its development. It is essen- 
tially a disease of childhood, although it occurs at all ages. Cold 
and dampness, and all unsanitary conditions, are known to favor the 
germ development. 

It occurs mostly in cold weather, as at this time catarrhal con- 
ditions are present, favoring the rooting of the germ. 



DISEASES OF THE GENERAL SYSTEM. 487 

Propagation. — The germs are introduced for the most part by 
the air, although food may contain these bacilli. Domestic animals 
have been known to frequently convey the poison. All articles of 
furniture, clothing, the hands of attendants, etc., are common carriers 
of the diphtheritic germ, which is very tenacious of life, unless pre- 
viously disinfected, hence the absolute necessity of the greatest care 
in thoroughly cleansing everything which has come in contact with 
a diphtheritic patient. The writer once had the disease. The mat- 
tress on which he slept was put away, after a simple cleaning, in the 
attic for two years, and when later on it was brought down to accom- 
modate his two little brothers on one occasion, the disease was com- 
municated to them and they both died. 

Incubation Period. — This is quite uncertain in the ordinary case 
of air inoculation, depending on the condition of the throat, but 
probably it varies from one to twenty days. In the case of inocula- 
tion of the bacillus into the tissues of animals the period is only from 
one to three days. 

Location of Disease. — The tonsils, uvula, pharynx, nasal pas- 
sages and the larynx are the ordinary locations where the membrane 
is formed, but it may be found less commonly on the conjunctivae, 
border of the anus, vagina, and respiratory tract. 

All the internal organs may eventually become involved through 
the absorption of the germ poisons, and at the autopsy show marked 
hemorrhages, inflammations, congestions or fatty degeneration of their 
tissues. 

Symptoms and Diagnosis. — The characteristic feature is the 
membrane, which is apt to be of a dull gray color, firmly adherent to 
the tonsil or throat, spreading gradually and becoming thicker. To 
distinguish it from simple follicular tonsilitis, which is so common, 
is often difficult and frequently impossible without a bacteriological 
examination. The membrane of simple tonsilitis is white, begin- 
ning as little white specks like the curd of milk, and is usually easily 
removed without bleeding. The membrane of diphtheria spreads and 
attacks the uvula and back of the throat, the adjacent tissues become 
swollen, the neck increases in size, breathing becomes more difficult, 
the pulse more rapid and smaller, and prostration with drowsiness, as 
a rule, more and more marked. 

In simple cases, there is usually not much fever, but in severe 
cases the temperature may run high, with great prostration and 
languor; delirium and restlessness accompany the severe cases of 
great absorption of poison. The heart usually is rapid, with feeble 
pulse, but many severe cases have a very slow pulse, which ordinarily 
is a bad symptom. The heart in diphtheria is always the uncertain 
element, many cases dying suddenly and unexpectedly from heart 
paralysis. Albumen often appears in the urine, and is usually an 
evidence of the involvement of the kidneys ; this nephritis may 



488 DISEASES OF THE GENERAL SYSTEM. 

become chronic and persist long after the convalescence from the 
original disease, and may even prove fatal. When the membrane is 
deposited in the nares, the breathing is more labored, and bloody 
mucus may be seen in the nostrils, which hardens, forming crusts, 
or may run down on to the lip and cause sore places. As the tonsils 
grow larger and the nose becomes plugged, sleep is more and more 
disturbed by snoring and inability to properly inspire the air, so that 
the child tosses from one side of the bed to the other every few 
minutes. Add to this an encroachment by the membrane on the 
vocal chords or the larynx, and one sees a truly terrible malady, dis- 
tressing in the extreme. The encroachment into the larynx is 
suspected when the voice becomes husky and hoarse ; it finally may 
be reduced to a whisper. The membrane may be limited to the larynx 
alone, as in the so-called membranous croup, which is no more or less 
than diphtheria of this region. The symptoms of this affection are at 
first local, and as the disease progresses, become more and more 
marked and distressing till death ensues from suffocation. The face 
becomes blue, the chest heaves with the deep, labored respirations, 
the nostrils dilate, and the little spaces below the collar-bones more 
and more depressed and drawn in. 

The severity of the case depends much on the amount of absorp- 
tion from the throat, nose, or pharynx, of the toxines produced by the 
growth of the germs on the one hand, and the ability of nature on 
the other hand to resist the invasion. 

The odor of the breath in diphtheria is characteristic, and when 
once experienced is never forgotten. 

Sequelae. — Besides the chronic catarrh which is left at the origi- 
nal site of the membrane, and the ansemia (or paleness consequent 
on the impoverished blood), the most frequent, and the most charac- 
teristic sequel of diphtheria is paralysis, which comes on in from one 
to five weeks after convalescence. This paralysis lasts from two to 
six weeks, though it may last for months, and even for a lifetime. 
It is in no wise, apparently, proportionate to the severity of the dis- 
ease. It is seen in all parts of the body, particularly the throat and 
nose, causing a nasal twang to the voice, and the regurgitation of 
food through the nose. It may affect the muscles of deglutition and 
speech, may attack the legs, arms, diaphragm, and the sphincter 
muscles of the bladder and rectum. 

Prognosis. — The prognosis varies according to the age and 
health of the patient, the severity of the symptoms, place of attack, 
and the character of the epidemic prevailing ; nasal and laryngeal 
complications, as well as the large area of mucous membrane in- 
volved, increase the risks of the patient. The mildest cases may termi- 
nate fatally from relapse. The heart may give out at any time, and 
death may be close at hand when apparently all is going well. Un- 
favorable symptoms are pallor, prostration, vomiting, and inability to 






DISEASES OF THE GENERAL SYSTEM. 489 

take much nourishment, Aveakness of pulse with great rapidity or 
slowness, hemorrhages into the skin, restlessness and delirium. 

Prophylaxis. — The complete isolation of the patient in a room of 
the top story, supplied with as little furniture as possible, is requisite. 
All utensils and dishes should be thoroughly disinfected before taken 
out of the room. All discharges received into a vessel containing 
corrosive sublimate. All clothing should be boiled when possible. 

During the disease, some volatile oil, like eucalyptus, turpentine, 
carbolic acid, etc., should be vaporized through the room. The 
nurse in charge should not be in communication with other members 
of the household, nor children of the family allowed to play with 
others in the neighborhood, although they should be kept out of 
doors liberally, but carefully fed and in every way protected from 
catarrhal disorders. The patient after convalescence should be 
thoroughly bathed with soap and water, and finally with corrosive 
sublimate solution, including the hair. As much as possible of the 
furniture and other equipments that cannot be thoroughly cleansed 
by boiling water, steam or corrosive sublimate, should be destroyed; 
finally the room and its contents should be fumigated with sulphur 
fumes by burning three pounds of sulphur to every thousand cubic 
feet of air space. 

Members of the family should be kept from school and church and 
other public places, and their mouths and nostrils daily washed with 
some disinfectant like carbolic-acid gargle. Only thin, washable 
clothing should be worn in the sick room. 

Treatment. — From the first the treatment should be supportive, 
tonic, and stimulating. The temperature of the room should be kept 
at about seventy degrees, and plenty of fresh air and sunlight ad- 
mitted. The clothing and bedding should be changed frequently, 
and the recumbent position without exertion be insisted on. The 
diet should be liquid, and given every two to four hours, in definite 
quantity, not exceeding what the child can easily digest. Beef-tea, 
milk and lime-water, egg and milk, Bo vox or Bovinine in milk or 
water, are samples of the class of foods to be administered. Alcohol 
in the form of brandy, whiskey, champagne, etc., should be given 
freely ; there is more danger of giving too little than too much. The 
more septic or poisoned the patient, the more the alcohol will be 
tolerated and required. Very large amounts are taken in this dis- 
ease, as well as in all severely septic diseases. A five-year-old child 
will easily take from two to fifteen ounces of whiskey a day. Other 
valuable stimulants are strychnine, digitalis, ammonia, camphor, etc. 

Fever when high should be allayed by cold sponging or the cool 
bath. All hemorrhages, diarrhoea, or other exhausting complications 
must be stopped. Of internal treatment, perhaps none has stood the 
test of time better than that recommended years ago by Dr. Jacobi 
of New York, of which the following is an illustration : — 



490 DISEASES OF THE GENERAL SYSTEM. 

Corrosive sublimate, one-half grain; wine of pepsin, four ounces. 
Teaspoonful every two hours, for a child five years old. This is an 
antiseptic to the intestinal tract, and helps disinfect the system. 
Locally, the throat is to be sprayed with a solution of peroxide of 
hydrogen. If this smarts or excoriates the mouth, it may be diluted 
even to equal parts with lime water. This solution may be injected 
through the nose. It must be used freely and often. 

To destroy the bacilli, a one part to one thousand solution of 
corrosive sublimate in the form of spray may be used after the 
cleansing with the peroxide of oxygen solution, or what has recently 
been introduced as the Lceffler diphtheria spray, which consists of 
several antiseptics. 

The use of papoid, papayotin and other solvents of membranes, is 
frequently very beneficial: they may be sprayed or swabbed on to the 
throat. The sequelae are to be treated on general tonic principles; 
the catarrh is to be treated by the application of mild nitrate of silver 
solutions, and the paralysis by strychnia, massage, electricity, and 
general tonics. 

These measures constitute the main essential points in treatment 
in those cases which for any reason do not receive the modern 
antitoxin treatment. 

Since the better understanding of the Klebs-Lcefner bacillus, at- 
tempts have constantly been made to produce an antidote to the 
diphtheria poison, and it would now seem as if bacteriology had at 
last revolutionized the entire treatment of diphtheria, for of late a 
remedy called antitoxin has been found and successfully tested. The 
death-rate of diphtheria has been reduced nearly one half ; apparently, 
one of the greatest boons ever sent to humanity has been realized in 
antitoxin. 

For some time it has been known that the serum of animals immune 
from diphtheria, when injected into susceptible animals, would prevent 
the infection of cultures made from the Klebs-Lcefner bacillus ; and at 
last the essential elements, or the antitoxin, has been isolated. 

Not only has it been found that the injection of a given amount of 
antitoxin into the human subject would kill out the diphtheria, but 
also that, when injected into children not yet taken down with the 
disease, but who have been subjected to it, this antitoxin would 
actually prevent the occurrence of the disease in them, or, technically 
speaking, render them immune. 

For over a year now this modern blessing has been enjoyed by 
thousands of people all over the world. Reports are everywhere 
published by public institutions and private practitioners, speaking 
in figures more convincing than any statement could be, of the 
greatest advance in medicine that the last half century has witnessed. 
It is to diphtheria what Listerism was to surgery. 

The essential features of this treatment consist in the injection into 
some convenient part of the body, like the back, loins, or thigh, of a 
certain amount of this liquid proportionate to the age of the patient, 



DISEASES OF THE GENERAL SYSTEM. 491 

the severity of the disease, and the time elapsed since the outset of 
the symptoms. 

The dosage varies with all these conditions, and the particular 
variety of antitoxin employed. The repetition of the dose depends on 
the amount of improvement in the membrane. At first a reddening 
about the diphtheritic patch is seen, then a thinning out of the mem- 
brane and a general amelioration of the symptoms. To prevent the 
occurrence of the disease, only quite a small amount is required, and 
it needs to be injected but once. The great advantage of this treat- 
ment, outside of its favorable statistics, is the comfort derived by the 
patient in not being so frequently disturbed by other auxiliary 
treatment, as nothing else is required -to be done when the case is 
seen early. As a matter of fact, cases are often seen so late, and the 
poison has so successfully invaded the system as to render the anti- 
toxin treatment less potent, that medical men employ local measures 
to help out the antitoxin. The earlier the treatment is begun, the 
less antitoxin will be required, and the surer the successful issue. 

Like all great advances in medicine and surgery, this method is 
not without its enemies, who will tell of the ill effects to the blood 
experienced later in life. The only ill effects are certain rashes 
resembling hives, or urticaria, situated generally near the site of the 
punctures and due to local irritation. These all pass off in a few 
days, and are only annoying at the very worst. Should abscesses 
occur they may be put down as the result of an unclean syringe, or 
ascribed to the neglect of proper aseptic precautions on the part of 
the physician. 

This antitoxin serum, taken from horses after repeated inoculation, 
may now be obtained from local boards of health, and other similar 
authorities, thus enabling the poor to be able to procure free of cost 
this antidote against the most ravenous of diseases. 

Canker. — Aptha Communis, 

Veet few, if any, standard medical writers have treated of canker. 
In truth, it is only a symptom of various complaints, and not itself a 
disease. It has accordingly been shut out from medical books. It 
afflicts — yes, sorely afflicts, numerous persons, who, though doubt- 
less affected by some constitutional disturbance as its cause, are not 
conscious of any complaint except this single manifestation — canker. 
You find not only the disease, therefore, but complaints respecting it, 
in almost everybody's mouth: "What shall I do for the canker?" 
meets us at almost every turn. " I am sorely afflicted with the 
canker," says one. " I am literally sick with the canker," says 
another. And a third says, "I can neither eat, nor converse, nor 
take rest, I am in such pain from canker in my mouth." And these 
complaints are not unnatural, for the sufferings occasioned by tins 
affection are indeed terrible. 



492 DISEASES OF THE GENERAL SYSTEM. 

Canker begins in the form of small blisters, generally upon the 
tongue, or inside of the cheeks or lips, or stomach, which, after a 
time, break and form little ulcers, which are oftentimes very sore 
and painful. These ulcers will, at times, not only multiply, but 
spread themselves to large dimensions, going deep into the flesh, and 
becoming painful almost beyond endurance. In many cases, the 
parts swell, and become so sensitive and tender that it is almost im- 
possible to swallow the blandest food. The mouth will frequently 
become filled with saliva, which runs involuntarily out, to the great 
annoyance of the patient. 

Treatment. — Canker is frequently dependent on a deranged state 
of the stomach and bowels. When this is the case the treatment 
may begin with a dose of gentle physic (12), (15), (19), (26). If 
the stomach be quite permanently deranged, let this be followed with 
a somewhat prolonged use of prescription (28) or (37), or of the 
neutralizing cordial. If the mouth be very sore, use a tea of slippery 
elm bark, or flax-seed, or a solution of gum-arabic ; and as the in- 
flammation subsides, touch the ulcerated patches with the stick 
nitrate of silver (lunar caustic) ; or use gargle (201), (202), (203), 
(205), (208), (209), (232), (243), (244), or sulphate of copper, 
eight grains dissolved in two ounces of water. A tea made of rasp- 
berry leaves, or blackberry roots, may be freely used as a drink. 

One of the best remedies is hamamelis. Of this a dessert-spoon- 
ful may be held for a few moments in the mouth and then spit out. 
A teaspoonful may be taken internally, once an hour until relieved. 
Receipe 205 is not only useful as a gargle, but may be reduced by 
adding one pint of water, and may then be swallowed four or five 
times a day, in doses of two tablespoonfuls at a time. 

The diet should always be carefully regulated, arid only the more 
simple food taken, and at regular meals. 

To rapidly heal a canker spot, touch it with a wooden tooth-pick 
which has been dipped in a strong solution of carbolic acid. The 
ulcer turns white, and in a few days is completely healed. 



DISEASES PECULIAR TO MODERN 
TIMES. 






In so short a space as we have at our command the mere outlining 
of this chapter is all that can be expected ; whole volumes might be 
written, and that, too, much to the reader's profit and interest. 

Within the last fifty years diseases have assumed different aspects, 
while many actually new or heretofore unrecognized diseases swell 
the list of ailments. The " diathesis " of disease is the type of con- 
stitution inherited from the parents. From time immemorial, almost, 
there have been recognized five such types : the strumous, the ner- 
vous, the bilious, the lymphatic, and the gouty. Diseases of modern 
times tend greatly to the nervous type ; not only this, but individual 
characteristics are at times so pronounced as to form what are pro- 
fessionally known as " idiosyncrasies." These idiosyncrasies con- 
tinually increase, — so much so that what may be "food for one is 
poison to another." The causes of this change of tendency in disease 
are most numerous and especially noticeable in young countries. 

Born of busy, hard-working parents, whose lot in life has been to 
struggle hard in new lands, or cast among neighbors whose life has 
been one of hurry and excitement, the child receives a nervous im- 
petus at an early age, and his precociousness is considered to be due 
to an inheritance of unusual mental strength rather than to an over- 
strained nervous system of the parents and a consequent nerve-debility 
of the child. The child's early training is a rapid one, and at the 
early age of five or six the youth begins a course of school instruc- 
tion calculated to make a man or woman within a given time. The 
already frail nervous system is overtaxed ; when he branches out into 
business life, he already shows signs of mental feebleness, which 
should be the concomitant of long years of hard labor only. Society, 
too, claims so much of young people as unfits them for anything else 
but its own exactions. Too long waking hours and too short sleep- 
ing hours waste the surplus energy and call on the nervous system to 
whip up the tired body. The wear and tear of business life, with its 
constantly increasing complications and confinement to indoor work, 
only add to the strain induced at dentition and puberty. In modern 
times, when every business in rapidly growing towns and cities is 
being more and more " cut up," and when, consequently, greater 

493 



494 DISEASES PECULIAR TO MODERN TIMES. 

struggling for existence occurs, greater speed and anxiety, and more 
frequent disappointments are necessarily incurred. We rush through 
life nowadays. Advancing civilization is the cause of much of this 
extra speed. The press, telegraph, telephone, and steam appliances 
enable us to live faster, know and see more in a given time than ever 
before. The temptation is too great, and we rush on, regardless of 
tired bodies and exhausted brains, of overtaxed stomachs and sleep- 
less nights, to keep up with the times. Climates which are dry, with 
extremes of heat and cold, also cause much waste of nerve-force. 
The upbuilding of a new country has much to do with our diseases. 
At present the West exhibits that feverish eagerness for success in 
life once exhibited in the East. Europe has passed that stage of 
barometrical change in disease, due to advancing civilization, while 
the United States is passing through it. The faults of Europe lie 
in the direction of pleasure-excesses ; ours is an overworked nervous 
system. Our American liberty, and freedom of personal ambition to 
rise from the lowest station in life to the highest, from poverty to 
riches, and from ignorance to intelligence and honor, will always act 
as an excitant to the nervous system, and is the one cause of our 
excessive activity. We must hurry less ; give more time for Dame 
Nature to repair the waste of the system and to store up potential 
energy. We must divide more evenly our periods of sleep, recrea- 
tion, and work, that our children may become the possessors of more 
vital energy. We neglect too much old-fashioned methods of strength- 
ening our bodies, as outdoor gymnastics and walks. Even our sports 
tinge too much of speed and undue excitement, and partake too much 
of "professional " knowledge. Let us have fewer " finely-cut " men, 
and more robust ones. 

Thus it is we inherit a greater diathesis to nerve diseases. This 
diathesis means a greater susceptibility to stimulants and narcotics, 
social evils and greater risks. The changes peculiar to this diathesis, 
or those much increased by it, are the early and rapid decay of teeth, 
neuralgia, premature baldness, and hay fever; nervous dyspepsia, 
sick headaches, short-sightedness, St. Vitus's dance, sleeplessness, 
hypochondria, hysteria ; cerebral, spinal, digestive, and sexual ex- 
cesses ; inebriety, epilepsy and insanity. 

The first signs of ascension or declension in the health of a nation 
are seen in woman. The American woman of to-day offers a striking 
contrast to the original female inhabitant of this continent. The 
difference in the mental, moral, and social types may be well worth 
the cost, but we have sacrificed too much of the physical and nervous 
strength to have gained the most out of our three hundred years or so 
of existence. Womb troubles are almost the birthright of every 
woman, — so much so that necessity has developed in America a 
science for their relief, in a short space of time, as wonderful as the 
telegraph or telephone. The physician of to-day feels he must have 
at least a knowledge of gynaecology, whatever else he may or may 
not know. 



DISEASES PECULIAR TO MODERN TIMES. 495 

The terms nervous exhaustion, nervous prostration, neurasthenia, 
etc., are of modern invention. Ancients knew little of the continual 
noises of factories and teams, electric and steam appliances ; their 
wearied bodies were lulled to sleep by gentle sighing of the trees, 
and refreshed by sweet air. The evident cure for these increasing 
evils lies in a change in our national habits. We must cultivate the 
restful out-door recreation of the Indians ; we must go through life 
more slowly, eat less rapidly, and sleep longer. Cultivate the desire 
to enjoy nature and art more. Do business only in business hours 
and on business days. Indulge more in cool baths, rides, walks, and 
natural sports. Learn to do less in amount, but better in quality. 



OLD AGE AND ITS DISEASES. 



Life, like the natural day, has its morning, its noon, and its even- 
ing. Each period has its sunshine and its clouds ; its light and its 
darkness ; its fair weather and its storms ; its joys and its sorrows. 
The old do not feel the exhilarating brightness of the morning of life, 
nor the fervid strength of its noon ; but they often experience what 
is better : a calm, quiet stillness, and peaceful repose, in its evening. 

There is, perhaps, no one thing — certainly not many things — 
which impress the reflective mind and tender heart with more sadness, 
than to see an old man, bending low with years, with little or no self- 
restraint ; the passions all untamed, except so far as age has quenched 
their fires ; fretful, peevish, jealous, complaining ; distrustful of the 
ways of Providence ; doubting the integrity of any human being ; 
surrounded by clouds and darkness ; and stepping down gradually 
and reluctantly, amid a cold, drizzly, sleety, moral rain, into a dark, 
uncheered, and unillumined grave. 

On the other hand, how unspeakably pleasant it is to see the silver- 
haired pilgrim, in the evening-time of life, cheerful, happy, trustful 
in God and hopeful of men ; the winds and storms of life bringing 
little or no disturbance of his peace ; baring the head reverently and 
bowing it meekly in the presence of great afflictions, and lifting it 
up rejoicingly when blessings fall upon it ; converting, by the soft, 
subdued, and beautiful sunshine which he spreads around him, the 
very unpromising elements of the latest autumn into the finest Indian 
summer of life ; and finally sinking down peacefully to his rest amid 
the golden evening sunlight, and leaving the sky, long after, tinted 
with colorings more beautiful than artists ever conceived. 

"Why weep ye, then, for him who, having won 
The bound of man's appointed years, at last, — 
Life's blessings all enjoyed, life's labors done, — 

Serenely to his final rest has passed : 
While the soft memory of his virtues yet 
Lingers like twilight hues when the bright sun is set ? " 

Besides these general reflections, it is proper in this chapter to 
contemplate the old from several points of view. 

They are experienced persons, and Ave may learn much from them. 
To be sure, they have, in most cases, lost the acuteness of their 
senses. They do not hear, or see, or taste as sharply as the young, 



OLD AGE AND ITS DISEASES. 



497 






or even always think as quickly; yet their judgments are founded 
on a large experience ; their decisions, though not as prompt, or 
emphatic, or brilliant as those of younger persons, are more safe and 
reliable. They are worthy, therefore, of our respectful confidence. 
We may seek their counsel and advice, and in most cases follow it 
with safety. True, they are apt to be conservative, and to distrust 
new things and ideas ; but these new things and ideas are matters in 
which they have had no experience — matters which belong to an 
age subsequent to their time — matters, therefore, which lie outside 
the sweep of their active life, and respecting which they should not 
be expected to judge. It is no disparagement to them to say that 
they are not fitted to judge of those new thoughts and discoveries 
which have swarmed upon the world since the sun of their life has 
been sinking low in the western sky. But in all those staple max- 
ims and ideas which underlie human duties, in all ages, the old may 
safely be taken as our counsellors. 

Depositories of Family History. — They are the frail depositories 
and keepers of a vast deal of valuable family history, anecdote, and 
reminiscences of events fast fading from human recollection. Few 
errors of my own early life have been so much regretted by me as the 
neglect to learn from my aged relatives, when I had the opportunity, 
some of the more important points in the history of my family. My 
grandfather, Col. Gideon Warren, — a first cousin of Gen. Joseph 
Warren, and a personal friend of Ethan Allen, — lived in some of the 
towns of southern Vermont, and finally spent his last days and died 
in Hampton, N.Y. There stands his tombstone to this day, with the 
following beautiful words from Young's " Night Thoughts " engraved 
upon it ; — 

"An angel's arm can't snatch me from the grave; 
Legions of angels can't confine me there." 

These few facts are about the substance of what I know of his his- 
tory. In what town his father settled, who was one of three brothers 
who emigrated to this country, or who were his brothers and sisters, 
or what became of them, I have not been informed, simply because I 
did not obtain the information, now so much desired by me, as I 
might ^ easily have done, between thirty and forty years ago, while 
spending a year in Hampton fitting for college. An uncle of mine, 
Caleb Warren, was then living in Hampton, an old man. He had 
learned from my grandfather the full history of the family; and 
from him I might have derived knowledge which I should now value 
above price — knowledge which I intend yet to acquire, if the pres- 
sure of professional business shall ever be so lifted from me that I 
can command time for the investigation. Bub I shall never cease to 
remember the fact, or to lament my misimprovement of it, that from 
this venerable relative I might have learned facts and put them on 
record in one hour, which it will cost me weeks and months of cor- 
respondence, travel, and the searching of records to acquire. I say 



498 OLD AGE AND ITS DISEASES. 

to all young persons, value very highly the knowledge of your family 
history, which you may easily learn from your parents, grandparents, 
uncles, aunts, etc., and esteem those very highly who are able to 
impart it to you. Soon these living records will be suddenly blotted 
by the hand of death ; and then no regret for past negligence will 
enable you to repair your loss, if you have not improved your oppor- 
tunity. 

The Fathers of our Race and the Founders of our Institutions. — 

The aged people who yet linger among us are our fathers. We have 
our existence, through God, from them, and from others who have 
preceded them to the silent land. They educated the present race. 
All that is valuable in the moral principle and mental culture of the 
men and women of this generation, has been derived from them. 
Much of their lives was spent in training us, mentally and morally, 
and fitting us for usefulness. 

Not only the fine moral and intellectual characters which are found 
everywhere, acting like salt and leaven in human society, are the 
work of their hands ; but society, and government itself, have been 
handed down to us by them, with much valuable instruction as to 
the means of their preservation. We can scarcely conceive the 
amount of obligation our fathers have laid upon us in giving us 
these vast blessings. The men who have been the means of bringing 
us into life ; who have educated and trained us ; who have preserved 
our government and passed it into our hands unbroken ; who have 
built and enlarged our colleges, established and improved our un- 
equalled common schools ; have founded and endowed our charitable 
institutions, and thus made our land famous throughout the world, 
are certainly worthy — those of them who are yet among us — of our 
constant regard and veneration. 

Loneliness of the Aged. — The old are left, in some sense, alone 
in the world. The age in which they have had their active being 
has gone by. The world has slid from under them ; and they stand 
far out, as it were, on a narrow neck of land between this world and 
the next, from which they hear strange sounds coming to them from 
the moving mass of beings of whom they are soon to take leave. 
Most of the companions with whom they started in the journey of 
life have, one by one, dropped away from their side, and the younger 
and stirring multitude who have come after them are moved by new, 
and to them strange thoughts and aspirations. The throng of younger 
men is driven forward by impulses which they never felt, and in paths 
which they never trod. Manners, speech, dress, modes of doing busi- 
ness — all have changed. The old-fashioned fire-place, the stage- 
coach, the boy's bow and the girl's courtesy to strangers in the street, 
these all — some of them useful and some of no further value — 
have disappeared, never more to be enjoyed by those who so much 
prized them in their day. 



OLD AGE AND ITS DISEASES. 499 

What wonder if at times a sense of loneliness and desolation should 
steal into the minds of the aged ? It is not without cause that they 
often yield to melancholy reflections. The young have their com- 
panions and their sports. The companions of the old have mostly 
gone ; and for sports they have no agility. Cut off from the present, 
they are thrown upon the past, and too often look gloomily to the 
future. They should be sympathized with and encouraged. We 
should sit by their side, and talk with them of the manners and 
events of other days. Their conversation is often instructive as well 
as amusing. Would we engage in it with right feelings towards the 
old, it would be to us a source both of profit and pleasure. To a 
right-minded person, few things are more pleasurable than, to sit by 
intelligent aged persons, cozily seated in a large armed-chair, and 
listen to their tales of personal adventure and experience. They 
enter upon such narratives with so much animation, and live over 
the past with such evident satisfaction, that the benevolent person 
would find pleasure in engaging them in that conversation for this 
reason alone. 

Helpless Dependence of the Aged. — No one thing should tend more 
to excite our pity, compassion, and kindly feelings for old people, than 
their helplessness and dependence. It is one of the best indications 
of humanity to deal gently with the weak. The old are in their 
second childhood. In their day, they have been strong and vigorous 
— laboring, many of them, in season and out of season, to support 
their families and gain a competence. They have felled the primitive 
forests, and brought the soil under the dominion of the plough and 
hoe ; they have constructed turnpikes and built bridges ; made ships 
and sailed them over stormy seas, whitened every harbor with the 
emblems of commerce ; filled every city with the beautiful creations 
of art, and the useful productions of mechanical handicraft ; created 
systems of education and philanthropy ; framed strong governments 
and worked them, — in a word, have carried the world upon their 
shoulders, without bending or giving tokens of exhaustion. But a 
multitude of years have robbed them of the strength which did all 
these things. They now totter like a young child. The brain which 
conceived and the arm which executed are alike feeble. How proper 
that much which is kindly should now be done for those who have 
done so much for us and for the world ! Oh, let the old have a 
warm place in the affections ! Supply, as far as possible, all their 
wants. Go with them, in spirit, into the shadows of evening, within 
which they are retiring, and there hold them up. Be a staff to them 
in their weakness ; and, if it be possible, when the shades deepen 
around them, lift the curtains of the future and let in upon them, 
though it be never so few, some rays of light from the heavenly world. 

From these general remarks, I pass to consider — 



500 OLD AGE AND ITS DISEASES 



The Changes occurring in Advanced Life. 

Growth, maturity, and decline are the three periods which divide 
and measure human life. 

During growth, the deposit of new matter takes place more rap- 
idly than the decay or waste which is also going on. 

During healthy maturity, waste and increase are exactly equal, 
the one taking place just as rapidly as the other. 

The decline of old age reverses the order of growth, and waste 
outstrips addition. The newly deposited matter comes, but not so 
rapidly as the old is cast away. 

Declining Age may be said to extend from fifty to sixty. 

Incipient Old Age from sixty to seventy. 

Ripe Old Age from seventy to eighty. 

Decrepitude or Second Infancy from eighty to the end of life. 

During all these periods, particularly during the latter, important 
structural and other changes are occurring in the human system. 
Piles, apoplexy, paralysis, diseases of the liver, kidneys, and bladder, 
with organic changes of the heart, dropsy, chronic affections of the 
breathing organs, gout, etc., frequently appear. 

No fear of Death. — It is a wise and merciful provision of Provi- 
dence, that as old age advances, and the natural end of life draws 
near, the dread of death diminishes. As the aged gradually lose 
their hold upon life, they do so with less and less reluctance, until 
finally they let go willingly, and part from it even with joy. Persons 
passing from life at the age of eighty or upwards, generally look 
forward to death with more of pleasure than of fear. It is one good 
reason why it is desirable to live to great age, that life may come to 
a close without those harassing fears which so many dread. 

Preservation of Old People's Health. 

It is proper here to speak of the hygiene of old age, or the means of 
preserving aged people's health. 

It is natural to desire a continuance of life ; and except in the case 
of the extremely old, there is a general wish for its prolongation. 
Those who are born of parents who have lived long, are more likely 
to attain length of days than those who have descended from short- 
lived ancestors ; yet the influence of correct habits may add quite as 
many years to their lives. 

Regular Habits. — The old feel the evil influence of irregular 
habits much more than the young. It is seldom that any change of 
habit, long indulged, is well borne by the aged. So true is this, that 
the attempt to correct some habits of evil tendency is sometimes 






OLD AGE AND ITS DISEASES. 501 

dangerous to the old, so much have they lost the power of adapting 
themselves to change. The discontinuance of the habitual use of 
spirit, or tobacco, or opium, by an old person, though the use of 
either is of acknowledged evil tendency, will frequently prove fatal. 
It is almost necessary that the habits of the aged should remain as 
they are. What an impressive lesson this fact gives the young on 
the necessity of forming good habits in early life ! 

Even the hours of taking meals should not be changed in the 
decline of life. Removing to new climates, and forming new social 
relations by those advanced in years, is not favorable to length of 
days. Old trees do not often take root and live long when trans- 
ferred to a new soil. 

Diet. — The food of old people should of course be easy of diges- 
tion. It is often the case that they bear made dishes such as " hash," 
so called, better than plain boiled or roasted meat. This can only be 
explained on the ground that the meat is chopped fine, and is more 
thoroughly cooked. 

node of Cooking Heats. — This leads me to speak of the best 
methods of cooking meats so that they may be tender. 

The flesh of all warm-blooded animals is identical in composition 
with that of human beings. That the flesh of animals used as food, 
therefore, may form flesh in the human body in the easiest manner, 
none of its essential constituents or parts should be taken from it 
during the process of cooking. If any one of its constituents is 
extracted, it will no longer be like human flesh ; and that lost part 
will have to be resupplied before it can become a part of the frame 
of man. 

Flesh is composed of two parts — that which can be dissolved, and 
that which cannot. The separation between these two parts is more 
or less completely effected in boiling, according to the amount of 
water used and the length of time employed in the process. 

In making soup, we have no objection to a separation between the 
hard and juicy parts of the meat, because the latter passes into the 
water and helps form the soup. Hence the proper way is to put the 
meat into cold water when it is put over the fire, and let it come to 
the boiling point very gradually ; during which time the juicy part 
has a chance to dissolve out, and, uniting with the water, make rich 
soup. 

But when the meat is to be boiled simply, and eaten as boiled meat, 
we should aim to retain the juice within it, that we may retain the 
whole of it. To do this, we must put the meat into water which is 
briskly boiling over the fire. The juice of the meat contains a large 
quantity of albumen, a substance just like the white of egg; and 
putting the meat suddenly into boiling water almost instantly hardens 
this albumen all around the surface, just as boiling water hardens 
white of egg, and this prevents all the juice of the inner portion of 



502 OLD AGE AND ITS DISEASES. 

the meat from running out into the water and being lost. Keep the 
meat in the briskly-boiling water a few minutes, then pour in a little 
cold water to reduce the temperature slightly, and keep it in this 
somewhat reduced temperature until it is done through. 

Broiling and roasting are pretty generally understood, and are 
done well enough where persons are disposed to take } tains. Frying 
is an abomination, and should be banished from all civilized house- 
holds. 

Milk is an excellent article of diet for old persons. Except in some 
few cases where it disagrees with the stomach, it is among the very 
best. Sometimes, when it disagrees with a weak stomach, a little 
lime-water added to it will make all right. Artificial ass's milk, which 
will generally sit well on aged people's stomachs, may be made by 
dissolving one ounce of pulverized sugar of milk in one pint of 
skimmed cow's milk. 

Potatoes, beets, carrots, parsnips, and asparagus are healthful; 
peas, beans, cabbages, etc., had better not be largely indulged in. 

Ripe Fruits, taken in moderation, are useful; but should be eaten 
at meal-time, not between meals. Among these, ripe apples, pears, 
peaches, plums, strawberries, currants, and grapes are luxuries in 
which not even the oldest persons need fear to indulge to a reason- 
able extent. 

Plain Puddings and Pies are not entirely objectionable ; but all 
rich and high-seasoned articles of pastry should be strictly rejected 
by the old, as they should, in fact, by all classes. 

Wine, etc. — If any persons in the world may indulge in a little 
wine for their stomach's sake, it is the old. But even they, if they 
have not been accustomed to its use, often get along very well with- 
out it ; and when they can do so it is better, for various reasons, 
especially that their example may have a good influence with others. 
When the feeble vitality of the aged seems to require it, especially if 
they have been in the habit of leaning upon it, they should be en- 
couraged to use it. And if they chance to be poor, and cannot pro- 
cure it themselves, for friends to withhold it from them on the ground 
of economy, or from the feeling of grudging stinginess, is nothing 
less than inhumanity and cruelty. 

To these remarks upon diet, I add : the old should never eat to 
excess or repletion. They should eat slowly, and chew their food 
very thoroughly. 

Susceptibility to Cold. — Aged people suffer very much from cold 
hands and feet, and, indeed, from languid circulation and low tem- 
perature generally. The heart, like all their other muscles, has 
become feeble, and sends the blood very lazily along the arteries. 
The clothing of the old should be thicker and warmer than that of 
younger people. We must prevent the escape of what little animal 



OLD AGE AND ITS DISEASES. 503 

heat there is by flannel worn next to the skin, and by woollen clothes 
generally — they being bad conductors of heat. Unless very fleshy, 
they seldom suffer from heat, even when their flannels are continued 
through the summer. 

It is during winter nights that the old are apt to suffer most from 
cold. On going to bed, therefore, they should be warm ; and on very 
cold nights should have a hot-water bag at their feet. The commu- 
nication of animal heat, particularly from the young, is better even 
than this to support the vital energies of age ; and some writers have 
recommended that the vital warmth of the old should be kept up by 
letting the young of our own species sleep with them. The human- 
ity of this suggestion is very questionable The aged would doubt- 
less be benefited by such a proceeding ; but the young would be 
injured. Whatever vitality should be gained by one would be lost 
by the other. While a few might be added to the limited days of 
the aged, many would be quite as likely to be subtracted from those 
of the young. I would much sooner recommend that old people 
attach to themselves, and take to their bed, an affectionate, clean, and 
silken-haired English terrier dog. Such an animal, usually as clean 
as a child, would impart warmth and vitality at night, and be a true, 
affectionate, and amusing companion during many a lonely hour of 
the day. Whatever may be said against this recommendation, — and 
of course some over-nice people will object, — I insist that it is in 
every sense far more proper than the expedient adopted with King 
David, when he "was old and stricken in years," and after "they 
covered him with clothes, but he gat no heat." (1 Kings i, 1.) 

Mortality in Cold Weather.- — Far more of the old people die in 
winter than in summer, or, indeed, in any other season. For this 
reason, old people should be very careful how they expose themselves 
during the coldest days of the winter. 

If there be any change which the old are likely to bear with im- 
punity or advantage, it is from a cold to a warm climate in their lat- 
ter years. The wealthy Romans, when they grew old, were taken 
to Naples. 

Care of the Skin. — Attention to the skin, always important to 
health, is very essentially so in the latter years of life. The scarf- 
skin of the old tends to become dry, and peel off. This may be pre- 
vented in a great measure by regular washing with tepid water, and 
rubbing. If the bath cannot be endured, not even the sponge-bath, 
let friction alone be employed. For friction, either the naked hand, 
a piece of flannel, or the flesh-brush may be used. In rubbing the 
belly, the hand should follow the course of the large bowel; that is, 
in the region of the stomach pass across from right to left, down on 
the left, across on the lower parts of the bowels, up on the right, etc. 
By this method, constipation and a windy condition of the stomach 
and bowels may frequently be removed, or rendered less distressing. 



504 OLD AGE AND ITS DISEASES. 

Exercise. — Always important, in all periods of life, exercise does 
not lose its advantages in old age. But the aged should always exer- 
cise with moderation. The violence used in youth would break the 
bones, and do various kinds of mischief were it indulged by the old. 
Carriage exercise is very suitable for old people, but the more active 
exercise of horseback riding, walking, and even working in the gar- 
den, should not be omitted — bearing always in mind that great 
fatigue is injurious. 

Sleep. — Aged people should get about as much sleep as nature asks 
for. They should retire early, and not be in haste to rise with the 
dawn. They require more sleep than persons in middle life. Eight 
or ten hours in the twenty-four is not too much. 

Sleeplessness. — Though the old require a good deal of sleep, it is 
unfortunate that many of them can sleep but little. A large propor- 
tion of persons far advanced in life, complain of inability to sleep. 
Many old people deceive themselves, and really sleep much more 
than they are aware. Yet they often persist that they sleep none at 
all, night after night. Their case is illustrated by an old lady whose 
doctor entered her room and found her sleeping very soundly and 
comfortably. The noise of a person entering the room awoke her 
soon after, when, rubbing her eyes, she turned to the doctor, and said 
all she wanted was sleep, that she had slept none for a month ; and 
unless he could give her something to bring sleep, she must die. 

Medical art, I am sorry to say, frequently fails to bring relief, when 
there is real want of sleep. Narcotics should always be avoided if 
possible. They do too much mischief ; yet it is necessary, sometimes, 
to resort to them. Much may be done sometimes by taking an earlier 
or a lighter supper. Early rising, and exercise in the open air, will 
often bring sleep at night. Occasionally a glass of wine, or a little 
spirit of any kind, taken just before retiring, will bring the needed 
sleep. 

Electricity. — In connection with sleep, the disturbing and the 
tranquilizing influence of electricity and magnetism has received some 
attention within a few years. A German philosopher contends that 
terrestrial magnetism exerts on persons of a sensitive organization a 
very soothing influence, when placed in proper relations with its cur- 
rents, and a disturbing impression when otherwise situated. He 
cites cases to show that lying from east to west is so intolerable that 
persons of delicacy cannot endure it ; while the horizontal position 
from north to south, with the head south, is more agreeable ; and most 
agreeable and tranquilizing with the head to the north. A German 
surgeon is mentioned in Reichenback's Memoirs, who always woke 
early in the morning, and turning his head where his feet had been, 
invariably fell into a sound slumber, which was more refreshing than 
that of the night. When he chanced to omit this, he felt ill all day. 
Observing that the head of his bed was directed to the south, Reich- 






OLD AGE AND ITS DISEASES. 505 

enback persuaded him to turn it to the north ; and ever after he slept 
soundly till the proper time to rise in the morning. 

Without pronouncing upon the correctness of this theory, I will 
simply say that in my winter residence in town, the head of my bed 
is to the south. I sleep tolerably well ; but not as well as at my 
summer residence a little out of town, where the head of my bed is 
towards the north. How much the stillness of the country and the 
greater purity of its atmosphere may contribute to this difference, I 
will not pretend to decide. 

Medical Treatment of the Old. 

In prescribing medicine for old people, we should bear in mind the 
difference between the sexes. Women in advanced life are less ex- 
citable, and enjoy better health, frequently, than in early life. Old 
men, on the contrary, are more nervous, in their latter years, and 
consequently more easily affected. 

The physician cannot rely on the reaction of the system in old age. 
He must do more by his remedies, and depend less upon nature to 
help him out of straits. 

The small power of rallying in the systems of the old, puts all 
blood-letting, severe purging, etc., entirely out of the question. The 
man is near enough to insanity who, except in some very rare case, 
bleeds the young. He who takes a drop of blood from the old, should 
be put in a straight-jacket and sent to the insane hospital. 

Larger Doses. — The torpid condition of the system in old age 
frequently requires larger doses of medicine to make an impression. 

Fluid Medicines. — Pills and powders sometimes pass through the 
stomach and bowels in the same state in which they entered. Fluids 
are more readily appropriated — especially when the more active me- 
dicinal ingredient is mixed with wine, or some stimulating tincture, 
or aromatic water. These things rouse up the torpid stomach and 
bowels, and cause the medicine to take effect. 

Medicine by Rectum. — When the disease is situated in the imme- 
diate neighborhood of the lower bowel, as the bladder, etc., it is 
sometimes better to administer the medicine by injection into the 
rectum. 

Suitable Medicines for the Old. — The acids, the alkalies, and the 
neutral salts are unsuitable to be administered much to old people. 
All metallic medicines must be given sparingly, and with caution. 
Iodine and iodide of potassium are not very well borne. Narcotics 
must sometimes be used to some extent. Harsh and drastic purga- 
tives are out of the question, except in some few instances in which 
they may be given sparingly in connection with compound tincture 
of gentian, or some other stimulating tonic. Sulphur is a valuable 



506 OLD AGE AND ITS DISEASES. 

remedy for aged people. So are the stimulant tonics, bitters, astrin- 
gents, gum-resins, balsams, etc., together with the various carmina- 
tives, as anise, coriander, fennel, cascarilla, ginger, etc. 

Surgical Operations. — Some of the smaller operations in surgery 
need not be forbidden in the case of the old ; but great operations are 
not to be thought of. There is not recuperative power enough to 
bear them. 

Diseases of the Old. 

Most of the diseases which afflict aged people are of course much 
the same as those which come upon people at all periods of life. 
These having all been treated of in the previous pages of this book, 
do not require to be gone over particularly again. There are a few 
complaints, however, which are peculiar to the old, of which I must 
briefly speak. 

Bronchial Flux. — Bronchorrhcea. 

A MORE than usual amount of mucous expectoration, accompanied 
with cough, is very common with old people — so common that in 
many cases they think very little of it, even when the expectoration 
becomes very profuse. This discharge, however, from the mucous 
surface of the bronchial tubes, is very apt to be attended by shortness 
of breath on making even very slight exertion ; and the whole trouble 
is aggravated in damp weather, and by constipation, and the stoppage 
of leucorrhcea in females, or the interruption of insensible perspiration 
through the skin. 

Slow progress. — This complaint makes very slow progress, as a 
general rule, often continuing many years without doing any great 
mischief. It is apt, however, to degenerate into a mischievous con- 
dition in the end ; and should, therefore, as a general thing, receive 
some attention. 

Treatment. — Attend carefully to the skin. Keep it in as healthy 
a condition as possible, by regular and faithful bathing and friction. 
This is of prime importance. 

Care must be had not to suppress the discharge too suddenly. It 
may be necessary, at times, to use some expectorant (see expectorants 
among the prescriptions) to make the raising easier. But when it is 
thoroughly loosened up, we should begin to suppress it by astringent 
inhalations. For this purpose Inhalant No. 4 is excellent. It might 
be well, however, to begin with the Inhalant No. 6, which is slightly 
styptic. 

If ulcers on the legs have recently healed, they should be opened, 
or blisters applied in their vicinity. 

Removal to a dry climate is a valuable remedy, provided the cli- 
mate is not too hot, and is healthful in every other respect. 



OLD AGE AND ITS DISEASES. 507 

Other Diseases. — The other diseases with which old persons are 
afflicted are so common to all ages, that I do little more than name 
them, adding a few general remarks. 

Asthma. — The asthma, or intermittent difficulty of breathing of 
the old, is connected with various other troubles, as chronic inflamma- 
tion of the bronchial tubes, air in the lung-tissue, swelling of the 
lungs, enlargement and dilatation of the heart, and diseases of its 
valves, etc. It is also dependent on impurities of the blood, and is 
connected with torpid action of the kidneys. It is impossible, some- 
times, to say which of these conditions it is dependent upon. As far 
as maybe, however, the cause must be searched out; and then, while 
the general remedies for asthma must be employed, the particular 
thing with which it is connected must also receive attention, especially 
if it be connected with derangement of the kidneys. 

Asthmatic old people are almost always dyspeptics. The stomach 
and bowels, therefore, require particular attention. The warm pur- 
gatives, combined with alkalies, are generally useful : as rhubarb and 
soda, equal parts, or Mettauer's Aperient, with a little tincture of 
ginger or tincture of cayenne in it. A very valuable preparation is 
compound tincture of gentian and tincture of calumba, two ounces 
each, one-half ounce of tincture of ginger, and half an ounce of bi- 
carbonate of soda. Mix, and take a teaspoonful as occasion may 
require. 

Apoplexy and Paralysis. — The nervous system being weakened 
in aged people, the way is opened for greater frequency of attack 
from apoplexy and paralysis. The exciting cause may be hyperemia, 
too much blood ; or anaemia, too little blood. It may be general 
debility, or gout, or a poisoned state of the blood. 

The treatment is to be conducted much on the same principles as 
when these diseases occur in younger subjects. 

I pass over numerous complaints which may be said to be somewhat 
more common in advanced life than at earlier periods. They are so 
fully treated in previous pages of this book, that it is deemed needless 
even to name them here. There is, however, one other class of dis- 
eases occurring so very often in old age, and in so many cases mak- 
ing advanced life a burden, that I cannot pass them wholly in silence. 
I refer to 

Diseases of the Urinary Organs^ — These afflict the old, not only 
very commonly, but very severely. A man who reaches the age of 
seventy or eighty without experiencing some serious trouble from 
deranged kidneys, diseased bladder or prostate gland, or gall-stones, 
or gravel, or unhealthy urinary deposits of some sort, may think him- 
self greatly favored. 

Treatment. — It is not necessary here to go over the whole ground 
of treatment. That is done in other parts of the book. I will say, 



508 OLD AGE AND ITS DISEASES. 

however, that a surgical operation for stone in the bladder is not often 
to be thought of in the case of old people. Other remedies must be 
sought. And among these, none hold out so good a chance of relief 
as the free drinking of the alkaline bicarbonates dissolved in water. 
This will frequently dissolve stones formed of uric acid, urate of 
ammonia, and triple phosphates. Poland water in large quantities 
is good. 



ACCIDENTS. 






Apparent Death from Noxious Vapors. 

When persons become insensible from breathing foul air in a deep 
well or other place where it collects, let them be immediately exposed 
to the open air, cold water be sprinkled upon the face and head, 
and strong vinegar be rubbed about the nostrils. As soon as there is 
ability to swallow, give some drinks, as lemonade, or a few drops of 
aromatic sulphuric acid, dropped into a tumblerful of water, and 
slightly sweetened. A stimulating injection (246) may be given. 

Apparent Death from Burning Charcoal. 

Some persons very thoughtlessly attempt to warm their sleeping or 
sitting rooms with a portable furnace, or open pan filled with burning 
charcoal, or live coals from a wood fire. This is very wrong, as such 
coals while burning throw off large quantities of carbonic acid gas, a 
deadly poison. This being heavier than atmospheric air, falls to the 
bottom of the room, and for a time may do no damage ; but, if there 
be no chimney-draught, or open door or window, it will rise above 
the heads of those in the room, and bring on asphyxia and death. 

Let such cases be treated the same as the preceding, with the ad- 
ditional measure of attempting to excite breathing, as in the case of 
persons apparently dead from drowning. 

To Recover Persons Apparently Drowned. 

Of all the sad accidents that may often be avoided Jby a knowledge 
of their prevention, drowning seems the most lamentable. Its oc- 
currence, too, is the most frequent. A knowledge, then, of how to 
restore the drowning to life, and to renew the suspended animation, 
is equally important to people as a knowledge of how to swim. 

Drowning persons die by what is called asphyxia. The air being 
shut off from the lungs, breathing stops, and the immediate accumu- 
lation of carbonic acid in the blood paralyzes the nervous system, and 
insensibility immediately follows. The heart continues to beat, how- 
ever, from five to twenty minutes after the occurrence of insensibility 
and apparent death. 

509 



510 



ACCIDENTS. 



Recovery may take place at any time before the heart ceases to 
beat, and has been brought about in some cases even after this organ 
has become still. It has taken place, in some few instances, as late 
as an hour after being under water, but it can scarcely be expected, 
even under the best treatment, later than twenty minutes from the 
time of submersion ; and even as late as this, the chances are much 
against restoration. 

Several main facts should never be lost sight of : remember, first, 
to empty the water out of the person's stomach and lungs ; second, 
to remove the patient as little away from the spot where rescued as 
possible ; third, to go to work at once, unless the atmosphere of winter 
prevent ; remember, finally, to keep at work long after hope seems 
gone, to many, of restoring the person to life. 




fig. 150. 



Roll the patient over on to his stomach, with a parcel of clothing 
(see Fig. 150), a barrel or box under him, and press firmly on his 
back, while an assistant pulls forward the tongue and clears the 
mouth of mucus. Repeat the pressure once or twice, and then roll 
the patient on to his back (Fig. 151) with the clothes rolled up 
resting under his lowest ribs. Loosen all clothing about the neck, 
chest, and waist. 

Let the assistant extend the arms in the direction of the body 
above the head, bringing them as near together as possible, while 
you blow into the patient's mouth. Now, straddling the body, re- 
place the arms and press firmly with your own weight upon the 
sides and front of the lower chest, as if to press out something from 



ACCIDENTS. 



511 



the lungs ; suddenly let go. Repeat these motions of the arms and 
chest perse veringly, ten or fifteen times a minute. 

While thus engaged, assistants should remove the wet clothing, 
wipe the body dry, and, by vigorous friction of the skin, endeavor 
to restore warmth to the surface. Hot-water bottles, if they can be 
procured, are very serviceable in securing this result. Neither the 
weather nor place may allow of this warmth. When, however, the 
asphyxia has been relieved, warmth should be abundantly supplied 
and light stimulants given. Avoid the warm bath. Rubbing with 
coarse cloths answers well in the absence of hot-water bottles. 




Fig. 151. 



As soon as the patient can swallow, give warm milk, beef tea, or 
coffee with a tablespoonful of some spirit. Volatile stimulants like 
ammonia, held before the nose, are very serviceable, even before the 
patient breathes. 

Sleep should now be encouraged, but a watch must be kept, in 
cases of prolonged asphyxia, lest a relapse occur. 

How long a person may be under water and yet recover, is not 
definitely known, although the duration depends on the amount of 
air confined in the chest just prior to the immersion. 

Unless you are well acquainted with heart or lung action, you 
may be deceived as to the existence of life ; persevere, therefore, in 
the worst cases, fully an hour, since the heart may beat so feebly as 
to escape your notice, and yet, finally, rally. 

It is doubtful if a heart that has actually stopped for five minutes 
can be resuscitated. 



512 ACCIDENTS. 



Apparent Death from Lightning. 

A STROKE of lightning will frequently produce asphyxia by par- 
alyzing the muscles of respiration. In such case, the same means 
for recovery should be used as in apparent death from drowning. Or, 
the apparently dead person may be placed in a current of fresh air, 
and cold water dashed upon the face, neck, and breast, and warm 
friction be applied if the body is cold. 

Apparent Death from Hanging. 

Persons found hanging, who have committed suicide, are to be cut 
down instantly, and the same means employed to re-establish breath- 
ing as in cases of drowning. It may help to restore the breathing, to 
bathe the forehead and face with vinegar, or tincture of camphor, and 
to pass hartshorn frequently under the nostrils. 

Clothes Catching Fire. 

It is perhaps unreasonable to look for presence of mind when this 
frightful accident occurs, yet it is never more needed than at such a 
time. 

The instant a lady perceives her clothes to be on fire, and in a blaze, 
she should seize the nearest large rug, cloak, blanket, coverlet, or any 
equivalent article, and, wrapping it tight around her, throw herself 
flat upon the floor, taking care to keep the protecting covering close 
to her until the fire is completely smothered. If she does this with 
energy, and effectually, she will put out the fire instantly. 

If she continue on her feet, the blaze will rapidly ascend, and burn 
her vital parts. If she run to seek relief from others not present, the 
motion of the air will fan the flame into a swifter work of destruc- 
tion. 

If it be a child that is on fire, let any person present treat it as 
above. If it be badly burned before the fire is extinguished, put it 
instantly into a tub of cold water, or dash cold water upon it, to 
prevent the burn from becoming deep. 

Accidents on the Water. 

If upset in a boat, or otherwise thrown into the water, and not 
able to swim, draw the breath in well, and keep the mouth shut tight. 
Do not struggle and throw the arms up ; but yield quietly to the 
water, hold the head well up, and stretch out the hands only below 
"the water. To throw the hands or the feet up, will pitch the head 
down, and cause the whole person to go immediately under water. 
Keep the head above, and everything else under water. 



ACCIDENTS. 513 



Poisoning Accidents. — Antidotes of Poisons. 

Accidents from poisons are of such common occurrence, that 
every person should know the proper remedies, and not be obliged to 
wait the arrival of a physician before the proper corrective is applied. 
The most common remedies, with the methods of applying them, 
will be given under the proper heads below. 

Poisons may be classified under two heads : viz., mineral and vege- 
table. 

In the treatment, three objects are to be kept in view : first, to get 
rid of the poison ; second, to stop its action ; and third, to avert its 
tendency to death. 

The first indication is accomplished by the administration of eme- 
tics to cause vomiting, or by the use of a stomach pump. The 
simplest way to provoke vomiting is to give large draughts of luke- 
warm water, and to thrust a finger down the throat. 

A teaspoonful or two of mustard in warm water is oftentimes an 
effectual emetic. Some of the emetics are ipecacuanha, tartar emetic, 
sulphate of zinc, and sulphate of copper. Sulphate of zinc in twenty- 
grain doses is about the best. 

The second indication is to use an antidote. The third indication 
is fulfilled by palliating the symptoms, and neutralizing the after- 
effects on the constitution. 

After copious vomiting, soothing liquids should be given, such as 
oil, milk, beaten-up raw eggs. These are useful when the poison 
has been of an irritating character. 

If the patient be much depressed in mind or body, the hands and 
feet cold, the lips blue, the face pale, a cold perspiration on the fore- 
head and about the mouth, some stimulant may be administered. 
Strong, hot tea is the best, because it is a chemical antidote to many 
poisons. Strong coffee is a good stimulant. Brandy and other 
spirits are sometimes necessary. Sometimes when the powers of life 
are much depressed, artificial heat also is necessary. 

Mineral Poisons. 

Poisoning by Ammonia. 

Water of ammonia, or hartshorn, if taken in an undiluted state, 
acts as a violent poison. 

When this accident happens, give vinegar instantly, mixed with a 
little water. Vinegar is an acid, and ammonia is an alkali ; acids and 
alkalies neutralize each other. 

Poisoning by Antimony. 

Tartar emetic, and wine of antimony, are sometimes taken by 
accident in large doses, so as to act as poisons, and cause dangerous 
vomiting and prostration. 



514 ACCIDENTS. 

Give a tea of slippery elm, flax-seed, marshmallow, etc. ; also 
syrup of poppies, paregoric, or laudanum in twenty-drop doses. To 
neutralize the poison, give a strong solution of tannin, or an infusion 
of oak-bark, or nutgalls. 

Poisoning by Arsenic. 

Use the stomach-pump instantly, if one is to be had; if not, give 
twenty grains of sulphate of zinc (white vitriol) in a little warm 
water; and promote the vomiting by filling the stomach with large 
draughts of warm or cold milk, sweetened water, or flax-seed tea. 
Or, vomiting may be induced still more quickly, by giving a large 
tablespoonful of strong ground mustard, mixed with a teacupful of 
water. 

But the best antidote for arsenic is hydrated sesquioxide of iron. 
Mix a tablespoonful of this with water, and give this amount every 
five or ten minutes, until half a dozen doses are taken. 

Treat the inflammation of the stomach which follows, by blisters, 
a bland liquid diet, mucilaginous drinks, etc. 

Poisoning by Verdigris, or Acetate of Copper. 

Cooking utensils made of copper never ought to be tolerated ; 
yet they are used ; and it is from the verdigris which forms upon 
them that most of the cases of poisoning by copper happen. 

Give an emetic instantly, and then two teaspoonfuls of carbonate 
of soda (baking soda) in a tumblerful of water, to be repeated in ten 
minutes. White of eggs diffused in water, and mucilaginous drinks, 
are proper. 

Poisoning by Corrosive Sublimate. 

This is the common bed-bug poison, and is often taken by 
mistake. 

Mix up quickly the whites of a dozen eggs, with two pints of cold 
water, and give a glassful of the mixture every two minutes till the 
stomach can contain no more. If there are not eggs enough at hand, 
take what there are, and make up the deficiency with milk. Wheat 
flour, mixed with water, is a good remedy. Use the stomach-pump, 
if it is at hand. Treat the resulting inflammation with leeches and 
fomentations. 

Poisoning by Sugar of Lead, or Acetate of Lead. 

Give a ground-mustard or a sulphate of zinc emetic ; then give 
diluted sulphuric acid, or either epsom or glauber's salts. 

Poisoning by Strong Lye. 

Strong lye is sometimes swallowed by children. The remedy is 
vinegar, or oil. Vinegar will convert the lye into acetate of potash, 
and any of the oils will unite with it and form soap ; and neither 
the acetate of potash nor soap will materially injure the stomach. 



ACCIDENTS. 515 

Poisoning by Nitric, Muriatic, or Sulphuric Acid. 

When either one of these acids is swallowed, not a moment of 
time is to be lost. Fill the patient full of calcined magnesia stirred 
up in water. This is the best remedy ; but if it is not to be had, 
give half an ounce of soap in a pint of water. If neither are at 
hand, give chalk, or whiting, in water, or even pound fine some of 
the plastering of the room, and give it in water. 

Poisoning by Nitrate of Potash, called Nitre, or Saltpetre. 

Induce vomiting by lukewarm water, and by tickling the throat 
with a feather ; but avoid irritating the stomach with the ordinary 
emetics. 

Poisoning by White Vitriol. 

Provoke vomiting by warm drinks, and by tickling the throat, 
and give freely carbonate of soda, in water. 

Poisoning by Oxalic Acid. 

This resembles epsom salts, and is liable to be taken for salts by 
mistake. The two can always be distinguished by touching a little 
to the tongue. Epsom salts taste bitter; oxalic acid, very sour. 

In cases of poison from oxalic acid, give magnesia in water as 
quickly as possible. When this is not at hand, give chalk, or lime, 
or saleratus. Use the stomach-pump, if it is ta be had. 

Vegetable and Other Poisons. 

The vegetable poisons are quite numerous, and many of them 
quite as virulent and rapid as any in the mineral kingdom. 

Poisoning by Aconite. 

Give an emetic of ground-mustard or sulphate of zinc, or use the 
stomach-pump instantly, and then give stimulants, as brandy, gin, 
whiskey, rum, etc. 

Poisoning by Opium, Morphine, and Laudanum. 

Use the stomach-pump, if at hand ; if not, a powerful emetic of 
sulphate of zinc, or sulphate of copper ; or, if these are not at hand, 
a tablespoonful of ground mustard in a teacupful of warm water. 
If vomiting is not induced at once, tickle the throat with a feather, 
or with the finger. If sleep is impending, take the patient into the 
open air, and keep him walking ; dash water upon his face, etc. If 
he still falls into sleep, and appears to be near dying, apply means 
for artificial breathing as for persons apparently dead from drowning. 

Poisoning from Belladonna, Hyoscyamus, Stramonium, and Conium. 

These are all narcotics, and when accidentally taken in poisonous 
doses, the treatment, is to be the same as for poisoning by opium. 
Strong coffee is said to counteract the effect of these articles. 



516 ACCIDENTS. 

Poisoning by* Dogwood, Ivy, etc. 

Give some of the salts as a cathartic, and apply to the skin a solution 
of sugar of lead, or still better, a decoction of witchhazel-bark or 
lime-water. 

Poisoning by Prussic Acid. 

This is the most deadly of all known poisons. One drop of the 
pure acid will cause immediate death. Give water of ammonia or 
hartshorn, one part diluted with six parts of water, freely. 

Poisoning by Strychnine. 

The same treatment as for poisoning by opium, excepting that 
sweet milk should be freely administered. This has been recom- 
mended by one respectable physician, at least, who says he has found 
it to be a specific. Camphor, two ounces dissolved in a quart of 
whiskey, and given freely, is also said to be an antidote. 
Poisoning by Spanish Flies. 

Give large draughts of sweet oil, sugar and water, milk, or flax- 
seed tea. For the inflammation of the bladder which is produced 
by it, apply leeches, and a liniment composed of camphor and sweet 
oil. To relieve the strangury or scalding of the water, give camphor 
internally. 



SURGICAL DISEASES. 



Modern Surgery. 

To one educated in surgery a quarter of a century ago, the cus- 
toms and theories of to-day must seem very odd, and the results of 
to-day's surgical science must seem truly miraculous. Formerly pus 
formation in a healing wound was regarded not only as unavoidable, 
but really beneficial. Pus, or matter, was known as laudable or good 
pus, and diseased, or bad pus. Wounds only occasionally healed by 
primary union or first intention, — that is to say, skin growing to skin 
and muscle to muscle as sewn, but they rather healed by a long, slow 
process of granulation attended with pus-formation, called second in- 
tention. The various surgical epidemics of contagious diseases were 
extremely common in the very best hospitals under the guidance of 
the very best men ; they were thought unavoidable. Hospital gan- 
grene, erysipelas, and the various forms of blood-poison diseases, were 
so common and spread so rapidly as often to render it necessary to close 
a hospital. Major operations were attended by a mortality that now- 
adays seems almost incredible. To amputate a leg, except under 
the most favorable circumstances, meant almost sure death. The 
late Dr. Pasteur of France first made known to the world that there 
were such things as germs, or microscopic life, capable of transmitting 
themselves and their spores almost endlessly. These germs were 
soon found to be the outcome of dirt and disease, and that possibly 
in their extermination lay a great future for surgery. It was Sir 
Joseph Lister, of England, who first discovered the fact that certain 
medicines, like carbolic acid, would kill these germs, and that in so 
doing wounds would unite by first intention in the majority of cases. 
This was the first great step toward the realization of the dreams of 
our forefathers. 

The study of bacteriology was then commenced, and it has pro- 
gressed rapidly ever since, till to-day it has become a marvelous 
science unfolding the life, nature and propagation of all sorts of 
bacteria. 

We now know that on the living skin there exist normally certain 
germs whose function apparently is to use up the waste products of 
the economy, but which, when introduced into the flesh, produce most 
deleterious effects. 

517 



518 SURGICAL DISEASES. 

Germ-life is found everywhere, — on our hands and clothes, in the 
dust of the air and in the water we drink. So long as they keep to 
their natural abodes no mischief is done. It is this germ-life which 
causes wounds to suppurate, erysipelas, blood-poisoning and gangrene 
to occur. It is the annihilation of these germs about all wounds, 
and on all objects which come in contact with wounds, that distin- 
guishes the newer from the older surgery. To-day the mortality 
figures are revised as regards all important operations. Regions of 
the body are invaded which fifteen or twenty years ago were thought 
to be inviolate to the scalpel. Thousands of lives are now saved and 
thousands of people rescued from becoming invalids. 

The methods of treating germs have changed very materially since 
Sir Joseph Lister first announced his antiseptic treatment and showed 
the way to a new era in surgery; but the principles are much the 
same. 

Some germs have been found to be innocuous, even on wounded 
surfaces ; others are deadly poisons. Some germs cause one kind of 
disease, some another ; some are even antagonistic to others. They 
are all endowed with great resistance to ordinary medicines and are 
capable of propagation under adverse circumstances ; they are con- 
tagious and infectious, and when carried from one person to another 
cause their specific disease to start up. The so-called blood-poison 
is a general name for many distinct varieties of germ-disease. 

It matters not whether a simple wound is to be dressed, a leg am- 
putated or a woman delivered, the one essential thing above all else 
which protects life and allows the wounded surface to heal is to 
make a clean field, to render the surfaces aseptic. 

Aseptic. Septic. — These are two terms which are daily becoming 
the common property of the laity : the former means without poison, 
germ-free, or surgically clean ; the latter means poisonous, germ-laden, 
surgically dirty. Let it not be supposed that the flesh looks to the eye 
differently in these two conditions, — it is not so necessarily. These 
bacteria are so minute that if a single rod-bacillus were enlarged fif- 
teen hundred times it would then only reach across the head of a 
pin. Nor is their virulence in proportion to their apparent numbers, 
for in twenty-four hours a single germ may multiply to sixteen and 
one-half millions! 

Surgical cleanliness is surgical morality, and consists not merely in 
washing off the rough, visible, outside dirt, but in rendering every- 
thing which can possibly touch the wound, directly or indirectly, 
germ-free. This condition is called asepsis ; when, however, germs 
have entered the wound and the consequent changes due to germ 
life have developed, then the condition is called sepsis. 

Antiseptics. — The important and practical question then is, how 
are these germs killed and how is the wound rendered aseptic? 
Lister discovered in carbolic acid a germicide of no mean power, and 



SURGICAL DISEASES. 519 

even to-day this acid is most extensively used for the cleansing of 
wounds and instruments. This process of killing germ-life is called 
sterilization. 

After carbolic acid came numberless other drugs, such as corrosive 
sublimate, phenyl, sulpho-naphthol, etc. Of this group corrosive 
sublimate is by far the most potent : it may be used in very weak 
solutions as one part to three, five, or even ten thousand of water. 

Heat. — By far the simplest, safest, and most economical method 
of sterilization is by means of heat, either in the form of boiling 
water, dry oven-heat, or steam. Whatever can be baked for an hour 
at 140° of heat, or whatever can be steamed for an hour, and what- 
ever can be boiled five minutes without impairing the integrity of 
the object sterilized, can be rendered absolutely sterile. Germs and 
their spores, which latter are more tenacious of life than the former, 
yield readily to boiling water in a few minutes ; while some germs 
of the most virulent type may soak for hours in a tolerably strong 
solution of the chemical sterilizers without being killed. The ten- 
dency of the present is to substitute these natural means of steriliza- 
tion for the chemical germicides. 

Preparation for Operation. — Nothing withstands boiling; but 
as the flesh cannot be baked, boiled, or steamed, it is the custom be- 
fore an operation to make free use of green soap and a brush to scrub 
off the external superficial dirt and then to give the skin a good 
scrubbing and soaking in corrosive sublimate, in the strength of 
about one part to two thousand. This prepares the skin antiseptically 
for the operation. The instruments and apparatus likely to touch 
the flesh are boiled; the hands and arms of the surgeon, assistant 
and nurse are rendered sterile by repeated scrubbing with soap and 
brush and some one of the several antiseptic processes in vogue. 
This requires fifteen to twenty minutes. All dressings such as gauze, 
cotton, etc., are steamed and neatly done up air-free and germ-free 
ready for use. Sponges, generally made of gauze, have been sterilized 
by steaming previous to the operation. Sutures, etc., have been boiled 
or steamed or soaked in some suitable disinfectant. The neighbor- 
hood of the wound is covered with steamed towels or sheets, the 
clothes of the operator covered with some sterilized coat, and in fact 
everything and everybody that is likely to approach the wound is 
first thoroughly rendered aseptic. 

In the subsequent dressing of a wound, and for all time till the 
wound is healed, similar precautions are taken. Thus it is that by 
shutting out all germ-life one succeeds in securing primary union, a 
quick convalescence and a freedom from the risks of septicaemia and 
other blood-poisoned diseases. 

The change from the old-fashioned soap-and-water cleanliness to 
the new antiseptic cleanliness has wrought marvellous results. 
Brains are exposed, gall-bladders incised and stones removed, kidneys 



520 SURGICAL DISEASES. 

removed, wombs and ovaries and huge tumors taken out with a small 
mortality rate. These same operations were but dreams in the pre- 
Listerian days. 

Inflammation. 

On this pathological basis much of surgical disease rests. Surgical 
inflammation is due in a great measure to the introduction into the 
tissues of germs which there multiply with great activity, forming 
as a result certain poisonous products called toxines. These toxines 
are deadly poisonous to the system, and when absorbed cause high 
fever, chills and sweats, loss of appetite and strength, and generally 
undermine the strength. It is as if so much mineral or vegetable 
poison had been introduced into the stomach. Their activity is 
astonishingly rapid when they are situated in tissues favorable to 
their development, like the peritoneum and other serous membranes, 
richly supplied with lymphatic vessels to convey the poison from one 
point to another. 

There are several conditions favorable to the development of germs 
when introduced into the body, chief among which is moisture ; hence 
to keep the wound dry and well drained is the constant aim of the 
surgeon. When bacteria are introduced into the system through a 
wound, they begin at once to put on their activity, and the produc- 
tion of toxines commences. Nature rushes, so to speak, to the field 
of the enemy, and a great fight at once occurs. She throws out a 
mass of lymph about the invaded portion of the flesh to surround the 
enemy and cut off his base of supplies. She forms out of her own 
blood antitoxines, so called. It soon becomes a question of which is 
the stronger form, — the toxines of the germs, or the antitoxines of 
the serum. This battle results in a thickened, congested, painfully 
swollen and reddened area, which, if nature conquers, softens and 
melts away, but which, if the enemy is victorious, breaks down and 
forms pus. The result depends largely on the location of the strug- 
gle, the strength of the patient, and the virulence of the germ. If 
it be in a part poorly supplied with lymphatic vessels and soft struc- 
tures, nature has the advantage, because the enemy cannot find easy 
access to structures beyond the field of battle; but if the neighbor- 
hood of the invasion is in soft structures, the enemy quickly seizes 
on some short route to a neighboring lymphatic station and there 
deposits its poison and thus extends its field till nature is over- 
whelmed. The ability of nature to manufacture antitoxines quickly 
and mobilize her forces to the rescue on the one hand, and the viru- 
lence of the germ or its capability to develop its poison quickly, on 
the other, are always deciding elements in the preservation or de- 
struction of the part attacked. Much is now being accomplished 
toward eradicating germ-diseases and germ-inflammation by the cul- 
tivation of this natural antitoxine. Its special victory is seen in the 
diphtheritic antitoxine with which that disease is now so successfully 



SUKGICAL DISEASES. 521 

fought. This antitoxine which nature throws out is cultivated in 
horses till such an amount is stored up that against it diphtheria no 
longer has any influence ; this serum, so rich in antitoxine, is then 
introduced into the human subject as an antidote to the forming 
toxines of the diphtheria. 

And so it is with lockjaw, rabies, and many other germ-diseases. 
This therapeutic agency is yet in its infancy, but much may be ex- 
pected of it in the future. 

But not all inflammation is necessarily of bacterial origin, at least 
so far as is yet proven. 

Every part of the body which has vessels and nerves is liable to 
inflammation. Where there are no nerves, it cannot exist. Many 
diseases are caused by it. Mechanical injuries, such as cuts, bruises, 
and fractures, produce it. And many other disorders, not caused by 
or causing it in the beginning, become entangled with it in their 
progress. It is very important, therefore, to understand the nature 
and management of inflammation. It is not always to be looked upon 
as a disease ; it is frequently a simple process of repair, whereby 
nature restores injured parts to health, in which there is no germ-life 
present. 

The Signs of Inflammation are redness, pain, heat, swelling and 
loss of function, though in some cases these do not all appear. 

Acute Inflammation. — When the redness, the pain, the heat, and 
the swelling are clearly marked, and the inflammation is so rapid 
that it either subsides in a few days, or quickly brings on suppuration, 
or ulceration, or mortification, it is said to be acute. 

Chronic Inflammation. — When it is less painful, and slower in 
its progress, beginning very gradually, and lingering a long time, it 
is then chronic. 

Common, or Simple, or Healthy Inflammation, is that which is 
not mixed up with any disease, but is established by nature for some 
salutary purpose, and is generally germ-free. 

Unhealthy Inflammation is that which has been caused by some 
other disease, like the poison from germ life, and is under its control. 

Specific Inflammation is that which seems to vary from all ordi- 
nary cases, being dependent on a particular state of the system, on an 
animal poison, or a principle of contagion or infection, and a power 
of propagation from one person to another, such as all germ-poisons. 

Some of these produce such permanent effects, that those having 
them are not liable to a second attack. 

Inflammation is Primary, or, as the doctors say, idiopathic, when 
it is the original disease. 

Inflammation is Secondary, or Sympathetic, when it is the re- 
sult of some other disorder, which goes before, and produces it. 



522 SURGICAL DISEASES. 

It has been explained elsewhere that the different parts of the 
body are connected by little threads or nervous strings which run 
from one to the other. If one part of the body become injured or 
disordered, it uses these nervous threads as telegraphic wires, to tell 
other, parts of its misfortune ; and it sometimes happens that when the 
intelligence conveyed is of a sad and alarming character, the part re- 
ceiving the news is so excited and distressed as to become inflamed. 
Nothing can be more proper than to call this sympathetic inflamma- 
tion. 

When the inflammation is violent, and is seated upon some impor- 
tant part, the sympathetic action is so great as to disturb the whole 
constitution ; and this general disturbance is sympathetic or symptom- 
atic inflammatory fever. On the other hand, it more frequently hap- 
pens, especially in the light of modern surgical pathology, that the 
lymphatic system, which is in reality a delicate railroad system for 
the economy, leading toward the great citadel of life, the heart, 
carries over its tracks to the nearest station some of these germs or 
germ-poison from the primary wound or inflamed spot, thus spread- 
ing the contagion to whatever lymphatic station the vessel happens 
to run. 

The Symptoms are quick and strong pulse, dryness and heat of 
skin, parched mouth, great thirst, scanty and high-colored urine, cos- 
tiveness, disordered nervous system, loss of appetite, anxiety, restless- 
ness, sleeplessness, headache, wandering and confusion of mind, and 
sometimes delirium. This fever John Hunter called a universal 
sympathy of the body with the disturbed condition of a part of it. 

It is only by inflammation that a wound is healed, or a broken bone 
repaired. 

Upon the surface of a wound nature pours out a fluid called plas- 
tic lymph. This is composed of fibrin, — the material of which flesh 
is made, — united with a little of the watery part of the blood, chiefly 
albumen. The watery part disappears soon after it is poured out, 
and the fibrin hardens into a kind of membrane. Through this, 
nature sends small nerves, arteries, and veins, which she uses as 
threads to sew up the wound. Fibrin being the chief material with 
which nature constructs our bodies, she of course uses it to repair 
them when wounded, just as a carpenter, Avho constructs a floor with 
planks, uses planks to mend it when it is broken through. 

Buffy Coat of the Blood. — The effects of inflammation extend to 
the blood. This fluid, when drawn from the veins of a person suffer- 
ing from an inflammation active enough to disturb the constitution, 
forms a clot in the basin more slowly than usual, but the clot is 
harder ; and a layer of fibrin is left upon the surface, of a yellowish 
buff-color, looking like size or glue, and called the buffy coat. The 
clot is also scooped out in the centre, and the blood is said to be 
cupped. 



SURGICAL DISEASES. 523 

Coin Discs. — It is another peculiarity of inflamed blood, that if a 
drop of it be examined under a powerful microscope, its globules, or 
discs, which are very numerous, will be found standing on their 
edges, and leaning against each other, like a row of copper or silver 
coins. (Fig. 152.) 

Inflammation may end in one of four different ways. 

I. By Resolution. — Suppose a large splinter of wood be stuck into 
the hand of a healthy man. It causes redness, heat, swelling, and 
pain ; and these combined are inflammation. The splinter is pulled 
out, and the hand well done up with a disinfectant dressing, and 
properly cared for. The redness fades, the heat declines, the swelling 
subsides, and the pain disappears ; the inflammation is ended, and the 
hand is well. Coming to a fortunate end in this way, inflammation 
is said to be resolved, or terminated by resolution. 





Fig. 152. Fig. 153. 

II. By Suppuration. — It does not always end so happily. The 
splinter may be broken off below the skin, and not pulled out ; or, even 
if removed, germs may have been introduced from the splint or from 
{he skin of the hand; these germinate rapidly and form pus, and 
in tead of the inflammation abating, it will increase, and the centre 
of the injured part will begin to rise up to a point, and grow white 
on the top. This shows that there is matter formed underneath, 
which is lifting up the scarf-skin, and seeking to come through. Fig. 
153 is a microscopic view of pus corpuscles. 

The pain is now very throbbing and pulsating — keeping time with 
the beats of the heart. When the scarf^kin can hold out no longer, 
it breaks, and yellow, cream-like fluid runs out, which we call pus. 
The redness, pain, etc., now subside. This process we call suppura- 
tion. 

At this time, if the wound have been a severe one, attended by 
sympathetic fever, and the discharge of pus be now large, there may 
be a change in the fever, marked by frequent shiverings and chilli- 
ness, followed by flushes of heat, which ends in sweating. We call 
this hectic fever. 

III. By Ulceration, or the formation of open, running sores. 



524 SURGICAL DISEASES. 

IV. By Mortification. — If the wounded part have been so much 
injured as gradually to destroy its vitality, it dies. The vivid red 
of the inflammation changes to a purplish, or livid, or black hue. 
The strained condition of the skin ceases, a bloody fluid lifts up the 
cuticle, the pain and feeling are all gone, — the part is dead and 
putrid, and gives out a peculiarly offensive smell. This process is 
called mortification. 

The mortified and dead part is called a slough; and it is separated 
from the living parts by a peculiar vital process which has the name 
of ulceration. 

Treatment of Inflammation. — Though inflammation sometimes 
ends kindly by resolution, and though it is often a salutary process, 
yet it is frequently very destructive, ending in suppuration, ulcera- 
tion, and mortification, thickening, hardening, softening, and en- 
larging parts affected by it ; and doing these things in textures of 
great delicacy, and of vital importance in the economy of life. It 
calls, therefore, for judicious, and, often, for very active treatment. 

There are three principal tilings to be done, — to remove the cause, 
if it be still active, to take the blood away from the inflamed part, 
and to render the part aseptic, if possible. 

If a bullet be lodged in the flesh, or a thorn, or a splint of wood, 
or a piece of glass, it is the exciting cause of the inflammation which 
follows, and little can be done to advantage till the offending sub- 
stance is extracted. If inflammation be excited in the bladder by 
the irritating presence of urine which cannot be passed, this must be 
drawn off with the catheter before relief can be had. If the stomach 
be inflamed by improper food, or too much of it, the diet must 
cease to follow appetite, and take reason for its master. If ladies 
have excited inflammation in the bowels, or any of the internal or- 
gans, by a dragging weight of skirts, they must either put off the 
burden, or hang it upon the shoulders with straps. 

The blood is removed from the inflamed part in two ways : — 

Cupping and Leeching. — It is done directly by cupping and leech- 
ing. These methods take the blood out of the small vessels, which 
are so full and crowded as to produce pain. Cold water, ice, etc., 
applied to the part cause these little vessels to contract, and squeeze 
the blood out of themselves. These are very useful applications ; 
and they are to be pursued as long as there is any hope of breaking 
up the inflammation, or causing it to end by resolution. But when 
this is no longer to be expected, and it is found that it will go on to 
suppuration, then apply warm fomentations and poultices. These 
will mollify and soften the parts, and cause the suppurating to go on 
more rapidly and with less pain. 

Counter=Irritation. — The other method of removing the blood 
from the inflamed part is by what is called counter-irritation. 

People are apt to think it very absurd that inflammation should be 



SURGICAL DISEASES. 525 

induced in one place to relieve or cure it in another. But it is not 
absurd. It relieves or cures on the principle of sympathy, which I 
have already explained. We put croton oil, or tartar emetic, or 
Spanish flies, or cayenne pepper, or mustard, upon the surface of the 
bowels when the internal parts are dangerously inflamed, and what 
is the result? Why, the terrible smarting and pain alarms nature, 
and she rushes up to the surface with a large amount of the blood 
around the inflamed parts, and there, for hours, perhaps for days, 
struggles to beat down the new mischief at the surface ; and, in the 
mean time the internal parts, relieved by the removal to the surface 
of so large a quantity of hot blood, make a long stride towards re- 
covery. 

A popular orator is speaking to a multitude in a hall, which is 
thronged to excess, and a few feeble persons faint, and are likely to 
be suffocated and trodden upon in the dense mass. A person at the 
door, seeing what has happened, cries '-'•fire.'" The crowd rush out ; 
the fainting persons get breath, and are saved. So, when the thou- 
sand streams of blood rush through their channels upon an inflamed 
and fainting internal organ, crowding and oppressing it, we set the 
skin on fire with some inflammatory substance ; the blood rushes to 
the new point of excitement, and the oppressed and fainting organ 
recovers. 

Cupping and leeching, which are often necessary, are not to be re- 
sorted to in very debilitated constitutions. In some persons, leeching 
produces erysipelas. 

Costiveness is always produced by the symptomatic fever which 
often results from inflammation. This should be removed by saline 
purgatives, such as Rochelle, Epsom or Glauber's salts, salts of tar- 
tar, tartrate of potassa, and the tartrate of soda (9), (7), (12), (14), 
(18), (20), (25), (27), (41). Sometimes more active purgatives 
are required, and then the compound extract of colocynth, etc. (29), 
will be excellent, or two compound cathartic pills, at night, followed 
by (299) may be used. 

As a drink, cream of tartar (298) will be found cooling and re- 
freshing. In all inflammations, the diet must be light and unstimu- 
lating. 

To allay the excessive fever and pain of inflammation, some of the 
coal-tar products may be used, like ammonol or phenacetine, in ten- 
grain doses, every two to four hours ; but it must be remembered 
that inflammation is the result of poisons and not the cause of them, 
hence these remedies are but temporary and palliative, and must be 
used while the real cause is being fought by removal of the original 
source of the trouble. 

The third method of treating inflammation is the most important, 
because generally it strikes home. Inasmuch as most inflammation 
which comes from outside causes is the result of the introduction of 
bacteria into the body, the most natural thing to do is to disinfect 



526 SURGICAL DISEASES. 

at once the injured or diseased part. The bruised ringer, the hole 
made by the bullet, or the cut by the knife, all need to be bathed in 
some antiseptic solution to kill all germ-life and arrest the develop- 
ment of their poisons, which inevitably cause inflammation. Such 
solutions should be injected into the wound or freely bathed over 
the surface. They are legion in number, but only a few may be 
mentioned, such as corrosive sublimate, which one can buy in tablet 
form of the druggist, and of which one is taken dissolved in two 
quarts of water; strong carbolic acid is another disinfectant, and 
may be used in strength of one teaspoonful of the ninety-five per 
cent acid to a pint of water. Sulpho-naphthol or oil of milk, is still 
a third disinfectant, and is used in strength of one-half teaspoonful 
to a quart of water ; this latter turns the water milk-color. Carbolic 
acid on standing long or being exposed to the light turns reddish, 
but is not impaired in efficacy. The sulpho-naphthol is the least 
expensive, and may be used for sinks, drains, etc. It is perhaps the 
safest and best to have in the house. 



Suppuration and Abscess. 

An abscess is the collection of pus or matter in the substance of 
some part of the body. When the matter is poured out from some 
part, the process is said to be suppuration; when it collects in a tissue, 
it is an abscess. When the matter collecting in some organ comes 
towards the surface, and a place in the centre rises above the sur- 
rounding skin, and turns white, the abscess is said to point. Some 
abscesses point and break in a week ; others of a more chronic char- 
acter will linger on for months. 

Fluctuation. — Before an abscess points, a fluctuation may gener- 
ally be felt in the swelling, which is one of the surest signs that it 
contains pus. Sometimes this fluctuation may be felt even when the 
matter lies very deep in the flesh. And when it is so deep that ft 
cannot be felt, if a sudden cessation of the symptomatic fever should 
occur, and shiverings or rigors should come on, attended by coldness 
in the affected part, we may reasonably suspect that pus is formed. 
It is not easy, at times, to say whether matter is really present ; and 
great care should be used not to plunge in a lancet where none 
exists. Chills and fever due to pus formation are caused by the 
absorption into the system of the poisons of ptomaines, which are the 
result of germ-life, and their propagation. 

Treatment. — When the abscess is completely formed, and there 
is no longer any doubt of the presence of matter, it should be opened 
at once. To let out the confined pus alleviates the pain and lessens 
the inflammation. If the matter lie close to a bone, the opening 
should be made without delay. The opening should be large enough 
to let the matter out freely. It is a rule to keep the incision open 



SURGICAL DISEASES. 527 

till the cavity of the abscess is so far filled up that another collection 
of pus is not likely to occur. 

If the matter do not readily get to the surface through the opening, 
it may burrow itself in the flesh, in a long narrow channel called a 
sinus. To relieve this, the opening must be extended in such a way 
as to give vent to the new collection. 

An abscess is sometimes indisposed to heal at the bottom, and pus 
continues to be formed a long time, and is discharged through an 
opening smaller than the sack which contains it. This is a fistula, 
and the opening to it should be enlarged so as to let out the matter 
more freely. A little soft lint may then be gently pressed into the 
wound to prevent its healing before the cavity below. The cavity 
should be freely scraped out to remove all germ-life, and then thor- 
oughly disinfected and kept clean and aseptic by aseptic gauze pack- 
ings, and in this way nature is bound to heal the wound. 

An abscess from acute inflammation requires to be poulticed for a 
time after it has been opened. When the swelling and inflammation 
are gone, the poultices are to be laid aside, and a bandage put on. 
When the inflammation is gone, let the diet be improved ; and if the 
discharge of matter be large, give wine and tonics. 



Mortification. 

The complete death of a part of the body, and its change into a 
black, stinking, cold, and insensible mass, with which the other parts 
of the system have discontinued all organic connection, is what we 
call mortification. That form of it which is most common is said to 
be humid, on account of the moisture of the dead parts. It is the 
result of nature having walled oft' by her antitoxin the scene of the 
battle, and while she has lost the original battle and the original 
field, has nevertheless succeeded in keeping out the enemy from the 
remainder of the system. The enemy feeds on the dead tissue, set- 
ting up a putrid, stinking cesspool of filth. 

Gangrene. — Before the mortified part is completely dead, and, 
consequently, while its recovery is supposed to be possible, the con- 
dition of the part is called gangrene. 

Sphacelus is the name given to it after its entire death. 

Sloughing is the process of separating the dead matter, and the 
susbtance separated is a slough. 

The causes of mortification are quite numerous. The most com- 
mon are, stoppage of the circulation by inflammation, by mechanical 
causes which obstruct the passage of the blood, by chemical agents 
and poisons, and by local or general debility. 

In a bad constitution, which bears disease poorly, mortification is 
very dangerous. 



528 SURGICAL DISEASES. 

Treatment. — In treating mortification, three things are to be aimed 
at, — to stop its progress, to promote the separation of the dead from 
the living parts, and to heal the ulcer which is left after the separa- 
tion. 

To stop the progress of mortification, we must remove its cause. 
If it be inflammation, treat that according to the principles laid down, 
though leeching, purgatives, etc., should be used sparingly, as mor- 
tification reduces the constitution so rapidly that it does not bear 
reducing well, and sometimes not at all. As soon as the inflamma- 
tion has subsided, particularly if the system be weakened, tonic bit- 
ters and a nourishing diet must be had. When there is fever, with 
great excitement of the nervous system, delirium, picking of the 
bed-clothes, etc., the patient should have anodynes (121) and anti- 
spasmodics (87), (91), (90), drafts upon the feet, and such other 
local remedies as the case may require. Here opium and stimulants 
are of paramount importance. 

It is of little use to put anything upon the mortified part, except 
with a view of lessening the stench. For this purpose, lay upon the 
part lint soaked in a solution of chloride of lime or soda, or a solution 
of pyroligneous acid, or of creosote. 

Very little can be done to hasten the separation of the dead part 
from the living ; but while it is taking place, a common flax-seed 
poultice, mixed with a little powdered charcoal, may be kept on it. 

The ulcer left after the separation is to be treated like other 
ulcers. A dressing of bovinine and five per cent solution of carbolic 
acid, equal parts, will be found to hasten the granulation. 

Pyaemia. 

This frightful affection has been called the bane of surgery. It 
is caused by a peculiar poison, resulting from the fermentation and 
disintegration of the tissues of a wound, which is taken into the 
system either by the veins or absorbents, and is usually accompanied 
by the formation of collections of pus in the various tissues and 
organs of the body. It follows very trifling as well as severe injuries, 
and it is a frequent sequela of surgical operations, oftentimes of a 
very slight character. The only tenable theory which can explain 
the different phenomena of this disease is, that the pysemic condition 
is caused by the absorption of septic material, sometimes in a fluid, 
sometimes in a gaseous state, which unfits the blood for the processes 
of healthy nutrition, induces capillary stagnation and its conse- 
quences, low forms of inflammation in different parts of the body, as 
in the joints and serous cavities, and may finally produce those sec- 
ondary deposits of pus, in any or all parts or organs of the body, 
called metastatic abscesses. 

When an internal organ is involved, the result is generally fatal. 
When suppuration attacks the integuments or the extremities, there 
is a fair chance of recovery. 



SURGICAL DISEASES. 529 

Thence the disease nas been divided into two classes : the internal 
or acute, the external or chronic pyaemia. When pyaemia involves 
the internal organs the course is usually rapid and fatal. When it 
attacks the external parts, it is slow in its course and may be recov- 
ered from. 

Duration of the Disease. — Sometimes its course is so rapid that 
the patient may die in two or three days after the appearance of the 
symptoms. As a rule, however, bad cases terminate during the 
second week. Some go on for six or seven weeks. In cases which 
recover, the patient goes through a long illness and may be left per- 
manently crippled by secondary affections of the joints. As a rule, 
the longer a patient lives the better the hopes of a successful ending. 

Pyaemic symptoms generally make their appearance after the fourth 
day. The first symptom is a chill ; this is repeated at irregular 
intervals, and is followed by profuse and exhausting sweats. 

The hot stage which characterizes the malarial paroxysms of inter- 
mittent fever is usually absent or but slightly marked. During the 
course of the attack, the temperature of the body, which is naturally 
98^° Fahrenheit, may rise six or eight degrees, and in ordinary cases 
its fall is, as a rule, gradual. The greatest elevation of temperature 
corresponds with the period of rigor. During the sweating stage the 
temperature falls again. Should the fall be sudden, a general break- 
down of the powers of the patient is indicated. The pulse rate varies, 
according to the violence of the attack, from ninety to one hundred 
and thirty. The respiration is usually rapid, from forty to fifty a 
minute, and in many cases a hay-like odor of the breath is present, 
which is considered pathognomonic of the disease. The countenance 
is flushed, the skin dusky, sallow, sometimes jaundiced and marked 
with sudamina. 

The tongue is coated, and there is a complete loss of appetite, and 
often nausea and vomiting. The urine is frequently albuminous. 
When the brain is involved there will be sleeplessness, or delirium 
of a low, muttering kind ; some unconsciousness, from which the 
patient can be aroused only to relapse. 

Intense pain usually attends the secondary complications, though 
it is sometimes remarkable how slight the symptoms often are when 
severe local disease exists. 

The wound becomes sanious, serous, and fetid ; sometimes the 
secretions are arrested and the surface becomes dry and glazed; 
sometimes absolute sloughing occurs. Union, if progressing, will 
become disunion, and all reparative action ceases. As the disease 
progresses, the symptoms become profoundly typhoidal, and the 
patient may die comatose or from exhaustion. 

The exciting causes of pyaemia are very obscure. It attacks the 
healthy as well as the feeble, those surrounded by perfect hygienic 
influences as well as those who are exposed to deleterious influences. 
It is found not only in hospitals but in private practice ; but it is 



530 SURGICAL DISEASES. 

more prevalent in unhealthy places, in the overcrowded wards, and 
in those spots where ventilation and drainage is bad. It lurks among 
the poorly housed and poorly fed and clad, and wherever those in- 
fluences exist which are depressing to the vital powers. 

The general treatment in these cases is of paramount importance. 
It is the duty of the surgeon to see that the patient's room is well 
ventilated, and that it is frequently purified by cleansing and disin- 
fectants. 

The wound is to be kept clean and well drained. 

The dressings should be changed as often as four times a day, and 
saturated with disinfectant lotions. 

When sloughing exists the charcoal poultice should be applied, and 
every measure pursued which will insure the utmost cleanliness of 
the patient and his surroundings. 

The curative treatment is to be conducted on the same principles 
which guide the surgeon in the management of all cases of atyphoid- 
al character. 

The bowels if constipated are to be opened by a gentle laxative, 
and the different secretory organs restored to a healthy action as far 
as possible. 

The vital energies of the patient are to be maintained or stimu- 
lated, and everything that tends to lower them must be warded off. 

Quinine is the most valuable remedy we have for the treatment of 
pyaemia. Some surgeons give it in large doses and speak highly of 
its effects. It is valuable in doses of four or five grains every three 
or four hours. It may be combined with iron advantageously in 
some cases. The best combination is with the citrate of iron. Four 
grains of each are to be given four or five times a day. 

Stimulants are also of great importance to maintain the powers of 
life. In some cases it is necessary to employ them freely to keep up 
the waning strength. 

The diet should be as nutritious as the patient's assimilative powers 
will bear. Milk and the animal broths are the best. 

When the stomach rejects nourishment it must be given by the 
rectum, enema of beef-tea and milk with brandy being administered 
every four hours. 

When the nervous system is disturbed by pain and want of rest 
and sleep, some of the forms of opiates or anodynes are to be given, 
small doses frequently repeated being better than large. 

Should diarrhoea exist it is to be kept under control. It should 
not be checked suddenly, as it appears to have an eliminative ten- 
dency in cases of blood-poison. 

Carbonate of ammonia in ten-grain doses five or six times a day 
is a valuable remedy when other tonics cannot be tolerated. 

When secondary abscesses form, they should be opened and kept 
cleansed by some disinfectant fluid, such as carbolic acid or the solu- 
tion of the chlorinate of soda, in their proper strength. 



SURGICAL DISEASES. 531 



Ulcerations and Ulcers. 

When the small particles composing the body have been used 
a while, they wear out, and become useless. Over the whole body 
are distributed a multitude of small vessels, called absorbents, whose 
business it is to pick up these worn and loosened particles, and carry 
them away. 

There is another class of small vessels, having just the opposite 
duty, — namely, to bring new particles of matter, and put in the 
places of those taken away. These are arteries. They are the natu- 
ral artisans, who construct our bodies. The absorbents are the 
demolishers who pull them down. Under these two forces, our 
existence is, for a time, a drawn game between life and death. The 
absorbents, like myriads of hungry insects, eat us up, — the con- 
structing arteries, like faithful builders, reconstruct us. The work 
of the absorbents, is called absorption ; that of the constructing arte- 
ries nutrition. 

When nutrition partially ceases, and absorption continues una- 
bated, we grow thin, or lose flesh. This happens in consumption. 
If nutrition should stop altogether, absorption going on as usual, our 
bodies would be quickly destroyed. We should be wholly devoured 
by these little absorbent vessels. This would be ulceration applied to 
the whole body. But it does not appear in so general a form. It 
confines itself to particular parts. 

When nutrition entirely ceases in any portion of the body, the 
absorbents devour all the skin, flesh, and vessels of the part, — leaving 
an open cavity. The process of taking away the flesh, etc., is ulcer- 
ation, — the cavity left is an ulcer or sore. 

Natural Surgery. — Ulceration sometimes acts the part of a nat- 
ural surgeon. When a part dies from mortification, it is necessary 
to have it removed ; so nature sets up, directly around it, an acute 
inflammation, in which all nutrition stops, and absorption goes on 
rapidly. In this way, a complete dike is in a short time made around 
the dead mass, and it is as handsomely amputated, or cut off, as any 
surgeon could do it. 

When the ulceration is going on, and the blood-vessels are being 
cut off by it, the blood coagulates or curdles in them for a short 
distance back from the breach, which prevents bleeding. This is as 
good as tying the arteries. 

Some textures ulcerate more easily than others, — the skin and 
mucous membranes most easily of all. 

Ulcers are divided into healthy, unhealthy, and specific. 

A Healthy ulcer is a simple sore, not showing any bad symptoms, 
but rather a kindly disposition to heal. It is generally small in size, 
of a florid-red color, and has upon its surface little elevations, pointed 



532 SURGICAL DISEASES. 

like cones, called </r emulations, which are not so apt as in the case of 
unhealthy ulcers, to rise above the level of the surrounding skin. 

Unhealthy Ulcers comprise those called irritable, indolent, pha- 
gedenic, etc. 

Indolent Ulcers are numerous. The edges of the skin around 
them are generally thick, prominent, and rounded. The granulations 
are pale, smooth, large, and flabby, with a peculiar gloss upon them. 
These ulcers form most often on the leg ; and the nearer they are to 
the ankle, the harder they are to cure. 

Phagedenic Ulcers are those which look as though they literally 
eat away the parts. Their surface has a livid appearance. The 
matter formed is small in quantity, and is frequently tinged with 
blood. 

Specific Ulcers embrace scrofulous, cancerous, venereal, scorbutic, 
and others. They are called specific because they are produced by 
particular diseases and states of the system. 

Treatment. — The first thing to be done is to remove the exciting 
cause. A venereal, or a scrofulous, or a scorbutic ulcer, cannot be 
cured, unless we first lessen the force of the disease in the general 
system. If the continuance of a sore depends on bad digestion, we 
cannot expect to cure it till we put the stomach right. 

Healthy ulcers need no treatment, except some simple dressing, 
such as oxide of zinc ointment. It is well, in some cases, to touch 
the granulations near the surface with lunar caustic. 

Ulcers upon the legs and ankles do not heal well if the patient 
walks about much, or even allows the legs to hang down a great 
deal. The patient must be put to bed and the leg bandaged, especially 
if the ulcers are the result of the breaking down of varicose veins, 
which are so common a cause of leg-ulcers. 

Indolent ulcers are to be touched by lunar caustic, or by diluted 
nitric acid. The diluted ointment of the nitrate of mercury is also 
often used with benefit. So is the compound tincture of benzoin, the 
basilicon ointment, etc. Or, apply a bread-and-milk poultice to the 
ulcer, and keep the patient twenty-four hours in bed. Then apply 
the lunar caustic to the whole sore, and to the skin around it. After- 
wards cover the ulcer with sticking plaster, and a bandage. 

The following is the best plan. Lay upon the sore a number of 
pieces of lint, soaked in the nitric-acid lotion (314), and cover them 
with a bread-and-milk poultice. Change these applications twice a 
day, and continue them till the discharge looks healthy, and the gran- 
ulations begin to appear. 

If there is inflammation about the sore, give some of the prepara- 
tions of salts to purge the bowels, and confine the patient to bed. 
When the parts begin to look healthy, lay some pieces of lint upon 
the sore, wet with nitric-acid lotion (214), or zinc lotion (215) ; and 



•SURGICAL DISEASES. 533 

then apply strips of adhesive plaster, one and one-half inches wide, 
two-thirds round the limb, and extending an inch below the ulcer 
and an inch above it, — at the same time drawing the edges of the 
sore together with a gentle force, and retaining them there with the 
plaster. Put a compress of soft linen over the plaster, and apply a 
bandage over the whole, making it tighter below and a little looser 
above, and extending to the knee. (Fig, 154.) 




Surgeons frequently snip out little pieces of healthy skin from 
some adjacent part and graft onto the ulcer, thus shortening the pro- 
cess of healing. A dressing of bovinine and water in equal parts 
hastens the growth of the flesh part. Whenever the flesh is even 
with the skin it should be kept at this level by some mild caustic, as 
stated above. Then comes the time for transplanting skin. The 
varicosities of the veins must be cured, or at least improved before 
the ulcers will remain healed. Avoid the use of pork or lard. 

Boils. — Ferunculus. 

Underneath the skin is a layer of tissue composed chiefly of cells. 
From this tissue there are small elevations, in the shape of cones, 
which rise up into the substance of the true skin. Like those papillse 
of the skin which become inflamed and produce corns, these eleva- 
tions are subject to an inflammation, which causes boils. 

At first, a tender knot or hardness is felt just under the skin, which 
soon begins to look red. A painful tumor now begins to show itself, 
of a dusky red or purple color, which acquires the size of a pea, a 
hazel-nut or a walnut. Some time between the fourth and eighth 
day it becomes pointed and white at the top, when the scarf-skin 
gives way, and lets out a* little pus mixed with blood, and exposes to 
view a mass of dead matter, called a core, which is too large for the 
opening, and is not ready to come away, if it were not. This core is 
a mass of mortified or dead flesh; and nature is cutting a space 
around it, that it may be thrown off. In two or three more days, it 
comes away, leaving a cup-like cavity, which gradually fills up, and 
the boil is over. 

Some constitutions yield boils in successive crops. When this hap- 
pens they are a terrible affliction. There are not many Jobs who can 
bear them with patience. 



534 SURGICAL DISEASES. 

Treatment. — A boil will generally run its course. A five-grain 
blue-pill, taken at bed-time, when the boil is first showing itself, is 
about the only thing I know that will blast it. And yet, my unwil- 
lingness to encourage a general use of mercurials makes me hesitate 
to recommend it. One pill, not to be repeated, can do no harm, how- 
ever, and may safely be taken. 

Boils may sometimes be stopped by touching them with lunar 
caustic. Water-dressing, if used early, and persevered in, will some- 
times prevent their growing larger than a pea. After the boil has 
opened, apply poultices for a day or two, then some simple, stimula- 
ting ointment, as basilicon salve, or Turner's cerate, or nitric acid 
lotion (314). If boils continue to come out in successive crops, give 
alterative medicines, or sulphurous mineral waters, or liquor potassse, 
or bicarbonate of soda. General tonic treatment, with iron, quinine, 
etc., is usually required (65), (75). A cupful of Indian meal soaked 
in a quart of water for four hours, and the water drunk freely, will 
often stop a boil if taken when it first starts, and if continued will 
prevent their returning. I would advise its trial, as it is often suc- 
cessful. 

Carbuncle. — Anthrax. 

This is like a boil, only much larger and more painful. Instead 
of one of the little cellular elevations being inflamed, as in the case 
of the boil, the carbuncle begins with the inflammation of several. 
Its surface is more flat than that of a boil ; its inflammation more 
violent; and the constitutional symptoms excited more severe. It 
has the breadth, sometimes, of the top of a quart bowl. Like the 
boil, it appears most often upon the neck, the shoulders, the back, the 
buttocks, the thighs, etc. It goes through the same process as a boil, 
and ends in the same way, only discharging a vastly larger core. 

Carbuncles most often appear in persons above middle age, and 
indicate an impaired and broken constitution. They occasion great 
suffering, and sometimes prove fatal. Upon the head or neck, they 
are more dangerous than in other situations. They are now con- 
sidered to be of bacterial origin. 

Treatment. — Apply, constantly, during the formation of the car- 
buncle, either fomentations and poultices, or cold-water dressing. I 
prefer the latter. To stop both the local and the constitutional dis- 
order, make two incisions in the form of a cross, cutting entirely 
through the dead mass. Then apply a fermenting poultice, or one of 
oatmeal, for two or three days, after which use the basilicon salve, or 
apply daily a weak solution of lunar caustic, or the nitric-acid lotion 
(314). During recovery, tonics are useful, such as quinine, tincture 
of peruvian bark, and sulphuric acid ; and morphine to procure rest, 
at every stage when it is required. A piece of caustic potash the 
size of a pea, dropped into the middle of the cross-cut, hastens the 
suppuration and subsequent healing of the wound. 



SURGICAL DISEASES. 535 



Malignant Pustule. 

This is one of the five diseases which man may take from animals. 
The other four are the cow-pox, hydrophobia, glanders, and malignant 
carbuncle. This last is what the French call charbon, — pronounced 
sharbo. My own mother and an elder brother came near losing their 
lives by it, — having taken it by handling the flesh and tallow of a 
dead cow. 

Malignant pustule begins with a water-pimple, not bigger than a 
millet seed. Underneath it is a hard point, surrounded with redness, 
like a flea-bite. This hardness is soon attacked by mortification, 
which spreads on all sides, and kills everything as it goes. Next, in 
fatal cases, come great restlessness, faintings, sunken countenance, 
dry skin, dry brown tongue, despondency, delirium, and death. It is 
supposed generally not to arise from constitutional causes, but to be 
produced by a specific poison or bacterium applied to the skin, or by 
eating the flesh of cattle which die of gangrenous diseases. The dis- 
order is probably the same as the malignant carbuncle. 

Treatment. — Deep incisions, and the application of the most pow- 
erful caustics, as the caustic potash, etc., and tincture of peruvian 
bark, quinine, aromatic sulphuric acid, wine, ether and opium. Prob- 
ably the best treatment is to surround the pustule with a thick layer 
of ointment ; then to fasten some lint to the end of a stick, wet it 
with nitric acid, and press it upon the pustule. Now apply cloths, 
wet with cold water, and when the slough comes off, dress with sim- 
ple ointment, or touch occasionally with weak solution of nitrate of 
silver (211). When once opened it should be thoroughly irrigated 
with disinfectants like corrosive sublimate, in strength of 1 part to 
2000 solution. 

Chemical Injuries. 

These are of two kinds, produced by causes of an exactly opposite 
nature. The first are 

Burns and Scalds. 

A burnis the effect of concentrated heat acting upon living tissues. 
The effects are inflammation, and sometimes complete disorganization 
and destruction of the parts. 

A scald is an injury produced by applying hot water or other fluid, 
to the skin or mucous membrane. The natural temperature of the 
human body is ninety-eight degrees ; that of boiling water, two hun- 
dred and twelve degrees. Bringing the skin in contact with a fluid 
heated so far above it, produces redness and pain ; and when nothing 
is done instantly to ward off the injury, the scarf-skin is raised from 
the true skin in the form of a blister, filled with water. 



536 SURGICAL DISEASES. 

The degree of danger from a burn or scald depends upon the ex- 
tent of the injured surface, and also upon the depth of the injuiy. An 
extensive scald or burn may prove fatal in a few hours, — the patient 
never rallying from the first prostration. These injuries are most 
dangerous when upon the head, neck, chest and belly. Old persons, 
and those who are feeble and have shattered constitutions, will sink 
under burns and scalds from which robust persons will sutler but 
little. 

Treatment. — For slight burns and scalds, make cold applications. 
Put the injured part in very cold water, or lay upon it pieces of linen, 
or lint, wet with vinegar and water, or rose-water and sugar of lead 
(238), or diluted solution of acetate of ammonia. When these are 
not to be quickly had, lay on scraped raw potatoes, which is one of 
the best remedies to give immediate relief. The object is to reduce 
the inflammation, and to prevent blistering. They must, therefore 
be put on very soon. If the scald be extensive, and on the body, — 
producing shivering, faintness, paleness and coldness of the skin, 
and a small pulse, — cold applications are not propor. In such case 
we may use warm fomentations, or, in the case of a child, the warm 
bath. A liniment of spirits of turpentine, linseed oil, etc. (194), 
makes an excellent application. Also (371). 

Raw cotton, spread out thin, and laid upon a burn, is a good dress- 
ing, and one which is much used. So is flour sprinkled upon the in- 
jured surface with a dredger. For loosening the flour when it is to 
be taken off, poultices are useful. 

Keep the air from the wound as much as possible. With this 
view, do not remove the dressing often, and when a cold lotion is 
used, merely pour it upon the rags, letting them remain undisturbed. 
Stimulate and narcotize the patient if exhausted by the shock of the 
burn. Nothing is more generally used than carron oil, which is com- 
posed of equal parts of linseed oil and lime-water. It soothes, heals 
and promotes granulation. 

Effects of Cold.— Frost-Bite. 

Cold is a relative term. The same temperature may be called hot 
or cold, according as it is compared with a hotter or colder tempera- 
ture. If we warm one hand by a fire, while we lay the other upon 
ice, and then plunge them both into cold water, the water will feel 
cold to the one which has been by the fire, and warm to the one taken 
from the ice. 

The warmth of the body being ninety-eight degrees, any tempera- 
ture below this may be said, in a certain sense, to be cold. Yet a 
temperature much lower than this, namely, from sixty to seventy, is 
the most agreeable and invigorating, because it takes away the heat 
just about as fast as it is produced in a healthy body. 

The first effect of cold applied to the body is to weaken the circu- 



SURGICAL DISEASES. • 537 

lation in the small blood-vessels of the skin. When applied with 
some intensity, the heart and arteries in general are weakened ; the 
blood is delayed in the vessels near the surface, and not being changed 
to a red color in the lungs as fast as it should be, the fingers, ears, 
etc., become blue or livid ; and, if the cold be continued sufficiently 
long, the circulation stops in these parts ; heat ceases to be evolved, 
and mortification or death is the consequence. Parts killed in this 
way are said to be frost-bitten. 

A free circulation of red blood is essential to the continuance of 
sensibility. Hence, when the circulation is seriously impeded by cold, 
the body becomes numb, — it loses its feeling; the muscles act feebly; 
a languor and torpor follows ; drowsiness comes on, followed by sleep, 
from which there is no waking. Drowsiness, during exposure to ex- 
treme cold, indicates great danger. 

Treatment It is a great principle in restoring frost-bitten parts, 

and persons benumbed with cold, to communicate heat in the most 
gradual manner. It has been said that the degree of external heat 
should be in proportion to the quantity of life. When life is 
weakened and nearly destroyed by frost, therefore, the warmth must 
be small, and rise no faster than life returns. 

To restore a frozen limb or part, rub it with snow, or place it in 
cold water for some time. When feeling begins to return, still keep 
it in cold water and let heat be added in a very gradual manner, by 
pouring in, now and then, a very small quantity of warm water. 

If a person be reduced by cold to insensibility, and apparently 
frozen to death, take his clothes off, and cover him all over with snow, 
except the mouth and nostrils. If snow is not to be had, put him in 
water as cold as ice, and let him lie for some minutes. Then rub 
him with cloths wet with cold water. When the body is thus thawed 
by degrees, and the muscles begin to relax, diy the body, and placing 
it in a cold bed, rub with the warm hands, only under the clothes. 
Continue this for hours. If signs of life appear, give a small injec- 
tion of camphor and water, and put a drop of spirits of camphor on 
the tongue. After a time, rub with spirit and water, and finally 
with spirit, and give tea, or coffee, or brandy and water, 

Chilblains. 

These are caused by exposure to cold, and affect the fingers, toes, 
and particularly the heels, with a painful inflammatory swelling, of 
a red, purple, or bluish color. The skin may be red in patches, and 
slightly swelled, with itching, tingling, pain, and lameness ; or there 
may be blisters, around which the skin is blue or purple ; or, worse 
yet, there may be ulceration and sloughing. 

Treatment. - — Stimulating liniments are the remedies usually em- 
ployed for this complaint. One of the best consists of six parts of 



538 SURGICAL DISEASES. 

soap liniment, and one part of tincture of Spanish flies ; and another 
excellent one is prescription 307. If there is ulceration, use Turner's 
cerate, or the resin ointment. 

Mechanical Injuries. 

Wounds are divided into several kinds. 

Incised Wounds are very common. Being made with sharp in- 
struments, they are cuts, and have no laceration or tearing about 
them. 

Stabs, or Punctured Wounds, form another class. They are made 
with pointed weapons, as bayonets, lances, swords, and daggers. 
They are more dangerous than the former, because they penetrate 
to a greater depth, — injuring blood-vessels, nerves, bowels, and 
other organs. 

Contused and Lacerated Wounds form still another class. They 
embrace gun-shot wounds, and all those produced by blunt instru- 
ments. They tear, and bruise, and mash the flesh. 

Poisoned Wounds form yet another class. They are such as are 
united with the introduction of some venomous poison into the in- 
cised, or punctured, or contused part. Stings and bites of venomous 
insects and snakes are of this class, — also the wounds made by 
poisoned arrows. 

Simple Wounds are such as are inflicted on a healthy subject with 
a clean, sharp instrument. 

Complicated Wounds are those inflicted when the state of the 
whole system, or of the wounded part, is such as to make it neces- 
sary for the surgeon to deviate from the treatment needed for a sim- 
ple wound, — as, for example, when there is bleeding, or nervous 
symptoms, or great pain, or locked-jaw, or much contusion, or ery- 
sipelas. 

Lacerated wounds are more dangerous than incised ones, because 
the parts are stretched and otherwise injured, besides being separated. 

A very small wound upon the brain, the spinal marrow, the bowels, 
or the heart, will often prove fatal, because the functions of these 
parts are intimately connected with life. 

Wounds of young persons heal much more rapidly and kindly than 
those of old persons. 

Septic Wounds. 

Whenever a surface has been cut, lacerated, or in any way in- 
jured, so that the surface can absorb germ-life from the instrument 
inflicting the wound, from the dressings used to cover it up, or from 
the dirt of the skin itself, we are very apt to get in a few days what 
used to be known as sympathetic fever, but which is no more or less 



SURGICAL DISEASES. 



539 



than the septic fever, or the systemic manifestation of germ absorp- 
tion. Fever, loss of appetite, headache, swelling and tenderness of 
the wound, with perhaps pus formation, are the natural outcome of 
such absorption. Hence it will readily be seen from what has been 
previously said about sepsis, that the first indication in all cuts is to 
disinfect the area injured with some one of the germicidal solutions. 
None is cheaper than corrosive sublimate in the strength of one part 
to two thousand. This, in many cases, is all that need be done. If 
the cut is to be sewn up, the wound is first cleaned with corrosive 
sublimate or oil of milk solution (a half-teaspoonful to one quart of 
water), and then sewn with needle and thread that have been boiled 
five minutes. The dressings or bandage should be disinfected with 
steam before being applied. Druggists nowadays keep in stock asep- 
tic gauze meant for precisely this class of cases, lacerated wounds, etc. 



Incised Wounds. 

When the flesh is divided with a cutting instrument, the cut edges 
separate, and the wound has a gaping appearance. This drawing 
apart happens in consequence of the elasticity of the skin. It often 
happens that vessels of considerable size are cut, so that bleeding is 
the principal thing to receive attention. 

Treatment of Hemorrhage. — Bleeding is stopped by the tourniquet, 
by the ligature, by compression, by the application of cold water and 
ice, and by astringents and styptics. 

The Tourniquet. — This instrument consists of a band and buckle, 
a pad and two brass frames, the 
upper of which is furnished with 
two small rollers, and the lower 
with four, over all of which the 
band plays. When the handle is 
turned to the right or left, the 
band is tightened or relaxed to 
just the extent required. (Fig. 
155.) The band is buckled round 
the limb in such a manner that 
the pad is placed exactly over the 
artery. When an artery is cut, it 
is known by the blood being very 
red, and spirting out in jets ; and 
in this case, the instrument must 
be placed upon the limb above the 
wound, or between it and the 
heart. FlG - 155 - 

The Ligature. — When an artery is divided, the surgeon lays hold 
of the end of it with his forceps, and ties a thread tight around it, or 




540 SURGICAL DISEASES. 

twists the end of the artery. This is called a ligature. By it, the 
bleeding is instantly stopped, and long before the thread becomes 
loose, the opposite sides of the vessel have grown together, and all 
danger of a renewal of the bleeding is over. In all these procedures 
the careful surgeon uses only disinfected instruments and ligatures. 

Application of Water and Ice. — This is done by saturating with 
cold water several folds of linen rags, or lint pads, and applying them 
to the wound, remoistening, and reapplying them as fast as they be- 
come hot, till the pain and inflammation subside. 

Compression. — When the blood does not come from any large 
vessel, but from several small ones, compression is sufficient. It con- 
sists in placing the opposite sides of the wound together, if possible, 
and then laying compresses over, and applying a bandage with mod- 
erate tightness. 

Astringents and Styptics. — These are spirits, tinctures of myrrh, 
Peruvian bark, diluted mineral acids, solutions of tannin, alum, sul- 
phate of copper, decoctions of white-oak bark, etc. These have the 
power to stop bleeding from small vessels. Monsel's salt is said to 
have more power than all the above. It is a preparation of iron and 
nitric acid, and has been used with great success in stopping violent 
bleeding. It is not a caustic or an irritant ; but it acts very power- 
fully upon albumen and blood, — producing with the latter a large 
clot, absolutely insoluble, which continues to enlarge for several hours 
after the application, and becomes quite hard and firm, so that no 
blood can get through ; but it leaves the wound filled with clots 
which afterward decompose and often give rise to blood-poisoning. 
The compress wrung out of some antiseptic solution is always the 
best method when practical. 

Beside these means, the application of the lunar caustic, potash, and 
the hot iron, are used, particularly the first, quite often. 

Union by the First Intention. 

When the bleeding is stopped, all foreign substances removed, and 
the wound properly cleansed, the next thing is to bring the opposite 
sides of the cut evenly together, and to keep them steadily in this 
position till they have healed. If this method succeeds, the healing 
takes place without the formation of any pus. This is called healing 
by the first intention, or adhesion. The cut surfaces grow together. 
For keeping the surfaces together, straps of adhesive plaster are used, 
putting them at right angles across the cut, and leaving spaces be- 
tween them. 

Sutures. — Incised wounds are sometimes sewed together by what 
is called the interrupted suture. After the bleeding is stopped, a 
a curved needle is threaded, and, the lips of the wound being brought 
together, is introduced through the right lip, and then, being directed 



SURGICAL DISEASES. 541 

across the wound, is pushed through the left lip, from within out- 
ward. It is now cut off, and tied in a bow. These stitches should 
be at least an inch from each other. These needles and sutures are, 
of course, to be boiled or otherwise rendered aseptic before using, as 
well as the hands of the one doing the sewing. Needles and thread 
come all ready put up in glass tubes, having been first sterilized, and 
kept in alcohol or in a vacuum for any length of time perfectly germ- 
free. 

The first plasters and dressings should remain on the parts at least 
three or four days, unless very great pain, bleeding, or some other 
bad symptom, should call for their removal. 

Useful Rules for Examining and Dressing Wounds. 

Never give the patient more pain from the mode of handling and 
dressing the wound than is necessary for his present good or future 
safety. Never distress him by probing, squeezing, etc., to find things 
that will be of no use when learned. 

Make all examinations as soon after the accident as possible ; for 
before inflammation and swelling take place, the probe or finger in- 
flicts much less pain. 

In changing the dressing of a wound, let all the fresh ones be ready 
before the removing of the old. The sponge, warm water, adhesive 
plaster, lint, ointment, lotions, bandages, etc., should all be at hand, 
and not have to be looked after when the wound is exposed. 

Put the patient in the most easy position, that he may not be 
needlessly fatigued during the dressing. 

If the bandage, plaster, and other dressings, have become hard, and 
glued together, and to the skin, by blood or matter, soften them with 
warm boiled water, which is to be pressed out of a sponge, — a basin 
being held below the part to catch the water as it falls from the 
dressing. 

The strips of adhesive plaster are to be removed by pulling gently 
at one end, and then the other, — each to be drawn towards the 
wound, so as not to pull its lips apart. 

In large wounds, take off one, or at most, two strips of plaster 
at a time. Cleanse, wipe dry, and again support this part of the 
wound with new strips of plaster, before any more are taken off. 
This will prevent the wound being torn open by the weight of its 
parts. 

If the wound be large and deep, its sides should be supported by 
an assistant while changing the dressings. 

If there are several wounds, dress but one at a time, that there 
may be no needless exposure to the air. 

Pay the utmost attention to cleanliness, asepsis and dryness. 

The frequency of the dressing must depend on the amount and 
quality of the discharge, the situation of the injury, the climate and 



542 SURGICAL DISEASES. 

season of the year, the effect produced by the dressing, and by the 
feelings of the patient. 

Remember that the one great desideratum is to keep away all 
germs from the wound and its vicinity. 

Antiseptic Dressings. 

Antiseptics have lately attracted a great deal of notice in the 
treatment of inflammation, especially resulting from wounds. 

The article most used at the present time for this purpose is car- 
bolic acid. Lister is its chief advocate, and under his authority it 
has established a position which deserves attention. 

It is based upon the germ-theory of disease, which is founded 
upon the observations of Pasteur. The theory supposes that animal 
decomposition is due, not to the chemical action of oxygen, or any 
other gas, but to the presence of organic germs floating in the atmos- 
phere. Carbolic acid is used on account of its known destructive 
effects upon low forms of organic life. 

These low forms of vegetable organisms, which float in the air in 
great abundance as constituents of the dust, are called by naturalists 
bacteria, of which there are many varieties. Whenever they find 
entrance into the body, there putrefaction is produced. 

These vegetable parasites are capable of a wonderful power of 
multiplying their species, — a single germ producing in a few hours 
many thousands. Once admitted into the body, they find their way 
everywhere, — into the muscles, into the blood, into the different 
organs of the body, — and they spread destructive fermentation and 
putrefaction wherever they go. 

In accidental wounds, it is first necessary to kill any septic organ- 
isms which may have been introduced from the air or from contact 
with foreign bodies. We do this by thoroughly bathing the surfaces 
with a solution of carbolic acid, of the strength of one part of the acid 
to twenty of water. 

When the wounds are made by the surgeon, the germs are de- 
stroyed by means of a spray imbued with the acid. This spray is 
produced by an atomizer, of which there are many kinds, and is 
thrown continually on to the surface of the wound, until the comple- 
tion of the operation, including the ligaturing of the vessels and the 
final stitching together of its edges. 

Lister also recommends the use of carbolized catgut for ligatures, 
being of an animal substance and finally absorbed. 

When the operation is fully completed, the antiseptic dressings 
are applied. Besides these antiseptic precautions, in cases of large 
and deep wounds a drainage tube is introduced to allow for the 
escape of the serum. 

The antiseptic dressings consist of — first, the protector ; second, 
the carbolized gauze ; third, the mackintosh ; and fourth, another 



SURGICAL DISEASES 543 

layer of the gauze, and a bandage of the same to keep the whole in 
place. For the purpose of protecting the cicatrizing parts from the 
irritating effects of the gauze, a layer of oil-silk coated on both sides 
with copal varnish, and afterwards brushed over with dextrine, to 
enable it to become uniformly moistened when dipped into a watery 
solution of the acid, is applied directly over the wound, the ends of 
the drainage tube protruding about an inch from each extremity of 
the incision. The wound is then covered with a layer of antiseptic 
gauze dipped into a solution of one to forty of the acid. There are 
then superimposed six other layers of dry gauze ; then the mackin- 
tosh or a piece of rubber cloth ; then an eighth layer of gauze large 
enough to cover in all the remainder, and finally a bandage of the 
same. 

When the dressings are renewed, it is to be done under the spray, 
great care being taken not to admit any non-carbolized air. 

The dressings are not to be changed until the discharge has begun 
to soak through and appear below the edge of the rubber cloth. 

The antiseptic gauze is made by impregnating cotton cloth of open 
texture with a mixture of carbolic acid one part, resin five parts, 
paraffine seven parts. The resin acts as a vehicle for the acid, while 
the paraffine is added to prevent inconvenient adhesiveness. 

The Way in which Wounds Unite. 

When the two surfaces of a wound are brought together, they be- 
come impervious to the blood, but not to coagulable lymph, or fibrin. 
This, — the material of which all flesh is made, — flows out upon the 
two surfaces, and becomes a bond of union between them. 

Into this layer of fibrin, the small blood-vessels, — arteries and veins, 
— which have been cut asunder, push themselves with open mouths, 
and, meeting in the centre, they inosculate, or grow together, and the 
blood resumes its circulation through them. 

By this method, incised wounds of moderate size are often healed 
in forty-eight hours. This method of healing by the first intention is 
always to be brought about, if possible. 

Punctured Wounds. 

These are produced by swords, daggers, etc. 

Great swelling and inflammation, large abscesses, erysipelas, the 
wounding of large arteries, and the consequent extravasation of blood, 
symptomatic fever, and lock-jaw, are the frequent results of punctured 
wounds. They are, therefore, more dangerous and hard to cure than 
cuts. 

Treatment.- — For the first twenty-four hours, use superficial dress- 
ings of lint, wet with some disinfecting liquid, and a loose bandage. 
If, after this, pain and swelling should increase, leeches may be ap- 



544 SURGICAL DISEASES. 

plied to the neighborhood of the wound, and fomentations, or poul- 
tices, be applied, placing a small linen rag or gauze, that has first been 
soaked in the disinfectant, over the wound. When the pain and in- 
flammation are great, saline purgatives (7), (18), (25), (27), and 
opiates are often called for. 

Contused and Lacerated Wounds. 

These are produced by cudgels, stones, bullets, or whatever else 
of a blunt nature tears asunder the muscular fibres, leaving jagged 
and uneven surfaces. They are rarely healed without suppuration, 
and are frequently followed by violent inflammation. They suppur- 
ate and slough, but they do not bleed much, — not even, sometimes, 
when large arteries are torn asunder. Whole limbs are occasionally 
torn away without hemorrhage. In warm climates, lock-jaw is a fre- 
quent consequence of them. 

Treatment. — Draw the edges of the wound loosely together, and 
retain them with a few strips of adhesive plaster. Sometimes a su- 
ture, here and there, will be proper. If a great deal of inflammation 
ensues, take away the adhesive plaster and the stitches, and apply a 
poultice, or water-dressing ; and if there be much fever, restlessness, 
or delirium, saline purgatives (18), (25), and opium (118), will be 
needed ; but especially will it be necessary to again disinfect the 
wound, and by every means possible render the field aseptic. 

The wound having thrown off its sloughs, suppurated, become 
clean, and formed granulations, the poultices are to be taken off, and 
simple dressings substituted. These should be adapted to the con- 
ditions of the sore, according to the directions for treating ulcers. 

When the wound is so severe that extensive mortification will be 
sure to follow, the limb must be immediately taken off, to save the 
life of the patient. 

Granulation and Scarification. 

Suppurating wounds heal in the same way as ulcers. The 
chasm is filled up by the appearance of little soft elevations of new 
substance, which originate at all points, and meet at the centre, draw- 
ing the sides nearer together, and raising the bottom towards the sur- 
face. This is called granulation, because these elevations look like 
grains ; and the result is a new tissue, of a peculiar character, which 
constitutes the cicatrix, on scar. 

Reproduction of Lost Parts. 

Among some of the lower animals, whole limbs which have been 
destroyed are easily reproduced. It is not so with man ; though cer- 
tain parts, when only partially destroyed, are sometimes regenerated. 
Thus, portions of skin, of considerable extent, are often reproduced ; 



SURGICAL DISEASES. 545 

and so are the whole of some long bones, when destroyed by necrosis. 
The same is true, to some extent, of ligaments. But portions of 
brain, and spinal marrow, and muscle, and mucous membrane, when 
once removed, are never regenerated. 

Gunshot Wounds. 

At a time when fire-arms are so much carried about the person, 
and so often used for purposes of duelling and murder, it is proper 
that every person should know something of the modes of treating 
gunshot wounds. 

Treatment. — It is often proper to make a gunshot wound larger 
at the orifice. When this is done, it is generally on the side where 
the bullet has passed out, if it has gone entirely through. A bullet 
is always to be removed, if it can be felt. 

The dressings are at first to be superficial, light, unirritating and 
aseptic. The common antiseptic dressing, covered with a piece of oiled 
silk, is one of the best. Where suppuration occurs, because of the 
introduction of germs into the wound, poultices may be called for, but 
the douching and cleansing of the wound with hot oil of milk solu- 
tion is often demanded and always grateful. 

Poisoned Wounds. 

To the bites and stings of various creatures man is exposed in 
most climates, and in all seasons of the year. These may be divided 
into three classes. 

Bites of Mosquitoes and Spiders, and Stings of Bees and Wasps. 

— For these, the best applications are a solution of common salt, or 
water of ammonia, or sugar of lead (239), or laudanum, or tincture 
of iodine. If none of these are at hand, at the moment, cover the 
part with wet earth. Tincture of arnica (240) is a good application. 
(See article on Bites, etc.) 

Bites of Venomous Snakes. — Either instantly cut out a. piece 
from the bitten part, or apply a dry cup, to prevent the absorption of 
the poison. Suction with the mouth will sometimes answer the same 
purpose. After doing one of these things, touch the part with caustic 
potash. Internally, give Fowler's solution, twenty drops, in a little 
water, every two hours. Also purgative injections, stopping the ar- 
senic when purging is well established ; or drink freely of whiskey. 

For the bite of the rattlesnake, the only known remedy is alcoholic 
drink, taken in large quantities, and immediately. Gin and whiskey 
are believed to be the best. Fill the system full. When the poison 
has begun to take effect, enormous quantities will be borne, before 
intoxication can be induced. Keep the whole person saturated until 
the symptoms decline. 



546 SURGICAL DISEASES. 



Fractures. 

The existence of a fracture is to be known by the symptoms. 
These are pain, swelling, deformity from the limb bending to one 
side, sometimes shortening of the limb, or loss of power to use it, and 
a crepitus or grating sound or sensation from the rubbing of the ends 
of the broken bone together. There are several kinds of fractures. 
They are 

The Transverse Fracture, which is directly across the bone. 

The Oblique Fracture, which runs from side to side, in an oblique 
direction. 

The Longitudinal Fracture, which runs lengthwise of the bone. 

A Simple Fracture is one in which the bone is broken simply, with- 
out any wound of the flesh with it. 

A Compound Fracture consists of a simple fracture, and of an ex- 
ternal wound in addition, caused by pushing the end of the broken 
bone through the flesh. 

A Complicated Fracture is one in which, besides the breaking of the 
bone, there is the dislocation of a joint, the wounding of an artery, 
the extensive tearing of the soft parts, or the wounding of the bowels 
or some other internal organ. 

A Comminuted Fracture is one in which the bone is broken into 
several pieces. 

Treatment of Fractures When a bone is broken, the first thing 

to be done is to get the injured person to his home, or to the nearest 
house. To do this in a rough or careless way might add much to 
his sufferings. 

If it be an arm which is broken, let it be placed in a broad sling, 
extending from the elbow to the fingers. In this condition the pa- 
tient, if in tolerable health, and the distance is not great, will find it 
easier to walk home, than to bear the jolting of a carriage. 

If the leg or the thigh be broken, then a hurdle of some sort (Fig. 

156), must be obtained as 
soon as possible, and, being 
covered with straw, or blan- 
kets, or garments, the pa- 
tient should be gently lifted 
FlG 156, upon it by just persons 

enough to raise him easily from the ground. This should now be 
carried by four persons, two at each end, moving with great gentle- 
ness, and keeping exact step with each other. If these persons 
take hold of the ends of two poles, laid under the hurdle, they will 
find they can carry it much more easily. If no hurdle be at hand, 




SURGICAL DISEASES. 547 

let four poles, two long ones, and two short ones, be laid across each 
other at right angles, and fasten together with nails or strings. Then 
lay upon these an old door, or some loose boards; and the injured 
person may be easily carried upon this temporary structure. A 
blanket fastened upon four poles, in the manner of a cot-bed, will 
answer a good purpose. 

Having placed the patient upon the hand-carriage, bring the sound 
limb and the broken one snug together, and tie them to each other 
with two or three pocket handkerchiefs ; this will support the broken 
limb, and prevent its being shaken about and injured by motion. In 
doing this, the limb should be laid as near as possible in the natural 
position, so that the bones may not get out of place, and their ends 
get pushed through the flesh. 

The Reduction, or Setting of the Fracture, is the first thing to be 
done. By this is meant the bringing of the ends of the broken bone 
together, and adjusting them to each other in their natural position. 
This is done by what surgeons call extension, counter-extension and 
coaptation. 

Extension means taking hold of the limb below the fracture and 
pulling from the body. 

Counter-Extension is pulling above the fracture towards the body. 
These opposite pullings are done at the same time to overcome the 
force of the muscles, which contract, and draw the ends of the bone 
by each other and shorten the limb. 

Sometimes no extension or counter-extension is necessary, the ends 
of the broken bone not being pulled out of their place. When the 
pulling is necessary, it should be gentle and steady. 

Modern surgery has developed two simple mechanical means of 
making extension and counter-extension for the purpose of overcom- 
ing muscular spasm which rarely fail. One is by the use of elastic 
rubber bands, and the other by the attachment to the limb of a cord 
running over a pulley at the foot of the bed and sustaining a suitable 
weight. The method of employing these will be given in detail in 
connection with special fractures. 

Coaptation means adjusting the ends of the bone to each other. 

The next thing is to provide for keeping the ends of the broken 
bone steadily in contact, so that nature may have a fair chance to 
unite them. 

To secure this object, mechanical contrivances are used, which are 
simple, and may always be had without difficulty. 

They consist of linen bandages, about the breadth of four fingers, 
and from four to ten yards long ; and pads, made of old woollen cloth 
or blankets lightly quilted together, or pillow-cases filled with tow, or 
chaff, or cut straw, or even leaves ; and of splints, made of clapboards, 
or thick shingles, four fingers wide, and in length corresponding with 



548 



SURGICAL DISEASES. 



that of the broken limb; or wheat straw laid side by side, and quilted 
into a piece of cloth to prevent them moving about. A very useful 
splint may be made from the fresh bark of trees. 

The pads are to be placed under the splints, to prevent injuries to 
the skin; and the bandages to be bound over the whole. 

A great point is to have the splints accurately adapted in each case, 
and the ability to affect this is an important element of success in this 
branch of surgery. Wood may be generally cut into suitable shape, 
but it is perhaps easier to use moulded splints of leather, felt, gutta- 
percha, or shellac cloth. The starched or plaster bandage or gummed 
paper may be effectively used ; and with a proper pair of shears, 
sheets of tin or zinc may be cut into splints, which will answer ad- 
mirably. Woven iron wire splints are highly recommended. 

For some hours after a limb is broken, the parts continue to swell, 
and if bound up immediately with the pads, splints, etc., much 
needless pain will be occasioned. It is best, therefore, not to put 
these on under two or three days, but merely to lay the limb in a 
natural position, and perhaps lightly bind one splint to it, Broken 
ribs and collar-bones are exceptions, and should be bound up imme- 
diately. 

A broken arm lies easiest half bent, upon a pillow ; the thigh or 
leg, upon the outside, with the knee bent. 

When the apparatus is once adjusted, the less it is meddled with 
the better. 

In fractures of the shoulder or arm, a sling is a contrivance of great 
importance. This, if well made and adjusted, keeps the broken bone 
in its place, and at the same time allows the patient to take some 
exercise by walking about. 

Besides the above contrivances, there is the double inclined plane 




Fig. 157. 



(Fig. 157) for giving the leg the advantage of a bent position. There 
are also fracture-boxes (Fig. 158), and fracture-cradles, — the latter to 
keep the bed-clothes lifted away from the painful limb. Fracture- 
beds are now brought to great perfection, and one should, if possible, 
be procured when the patient is likely to be confined a long time 
with a compound fracture. The fracture-box represented by Fig. 



SURGICAL DISEASES. 



549 



158, may be made from thin boards, by any carpenter. It lias a 
hinge at the knee to enable it to fulfil the double purpose of a double- 
inclined plane and a fracture-box. 




Fig. 158. 



The Way in which Broken Bones Unite. 

The union of broken bones is much slower than that of severed 
flesh. The ends of the bone being kept steadily together, they soon 
become surrounded by a swelling of the soft parts, which change to 
a sort of osseous substance, making a kind of bony hoop, to act as a 
splint or support, — nature not being willing to trust the surgeon to 
keep the fragments exactly in their place. This is called a provi- 
sional callus, because it only has a temporary use. 

This First Stage lasts about ten days. At the end of this time, a 
spongy substance appears between the ends of the bone. This sub- 
stance is not bone, but in the swelling around the fracture specks of 
bone begin to be deposited; the fibrin here poured out becoming 
first cartilage, and then receiving into itself phosphate of lime, it be- 
comes bone. A similar work is going on within, in the part called 
the medullary membrane. 

This Second Stage lasts from the tenth to the twenty-fifth day. 

Then begins the Third Stage, which goes to the end of the sixth 
or eighth week. During this period the external swelling, and the 
internal medullary membrane, become completely ossified and firm ; 
though the ends of the bone are not yet grown together. 

The Fourth Stage goes to the end of the fifth or sixth month. Dur- 
ing this time, the external swelling, or provisional callus, becomes cov- 
ered with a periosteum, and the ends of the bones themselves are fas- 
tened together by a bony union. 

The Fifth Stage extends from the fifth or sixth to the twelfth month. 
During this time, the ends of the bone become grown together so 
strongly that the bony ring, or provisional callus, is no longer wanted, 
and it becomes absorbed, and disappears ; in other words, having no 
further use for it, Nature takes off her splint. The place where the 
fracture was is now as strong as any other part. 



.")50 SURGICAL DISEASES. 



Union in Compound Fractures. 

The union of compound fractures takes place in a different way 
from that of a simple fracture, just described. The bones remain dis- 
united several weeks, and there is no provisional callus formed ; but 
after some weeks the ends of the bone soften and granulate, and these 
granulations are gradually changed into bone. 

In nothing have the benefits of antisepsis been shown so vividly as 
in the treatment of compound fractures. Twenty 3-ears ago a large 
percentage of all compound fractures either suppurated or caused the 
death of the patient ; but now suppuration and high mortality are not 
seen. The wound is treated exactly like any other wound, on aseptic 
principles, the bones being held in place as usual. Union thus results 
without suppuration, and a cure is completed in one-half the time, with 
over fifty per cent less mortality than was the case previous to the 
introduction of aseptic and antiseptic surgery. 

The first thing in event of a compound fracture is to render the 
parts aseptic as soon and as completely as possible. This may be done 
by a thorough scrubbing with tincture green soap and water for five 
or ten minutes, and then, after washing off the soap with alcohol, to 
thoroughly scrub the skin adjoining the wound with some one of the 
disinfectants mentioned under the heading of Sepsis and Asepsis ; as, 
for instance, corrosive sublimate, one part to two thousand parts of 
water. The wound is to be dressed precisely as any wound, and is 
to be so arranged that access may be had to it for future dressings. 
When skin and flesh are much torn they may be sewn together with 
a needle and thread or silk which has been boiled five minutes. The 
stitches are to be removed from the fourth to seventh day. The bones 
are to be approximated just as in simple fractures, and splints 
applied. 

Formerly the mortality of compound fractures was very high, owing 
to the invasion of the tissues by germ-life, but since the introduction of 
antiseptic measures in surgery, the death rate has fallen so markedly 
as to be a matter of great pride to surgeons and the world at large. 

In cases where the wound does not allow of good coaptation, and 
much mangling of the- tissues has occurred, it ma} r be well not to suture 
the parts, but to dress them with some antiseptic gauze drainage, and 
do them up like an open wound. 

Time Required for Uniting Different Bones. 

Fractures of the arms unite sooner than those of the legs. 

The ribs and collar-bone unite with tolerable firmness in about a 
month ; those of the arm in six weeks ; of the thigh and leg in eight 
weeks. I only mean the firmness derived from the provisional callus. 

A broken bone will unite much sooner in a healthy person than in 
an unhealthy one ; much sooner in a young than in an old person. 



SURGICAL DISEASES. 551 

As a general rule, the apparatus should be kept on thirty clays in 
the ease of children : forty days in that of adults ; and much longer 
in that of aged persons. 

False Joint. 

The union of a broken bone is sometimes prevented by a frequent 
moving of the limb. The ends of the bone, having failed to grow to- 
gether, will sometimes become rounded and smoothed, uniting only 
by a kind of ligament, and acquire the habit of sliding upon each 
other, and thus form what is called a false or artificial joint, — the 
limb being permanently capable of bending to some extent, at the 
place of the fracture. 

Fractures of the Skull. 

These are always dangerous in their nature, and the aid to be de- 
rived from surgery is much less than in other fractures. If a fracture 
of the skull produce deep sleep and snoring, and the patient does 
not show any symptoms of pain when pinched, etc., we are to infer 
that a piece of bone is pressed down upon or into the brain. 

In this case, if the position of the blow be known, a cut is to be 
made through the skin, two or three inches long, down to the bone. 
If arteries bleed, they must be taken hold of with a pair of forceps, 
and tied with a silk thread, the ends of which are to be cut off. The 
bone being well exposed by one or two incisions, the piece which is 
pressed down upon the brain is to be raised with a chisel, or some 
similar instrument, to a level with the other bones. The surface 
must then be cleansed antiseptically, the hair around shaved off, the 
skin brought together, and the cut edges reunited by sticking plaster. 

When the inflammation appears, twenty-four hours after, it is to be 
kept down by doses of from five to ten drops of tincture of veratrum 
viride, given every one or two hours. 

Fractures of the Bones of the Nose. 

Injuries of this kind may generally be rectified by passing a strong 
probe up the nostril, and pressing out the bones to their natural place, 
at the same time using the fingers on the outside to prevent their 
being pressed out too far. Inflammation must be kept down by cloths 
wet in cold water and laid on, and by light diet. 

Fracture of the Lower Jaw. 

This usually takes place near the chin. It may occur also near 
the angles of the jaw. It may be simple or compound, and is known 
by the pain, the swelling, the inability to move the jaw, the indenta- 
tion felt by the finger, the irregularity of the teeth, and the grating 
sensation felt while moving the jaw with the hand placed on the back 
fragment. 



552 



SURGICAL DISEASES. 



Treatment. — Let one or both thumbs be introduced into the mouth. 
With these, keep the back part of the jaw stationary, and pull for- 
ward the fore part with the ringers on the 
outside. In this way the fracture can soon 
be put right. This done, shut the mouth 
firmly, and place a thick compress of lint 
over the broken part; over this put a piece 
of pasteboard, wetted so as to bend easily 
to the parts, and over this a strong band- 
age of muslin, two and a half inches wide, 
with a small bag to fit and hold the chin ; 
FIG - m all which is represented in Fig. 159. 

For a fortnight the patient must feed on gruel, broth, arrow-root 
and milk, that the jaw may not be displaced by chewing. 




Fracture of the Collar=Bone, or Clavicle. 

This accident generally occurs about the middle of the bone, and 
is generally caused by falls on the arm and shoulder. 





Fig. 160. 



Fig. 161. 



Symptoms. — Pain and tenderness at the place of the injury, and 
inability to lift the arm ; a small bunch or prominence at the point of 
the fracture ; the distance from the point of the shoulder to the 
breast-bone shorter than on the other side ; and the dropping down- 
wards, forwards, and inwards of the shoulder. To make the case 
sure, compare the two bones, and see whether they agree. 

Treatment. — Place the knee between the shoulder-blades, and 
grasping the round ends of the shoulders with the two hands, draw 
them gently back till the ends of the bone come to their proper place; 
or place the elbow of the patient close to the body, and a little for- 
ward, and then push it upward. 



SURGICAL DISEASES. 553 

To retain the shoulders in this upward and backward position for 
some weeks, pass a flannel bandage, four inches wide, around the 
front of one shoulder, under the arm-pit, across the back, over the 
opposite shoulder, under the other arm-pit, and again across the back, 
in the form of the figure oo. To prevent the bandage from cutting 
the skin, put pads under the arms. (Figs. 160 and 161.) 

Fracture of the Shoulder-Blade. 

When this accident happens, the body of the bone is generally 
broken across by some great direct violence. In a few instances, the 
end next to the collar-bone is broken. * 

Symptoms. — Great pain in moving the shoulder, and the grating 
sensation which may be felt by placing one hand on the upper end 
of the bone, and moving the lower portion with the other. 

Treatment. — A bandage must be passed round the chest, and a 
few turns be made around the upper arm, so as to fasten it to the 
side, and prevent all motion. Purging, low diet, and the tincture of 
veratrum viride will be required to keep down inflammation. 

Fracture of the Acromion, or the end of the scapula which unites 
with the collar-bone, may be known by the flattening of the shoulder, 
— the broken part being drawn down by the action of the deltoid 
muscle. 

Treatment. — It must be supported by the same bandages as are 
used for a fracture of the collar-bone ; and the elbow must be well 
raised, so that the head of the upper-arm bone may be lifted against 
the upper portion of the scapula, and act as a prop to keep it in place. 
No pad should be put in the arm-pit, for this would push the broken 
part too much outward. Gentle motion of the arm may be begun 
about the sixth week. 

Fracture of the Upper=Arm Bone. 

The bone of the upper-arm is most frequently broken near the 
centre, though it may be fractured 1 near the ends. It may be known 
by taking hold of the arm above and below the suspected fracture, 
and attempting to move the ends of the upper and lower fragments 
upon each other. If there be a fracture, the grating of the broken 
ends against each other will either be heard or felt. The arm will 
also be bent and helpless ; and if the ends of the bone be slipped by 
each other, it will be shortened. 

Treatment. — Let a powerful man take hold of the arm and pull 
gently and gradually, but with considerable force, till the arm is 
brought to its natural length, another man taking hold of the body 
of the patient, and pulling in an opposite direction. In the mean 
time, the surgeon is to adjust the ends of the bone to each other, and 




554 SURGICAL DISEASES. 

apply a bandage, but not very tightly, from the elbow to the shoulder, 
and over this, four splints, with pads under them ; one in front, reach- 
ing from the shoulder to the bend of the elbow, 
with a few turns of the bandage over it ; another 
behind, reaching from the shoulder to the point 
of the elbow, with a few turns of the bandage 
around it also ; another on the inside, extending 
from the arm-pit to the inner projection of the 
bone at the elbow, also secured by a few turns of 
the bandage ; and the fourth one on the outside, 
reaching from the shoulder to the outside knob 
at the elbow. The whole is now to be secured 
either by a bandage or tape. (Fig. 162.) The arm is to be confined 
to the side, and the hand and fore-arm placed in a sling. In from 
seven to ten days, the dressing should be taken off to see if all is 
right. 

Fracture of the Elbow. 

This may be known by the patient being able to bend the arm, 
but not straighten it, and by the grating which may be heard or felt 
when the arm is moved back and forth by the operator, and also by 
the severe pain felt in the fractured part. 

Treatment. — First apply leeches and evaporating lotions to re- 
duce the inflammation. When this is effected, straighten the limb, 
and apply a bandage snugly from the fingers to the elbow. The 
broken end of the bone must now be brought to its place, and the 
bandage continued over it, and for a few inches above it. Secure it 
here, and bring it back, — carrying it above and below the elbow for 
several times ; and then extend it up to the shoulder. A splint 
must now be applied to the inner side of the arm to prevent its being 
bent, extending from the hand nearly to the shoulder, and another, 
of similar shape, to the outside. The joint should be kept quiet for 
four or five weeks, during which time the splints may be taken 
off three or four times, to see if there is any chafing of the skin, or 
any disturbance of the bones. 

Fractures between the Elbow and Wrist. 

The part of the arm between the elbow and wrist, called the fore- 
arm, has two bones, — one extending from the elbow on the inside 
to the wrist at the root of the little finger, called the ulna, and the 
other on the side next the thumb, a shorter and a smaller bone, and 
called the radius. 

When both these bones are broken at the same time, the fracture 
may be easily discovered ; when only one, the sound bone keeps the 
other in place, and the injury is not so easily made out. 



SURGICAL DISEASES. 555 

Treatment. — Relax the muscles by bending the elbow, and then, 
by extension and counter-extension, put the ends of the bones in 
proper place ; then place two splints, thickly padded in the centre, 
one upon the front of the hand and forearm, and the other upon the 
back of the hand and forearm, — the palm of the hand being turned, 
not towards the chest, but downwards. They are to be covered with 
a bandage from the fingers to the elbow. The whole arm and hand 
should be placed in a sling, and remain in this position four or five 
weeks. 

Fractures of the Wrist, Hands, and Fingers. 

The setting of fractured bones in these parts is to be done by ex- 
tension and counter-extension, as in the case of other bones. 

If the wrist be broken, a splint should be applied in front and one 
behind, and a bandage bound tightly from the hand half way to the 
elbow. 

In fracture of the bones of the hand, a pad or compress must be 
put upon the palm of the hand, and a splint placed over this, with a 
bandage extending from the wrist to near the ends of the fingers. 

If one finger only be broken, apply narrow pasteboard splints on 
four sides, and cover them with a narrow bandage ; and then bandage 
the whole hand. 

In all these fractures, place the hand in a sling. About three 
weeks will be required for the bones to unite properly, and several 
weeks more for the parts to acquire their natural usefulness. 

Fracture of the Ribs. 

This accident occurs either by blows, or by being crushed between 
two opposing forces. One, two, or more ribs may be broken at a 
time, according to circumstances. 

Symptoms. — A fixed, piercing pain, made worse by breathing, 
coughing, or any other motion, and also a grating sensation during 
the taking of a long breath, the hand being laid upon the injured 
part at the time. 

Treatment. — The ribs are to be held steadily in their place by 
pressure. To effect this, request the patient to draw in a long breath, 
and hold it. While the ribs are swelled out in this way, and the 
broken ends are thus brought to their proper place, pass a woollen 
bandage, five or six inches wide, several times tightly around the 
chest, from the arm-pits to the pit of the stomach. This will confine 
the muscles of the chest, and the breathing will have to be done with 
the muscles of the belly, and the ribs will thus be kept still, and 
have a chance to grow together. 

If the pleura be wounded, and inflammation follow from this or 
other cause ? the patient must be confined in bed, kept on a low diet, 



556 SURGICAL DISEASES. 

and his pulse be kept clown by tincture of veratrum viride. The 
bowels should be emptied by recipes 18, or 10, or 27, or 41, both to 
subdue inflammation, and to give the diaphragm a chance to drop 
down freely. 

Fracture of the Breast=Bone. 

Symptoms. — The injured part is frequently either sunk down or 
raised up ; there is difficult breathing, cough, spitting of blood, pain, 
inability to lie on the back, and a grating noise caused by breathing. 

Treatment. — The same as that for broken ribs. Should the broken 
part be pressed down upon the lung, so as to cause serious difficulty 
of breathing, an incision may be made, and the broken piece raised 
up with a chisel, or stiff case-knife, or some similar instrument. 

Fracture of the Haunch=Bones, or Pelvis. 

These fractures are dangerous, — being often connected with some 
other injury, as tearing of the bladder, lower bowel, or great veins or 
arteries. Fortunately, however, they are only caused by some great 
violence, and do not often occur. ■ 

Treatment. — Place the patient in the easiest possible position, and 
keep him entirely at rest. Generally a catheter should be kept in the 
bladder, that the water may pass off easily ; and the whole hips 
should be bound round tightly with a flannel or calico bandage, and 
made as firm and fixed as possible, to keep the broken bones together. 
The most perfect rest must be ordered for six weeks or two months. 

If the extreme lower end of the sacrum, the os coccygis (Figs. 8 — 3) 
be broken, the separated portion must be put in its place by introduc- 
ing the finger into the rectum; and the bowels must be kept loose by 
gentle physic, that the broken bone may not be pushed from its place 
by the pressure against it of hard stools. 

Fracture of the Thigh=Bone. 

The points where this bone are broken are at its upper portion or 
neck, and near its middle. The break at this latter place may be 
straight across, or oblique, — partially lengthwise. When oblique, 
the point of the bone may stick into one of the large muscles, and be 
made fast by it. 

Symptoms. — The fracture in the middle of the bone, if it be trans- 
verse, may be known by some swelling or irregularity discovered by 
running the hand along the thigh, and grasping it here and there ; 
and if it be oblique, the ends of the bone will be drawn by each other, 
and the limb will be shortened. 

Treatment. — Place the patient on his back, and let two strong 
men use extension, — one taking hold near the hip, and the other 



SURGICAL DISEASES. 



557 



grasping the limb at the knee and pulling steadily and strongly till 
the limb is of the proper length, and the ends of the bone are in their 
place. The man who takes hold of the upper end of the limb may 
hold it more firmly and with less fatigue by passing a folded sheet 
around the groin. 

The extending force being still continued, the operator is now to 
apply the splints, which are to be four in number, — one in front, 
reaching from the knee-pan to the groin ; one behind ; one on the 
inside, from the upper part of the thigh to the inside of the knee ; 
and a fourth one, about four inches wide, reaching from the arm-pit 
to a distance of two or three inches beyond the sole of the foot. Cot- 
ton must be placed under these splints to prevent their injuring the 
skin, and they must be of a width to nearly, but not quite, touch 
each other. These being properly adjusted, and the extension still 
continued if the fracture is oblique, the bandage is now to be firmly 
applied from the foot to the upper part of the thigh, and then passed 
a few times around the body. This fracture is sometimes treated 
without splints, as represented in (Fig. 163). 






If 
1 





Fig. 163. 



Fig. 164. 



Six or seven weeks will be required for the bones to grow together, 
during which time the patient will need to lie upon Ins back. But the 
dressing may now and then be taken off and put on again. 

Sometimes only a single long splint is used ; sometimes no splint; 
in still other cases, four splints, — the outside one being short, and 
the limb resting on a double inclined plane. 



558 



SURGICAL DISEASES. 



Fracture at the Neck of the Bone. — When the bone is broken at 
the neck, close to the hip-joint, the injury is known by the knee and 
foot turning outward, and by the limb being an inch or two shorter 
than the other (Fig. 164). This is an accident to which old persons 
are particularly liable. When the bone is broken here, it seldom 
grows together again. The union which is formed is generally by a 
ligament. 

Treatment. — This requires a very long splint, reaching from the 
armpit to beyond the sole of the foot, and bound firmly with a band- 
age, as in fracture in the middle of the thigh. The limb should be 
kept extended, and the injured one must be bound to the other by a 
bandage, keeping both legs straight and immovable. A broad leather 
strap, bound firmly round the hips and thighs will be serviceable. 

Two or three months will be required for the injury to become re- 
paired, so that the limb may be used. The patient must get up cau- 
tiously, and be careful not to use the limb much so long as pain is 
produced. 

Fracture of the Knee=Pan. 

The knee-pan (patella) may be broken up and down, or across ; — 
the latter fracture is the more common. It is a troublesome fracture, 
and is very apt to leave a stiff knee. 

Symptoms. — When the bone is broken across, the patient cannot 
stand upon the limb ; the leg may be flexed or crooked, but cannot 
be straightened , the upper part of the knee-pan is drawn up away 
from the lower portion, leaving a wide gap, into which the fingers 
may be laid, — at the top and bottom of which the rough edges of 
the movable bones may be felt. 

Treatment. — First, reduce the inflammation by tincture of arnica, 
leeches, etc. Then straighten the limb, and put a well-padded splint 
behind, to keep the knee motionless ; place the patient's body in a 
half-sitting posture, and raise the foot considerably above a level. 
Put a bandage over the splint, beginning half way up the thigh, and 
extending down to the knee-pan, and being made very tight just 
above the broken bone, so that it cannot easily slip under it. The 
broken bones must now be brought together, and the bandage be 
passed below and again above the knee several times in the form of 
a figure 8, to keep the bones from parting. 

The bandage, generally, may not be removed for a fortnight. After 
this period, if everything has gone on well, the limb may be carefully 
bent a little every day, to avoid a stiff knee. 

Fracture of the Bones of the Leg. 

The leg is that part of the limb between the knee and ankle. It 
has two bones; the smaller on the outside, called the fibula; the 
larger on the inner and front side, called the tibia, or shin-bone. 




SURGICAL DISEASES. 559 

One or both of these may be broken at the same time. If both 
are broken, it is impossible to walk upon the limb ; there is a change 
in its shape ; it may be bent ; and the grating of the broken ends of 
the bones may be felt or heard. 

Treatment. — First, adjust the bones by means of extension and 
counter-extension, as in other fractures. 
Then apply two splints, one on the out- 
side from the knee to the sole of the foot ; 
the other upon the inside. Over these a 
bandage is to be firmly applied, reaching 
from the toes to the knee. The leg may 
rest upon the side or the back, as the com- 
fort of the patient may require. Upon 
the side is generally the easiest position, 
with the knee a little bent (Fig. 165). 

The dressing may be removed in six or seven days, to see that the 
bones are in their proper place. Five or six weeks will be required 
for recovery ; and at the end of this time, the dressing may be laid 
aside. But the patient must use his leg very gradually. 

In the treatment of fractures of the shafts of the bones of the 
lower extremities, three indications should be fulfilled : First, coap- 
tation and fixation of the fragments ; second, moderate extension ; 
third, gentle compression and support. Provided these requirements 
are carried out, it matters little what apparatus may be employed ; 
but that which can be applied with the least disturbance of the 
fractured bone, and is most comfortable to the feeling of the patient, 
should be preferred. 

The best mode of extension and counter-extension now in use is 
by raising the foot of the bedstead about eight inches, by a block of 
wood placed under each fore-leg. This makes an inclined plane, and 
the body consequently tends to incline towards the head of the bed ; 
this is the counter-extension. 

Then extension is made as follows : A strong piece of adhesive 
plaster, about two and one half inches wide and about three feet long, 
is applied to the sides of the leg, extending from a little below the 
knee, leaving a loop under the foot four or five inches long. This 
is secured firmly in place by a bandage to the whole length of the 
leg. A piece of cord is fastened to the loop and passed over a pul- 
ley, which is fixed to the foot-board of the bed. To the other end of 
this cord is attached a weight. This need not exceed ten or twelve 
pounds. 

In this way we get our counter-extension and extension : the body 
is drawing one way and the weight is pulling the other all the time. 

This is a simple and comfortable way of treating fractures of the 
shafts of the bones of the lower extremities which require extension. 
It may be applied to the different fractures of the neck of the thigh 
bone, to fractures of the shaft, and also to fractures in the shafts of 
the bones of the leg. 



560 SURGICAL DISEASES. 

It is the best and most effectual way of preventing undue short- 
ening that we have in use, and what is of as great importance to the 
patient, a most comfortable way of keeping the painful limb in the 
proper shape. 

Fractures of the Bones of the Foot. 

These are to be treated in the same manner with fractures of the 
hand. They are often attended with much other mischief, as lacera- 
tion of the flesh, ligaments, etc. Hence, cutting off the foot, or a 
part of it, is often necessary. Pasteboard splints are frequently used 
in these fractures. If matter forms, it must be let out by opening 
the parts. 

Compound Fractures. 

When, in connection with a broken bone, there is a wound of the 
flesh, which leads to, and communicates with the space between the 
broken ends of the bone, the whole injury is called a compound frac- 
ture. The wound in the flesh may be caused by the same force 
which breaks the bone, as a bullet from a gun, or a cart-wheel, or 
some machinery in which the limb is entangled. Quite often the 
flesh wound is caused by one of the ends of the bone being forced 
through the flesh and skin. 

But, however caused, a compound fracture is of a much more 
serious nature than a simple one ; and it is particularly dangerous 
when a joint is involved. It is more serious above the knee and 
elbow than below, and more to be dreaded in the lower limbs than 
in the upper. 

Treatment. — An attempt should always be made to preserve the 
limb ; it should not be cut off, unless the compound fracture is of 
the worst kind. But if there be no hope of saving the limb, the 
amputation should be performed at once, while the constitution is 
tranquil, and before it has been shocked and injured by suppuration, 
abscesses, and sepsis, which sometimes follow such grave injuries. 

But, suppose it be determined not to cut the limb off, — as it gen- 
erally should be, — the first thing is, after the bone is set, to close the 
wound against all entrance of air, and to cause it to heal by the first 
intention, that is, without suppuration. To do this, one method is to 
cover the wound with lint dipped in blood ; but the more usual mode 
is, to bring the sides of the wound together, and secure them very 
carefully by strips of adhesive plaster, in the same way as in common 
cuts. The bandage should be kept wet with cold water, by squeez- 
ing a sponge over it, or by sprinkling cold water upon it as fast as it 
becomes dry. 

It will be necessary, in this case, to keep the bed-clothes away from 
the limb while it is thus wet, which may be done by cutting a barrel 
hoop in two, and nailing it to two pieces of lath. There should be 



SURGICAL DISEASES. 561 

air circulating under the sheet, that the heat of the inflammation may 
not keep the limb in a steam bath. 

Should the wound heal by the first intention, the danger will soon 
be over, and the treatment may be the same as for simple fracture. 
But this, unfortunately, does not always occur. 

It occasionally happens, that after three or four days, the patient 
grows restless, has very short and disturbed sleep, is hot and thirsty, 
has headache and shivering fits, is more ill towards evening, wanders 
in his mind, or becomes delirious, and perhaps dies in ten days or a 
fortnight from the sepsis or blood-poisoning that has taken place. 
If the symptoms are a little less severe, the wound will at first dis- 
charge a small quantity of dirty, bloody matter, which, if everything 
goes well, will, by degrees, change to healthy matter, without smell, 
of a straw-color, and about as thick as cream. 

The fever, and other bad symptoms, will now subside ; the sleep 
and appetite come back, and a new process begins, that of healing by 
granulation, or the formation of new flesh to fill up the gap made by 
the wound. 

For old persons, or those whose health has been broken, this stage 
is full of danger, and is apt to result in death, if the lower limb be 
the injured part. 

li the constitution proves unable to bear up against this stage of 
the injury, alternate heat and sweating set in, the face is flushed with 
a pink color, the pulse becomes weak and quick, the body wastes, the 
appetite disappears, the tongue becomes dry and brown, restlessness, 
wandering, and delirium follow in quick succession, and all are 
speedily terminated by death. With the setting in of these symp- 
toms, the wound stops discharging, or throws out only a thin, watery 
and stinking matter. Quite often the skin and other parts mortify, 
and if there be strength enough to throw off the dead parts, the 
broken ends of the bone stick out, looking dead and white. 

When the constitutional symptoms begin, open and thoroughly 
disinfect the wound and provide for free drainage ; a poultice may 
also be used if much pain be present. The poultice must be 
continued till the wound is filled with new flesh nearly to the 
surface. 

It must be said in justice to modern surgery, that, if antiseptics 
are used at the first dressing of the wound, we expect union by first 
intention, and the avoidance of pus formation with all the dangers 
this entails. The wound is to be treated just like other fresh 
wounds, aseptically ; the limb may then be done up like a simple 
fracture, but the dressings should be so arranged as to allow of sub- 
sequent inspection. (See article on Asepsis, etc., p. 518.) 

Dislocations. — Luxations. 

The surfaces where two bones meet and glide upon each other for 
the purposes of a joint, are called articular surfaces, and the union is 



562 SURGICAL DISEASES. 

said to be an articulation. These surfaces are covered by a smooth 
cartilage, to render their play upon each other easy. 

The joints are held together by cartilaginous straps and ligaments, 
which serve as pullies ; by the aid of these, the joints turn back and 
forth, as a door opens and shuts upon its hinges. 

When by some external violence, or the weakening of these liga- 
ments, these surfaces are suddenly separated, or forced apart, there 
is said to be dislocation or luxation. 

Joints are divided into two kinds, the ball-and-socket (orbicular), 
which has a rotatory motion, as the shoulder, hip, thumb, — and the 
angular, or pump-handle (ginglymoid), as the elbow and knee. 

The ball-and-socket joints have a greater diversity of motion, and 
are more exposed to dislocation. They are likewise more easily put 
in their place. 

In a Primary Dislocation, the bone is thrown at once into the 
place where the surgeon finds it. 

The Secondary Dislocation is one in which the muscles pull the 
head of the bone still further from its natural place than it was 
thrown by the first shock of violence. 

A Dislocation is Simple when there is no wound penetrating the 
synovial membrane. 

It is Compound when attended by such a wound. 

A Dislocation is Complete* when the articular surfaces are entirely 
separated. 

It is Incomplete when the separation is only partial. 

Recent Dislocations are rectified with comparative ease. 

Old Dislocations are hard to be repaired, and sometimes cannot be 
reduced at all. 

The Symptoms of Dislocation are, inability to use the joint ; the 
head of the bone being felt in an unnatural place ; the limb shortened, 
lengthened, or distorted ; a change in the shape of the joint, etc. 

Simple dislocations are generally trivial. Compound dislocations 
often render amputation necessary, and are always perilous. 

Aged persons are less liable to dislocations than the young. 

When a dislocation and a fracture occur at the same time, the 
dislocation is to receive attention first. 

A dislocation is to be reduced by a gradual and continuous extend- 
ing force. The reduction is known by the limb recovering its natural 
length, shape and direction, and by its being able to perform certain 
motions which are not possible while in a dislocated state. The pain 
is immediately reduced upon reduction taking place. In shoulder 
and hip dislocations, the head of the bone makes a loud noise when 
it slips into its place. 



SURGICAL DISEASES. 563 

Dislocation of the Lower Jaw. 

Gaping very wide is the usual cause of this. It has been known 
to result from a mere yawn. One or both sides may be disjointed. 

Symptoms. — If but one side is dislocated, the chin is twisted to 
one side, and immovable, and the jaws are partially open; if both 
sides, the mouth is wide open, the chin projects, there is a hollow in 
front of each ear, great pain, inability to speak, and dribbling of 
spittle from the mouth. 

Treatment. — To effect a reduction, cover the thumbs with a towel 
or a piece of wash-leather to prevent their being injured by a sudden 
snapping together of the jaws, and then, standing in front of the 
patient, introduce them into the mouth, press them upon the crown 
of the back lower teeth, at the same time lifting the chin with the 
fingers. 

After the jaw is set, it should be kept bandaged for a few days, — 
the bandage being merely passed once or twice over the top of the 
head, and under the chin. No solid food requiring chewing should 
be taken for a short time. 

Dislocation of the Collar=Bone. 

This may take place by the end attached to the breast-bone slip- 
ping over or under that bone, or by the other end slipping above or be- 
low the bone to which it is attached. When the first named end of 
the bone slips over the breast-bone, it is said to be a forward disloca- 
tion ; when it slips under the breast-bone, it is backward. In this 
latter form of dislocation, the end of the collar-bone sometimes presses 
upon the gullet, and prevents swallowing. 

Symptoms. — In the forward dislocation of the inner end of the 
bone, a bunch may be felt by the hand at the top of the breast-bone ; 
in the backward dislocation, a depression or hollow. The upward dis- 
location of the outer end of the collar-bone may be known by the 
flattened and sunken condition of the shoulder. 

Treatment. — To put the bone in its place in the first of these ac- 
cidents, draw the shoulders back, by which means the collar-bone (clav- 
icle) is drawn away from the breast-bone (sternum), and easily slips 
into its place. To reduce the dislocation at the other end of the 
bone, place the knee between the patient's shoulder-blades (scapulae), 
and draw his shoulders backwards and upwards. After the reduction, 
support the arm in a sling. 

Dislocation of the Shoulder-Joint. 

The head of the long bone of the arm (humerus) may be displaced 
in three different directions, — downward, into the arm-pit (axilla) ; 



564 



SURGICAL DISEASES. 



forward, under the muscles of the breast; and backward, upon the 
back of the shoulder-blade. 

It is recognized by the shoulder losing its roundness, and becoming 
flat; by the lengthening of the arm; by the head of the bone being 
felt in the arm-pit ; and by severe pain. 

To effect the reduction in the first form of displacement, put the 
patient on a bed, or upon the floor. Put one heel in the arm-pit, 
against the head of the bone. Then, taking hold of the arm above 
the elbow, or at the wrist, pull steadily, and push with the h§el. 
(Fig. 166.) The extension may be more steady and powerful by a 
double towel around the surgeon's neck. 




Fig. 166. 



If the reduction cannot be effected, relax the muscles by a warm 
bath or by etherization. 

A simpler method often succeeds and is the only one required in 
certain forms of shoulder dislocation. Bend the elbow at right an- 
gles and place it at the side of the body. Next rotate the fore-arm 
outward as far as possible ; then carry the elbow, still flexed, inward 
and upward onto the chest, and then allow the elbow to fall. The 
head of the humerus often slips into place with the greatest of ease. 

After the reduction, a sling will be required, and three weeks' or a 
month's rest. 

Dislocations of the Elbow=Joint. 

Of these there are six varieties. In the first, both bones of the 
fore-arm (radius and ulna) are thrown backwards ; in the second, both 
are drawn backwards and inwards; in the third, both are thrown 
backwards and outwards ; in the fourth, the ulna alone is forced back- 
wards ; in the fifth, the radius is forced forwards ; and in the sixth, 
the radius is thrown backwards. 

In general, these dislocations are all easily set. In the first four, 




SURGICAL DISEASES. 565 

the knee is to be placed at the bend of the elbow, and the fore-arm 
bent upon it, the surgeon grasping the upper arm with one hand, 
and the fore-arm with the other. In the dislocations of the radius, 
the upper arm is to be put in a fixed condition, while the surgeon 
takes hold of the hand and pulls, at the same time throwing the bone 
forward. If the luxation be backwards, there must be the same ex- 
tension and counter-extension, while the fore-arm is bent. 

Treatment. — The fore-arm must be placed in a half-bent position, 
and a splint should be bandaged upon the front of the whole limb, 
compresses being placed upon the head of the bones opposite the di- 
rection of the dislocation. This confinement must be continued three 
weeks. 

Dislocations of the Wrist. 

These are caused by falls upon the hand. Both the radius and 
ulna may be thrown back- 
wards or forwards upon 
the wrist, causing a pro- 
jection either in front or 
behind. (Fig. 167.) The 
bones are to be set by 

1V . ., -,. J Fig. 167. 

pulling in opposite direc- 
tions upon the hand and the forearm, and pressing laterally, if the 
displacement be at the side of the wrist. 

Treatment. — Put a straight splint on the front, and another on the 
back of the fore-arm and hand, with compresses on both sides of the 
wrist, and a bandage over the whole. Support the fore-arm in a sling, 
and keep down inflammation by cold water, cooling lotions, etc. 

Dislocations of the Bones of the Hand. 

Some one of the carpal bones may be pushed up out of its place, 
so as to form a projection on the back of the hand. To put it in its 
place, press upon it simply, and then put compresses on the front and 
back, with straight splints upon these and a bandage over all. Put 
the hand in a sling. 

Dislocations of the finger-joints may generally be replaced by bend- 
ing the displaced phalanx over the head of the bone from which it 
has been disjoined. Sometimes a good deal of extension and counter- 
extension are required, for which purpose a piece of cord may be 
wound around the finger, — the skin being protected by covering it 
with a piece of wetted buck-skin. 
4 

Dislocations of the Hip= Joint. 

These are four in number, — upwards, downwards, backwards and 
upwards, forwards and upwards. 



506 



SURGICAL DISEASES. 



To reduce these, a greater amount of power is needed than m the 
dislocations of any other bone, — owing to the greater power of the 
muscles which are to be overcome. 

Dislocations of this joint are often confounded with fracture of the 
head and neck of the thigh bone. This latter may be distinguished 
from the luxation by the grating sound to be heard, by the possibility 
of pulling the limb out to its natural length, and by its being short- 
ened up again by the action of the muscles the moment the pulling 
is given up. 

The Upward Dislocation of the head of this bone upon the back 
of the haunch-bone is known by the shortening of the limb, and by 
the knee and foot turning inward, — the foot lapping over the oppo- 
site foot, and the great toe resting upon the other instep. (Fig. 168.) 

The Dislocation Downward is known by the lengthening of the 
limb, the projection of the knee, the turning of the foot and knee out- 
ward, and the bending of the body forward. (Fig. 169.) 





Fig. 168. 



Fig. 169. 



The Dislocation Backward and Upward is distinguished by the 
inclining of the foot and knee inward, the drawing up of the heel, and 
the resting of the great toe against the ball of the great toe of the 
other foot. (Fig. 170.) 

The Dislocation Upward and Forward is known by the shorten- 



SURGICAL DISEASES. 



567 



ing of the limb, and the turning of the foot and knee outward. (Fig. 

mo 

For replacing the bone, put the patient upon a table, on his back. 
Draw a sheet between his thighs, and extending it up by the side of 
his body, let it be fastened to a staple. Put a padded belt, with rings 
attached, around the injured limb, just above the knee. To these 





fig. 170. 

rings, fasten one block of a pulley, and attach the other to a post, 
giving the pulley-rope to an assistant. The surgeon now, standing 
on the injured side, directs gradual extension to be made, while he, 
by his hands, or by a band passing around the injured thigh and over 
his own shoulders, lifts the head of the bone, and guides it into its 
socket. Etherization is not infrequently required. 

Treatment. — Keep the patient in bed for two weeks or more, with 
his knees tied together by a strip of muslin, and a broad belt around 
his hips. 

Dislocations of the Knee-Pan or Patella. 

This bone may be thrown outward, causing a great projection on 
the outside, and an inability to bend the knee. 

It may be thrown inward, causing the same impossibility to bend 
the knee, and a projection on the inside. 

To restore the bone to its place, put the heel of the patient upon 



568 



SURGICAL DISEASES. 



the shoulder of an assistant; then press down the edge of the knee- 
pan which is farthest from the centre of the joint, thus tilting up the 
other edge of the bone, when the muscles, aided by a lateral pressure, 
will draw it to its place. 

Treatment. — Put a straight splint upon the back of the limb, 
and make moderate pressure upon the knee by a bandage. Cold 
water, or cooling washes, should generally be applied. Keep the pa- 
tient in bed two weeks. 

Dislocations of the Knee=Joint. 

There are four of these, — forward, backward, inward and out- 
ward. 

They are readily corrected by extension and counter-extension from 
the ankle and thigh, and pressure upon the head of the displaced 
bone. 

Treatment much the same as for displacement of the knee-pan. 



Dislocations of the Ankle. 

These may occur in a forward, backward, outward, and inward 
direction. (Figs. 172 andl73.) 




Fig. 172. 




Fig. 173. 



To rectify it, bend the limb, so as to relax the muscles on the back 
of the leg; then, while extension and counter-extension are made 
upon the foot and thigh, press firmly on the dislocated bone, and thus 
force it to its place. ■ 

Treatment. — Confine the foot and leg in splints made of thick 



SURGICAL DISEASES. 569 

pasteboard, soaked in hot water and moulded to the shape of the 
limb, with a foot-piece at right angles. Keep the patient in bed five 
or six weeks, and when he begins to walk, support the ankle with a 
roller bandage, or a laced gaiter. 

Contusions. — Bruises. 

When any blunt, hard substance comes in violent collision with 
the soft parts of the body, without breaking the skin, the injury re- 
ceived is called a bruise. One of these accidents generally ruptures 
a great number of the very smallest blood-vessels, which let out 
blood under the skin, producing "black and blue" or livid spots 
(ecchymosis). What fist-fighters call a black eye is an example. 

Treatment. — Cold applications at first to prevent the blood run- 
ning out of the small vessels under the skin. After the inflammation 
has subsided, stimulating applications, as vinegar and water, alcohol, 
camphorated liniment, ammonia and alcohol, equal parts, and some- 
times bandages. 

Sprains. 

A sprain is a forcible wrenching and twisting of a joint to such a 
degree as to stretch and more or less lacerate the ligaments of the 
part, and sometimes to break a tendon, but without entirely displac- 
ing a bone. Its symptoms are, violent pain, swelling, and discolora- 
tion of the parts from the blood running into the cells under the skin. 
In elderly persons, the effects of sprains are very tedious, disabling 
them for many weeks, or even months. 

Treatment. — Elevate the limb, keep the joint perfectly quiet, 
and apply cold lotions or fomentations. When the inflammation is 
all past, apply stimulating liniments, and bandages, or shower the 
part with cold water. 

When first done, put the part, if possible, into as hot water as can 
be borne and maintain it there for half an hour, then strap the part 
moderately tight with plaster. An ice-bag applied over a joint when 
the hot water cannot be obtained, or is inapplicable, is nearly as effica- 
cious. 

Ruptures of Tendons. 

These accidents are known by a sudden snap, followed by pain, 
loss of motion in the part, and swelling and discoloration. 

Treatment. — Place the part in such a position as to relax the 
broken tendon, the ends of which must be brought together, and re- 
tained in contact till they grow together. They are to be sewn 
aseptically and the wound treated like any closed wound. 



570 SURGICAL DISEASES. 



Diseases of the Bones. 

The bones are supplied with blood-vessels and nerves ; and as they 
live and grow like other parts of the body, so they become diseased 
and die in like manner. 

Ulceration of the Bones. — Caries. 

Bones, like the soft parts, when attacked by violent inflammation, 
may ulcerate, discharge matter, and heal by granulation ; or, having 
lost a portion of their substance, may sink under entire disorganiza- 
tion and death. ' This disease passes, in some parts of the country, 
under the name of " fever sore." It is generally the result of poor 
blood, scrofula and like disease, and, hence needs tonic, constitutional 
as well as local treatment, cod-oil, iron, etc. 

Treatment. — Apply splints, and keep the part in a state of abso- 
lute rest. Subdue the local inflammation by the usual means. If 
the disease arise from scrofula or syphilis, use the remedies for those 
diseases. 

Death of the Bones. — Necrosis. 

This is like mortification of the soft parts. It occurs from injuries 
and inflammation of the periosteum. 

It is known by dull, deep-seated — sometimes acute — pain; and is 
followed by increase of size, from the formation of new bone around 
the old, — the old being gradually broken into pieces, and discharged 
through external openings. 

Treatment. — Poultices and quieting fomentations. Resort will 
generally be made to surgery. 

Unnatural Growth of Bones. — Exostosis. 

This disease consists either of a tumor of a bony nature, growing 
upon and arising from a bone, or an enlargement of a bone. It 
springs from the periosteum, or from the surface of a bone, or from 
its spongy texture. The enlargement or the tumor may be white 
and hard, like ivory, or dark-colored and spongy, or a mixture of the 
two. 

At first, a tumor of this kind is not attended with pain or incon- 
venience. It comes on slowly, and sometimes remains nearly sta- 
tionary for several years. 

Treatment. — If the tumor be large and inconvenient, remove it 
with the knife. If not, use local pressure with pads and bandages ; 
also leech, blister, and restrict the patient to a spare diet. 



SURGICAL DISEASES. 571 



Diseases of the Joints. 

Some of these diseases begin in the cartilages, some in the synovial 
membrane, and others in the heads of the bones. 

Disease of the Hip=Joint. — Coxalgia. 

This generally consists in inflammation of the synovial membrane 
and capsular ligament of the hip-joint, ending frequently in ulceration 
and destruction of the head and neck of the thigh bone. 

The symptoms are fullness in the groin ; pain, which is increased 
by motion ; aggravated when the limb hangs without touching the 
ground ; is more felt in the knee than in the hip itself ; and shoots 
down along the inside of the leg, as far as the instep. The thigh 
inclines forward, and the limb has the appearance of being longer 
than the other, — though in the latter stages, it is really shorter. 

Treatment. — Before suppuration takes place, apply leeches and 
blisters, and enjoin perfect rest. After suppuration, keep the patient 
upon his back, on a mattress, and mould to the parts thick paste- 
board splints, with pads, and give tonics. Keep the bowels open with 
senna and bicarbonate of potash, and rub the parts with iodide of 
potassium ointment, or with preparations (282), (283), (195). The 
disease being scrofulous, the iodide of potassium (140) may be taken 
with advantage internally. The disease occurs for the most part in 
children. They should be put on a long splint from the very first 
and the joint kept immobilized. 

White Swelling. — Synovial Degenerations. 

There are several diseases of the knee-joint, characterized by swell- 
ing and white color from tension of the skin, which have passed 
under the common name of white-swelling. The diseases are not 
strictly the same, but as they all affect the knee, and have symptoms 
to some extent in common, it is well enough to group them under 
the same title, — especially as one treatment is adapted to all. 

One is a pulpy disease of the synovial membrane. It begins with 
a trifling stiffness, and a slight swelling. The swelling increases by 
degrees, and on touching the part there is a sensation as if it con- 
tained fluid. By and by the cartilages ulcerate. The disease is in- 
curable, as the synovial membrane is finally converted into a pulpy 
substance, and the limb has to be amputated. 

Another of these is inflammation of the synovial membrane, be- 
ginning with ulceration of the cartilages. It begins with pain in the 
joint, which is severe at one point, and attains its height in a week. 
In a day or two, the joint is swollen from a collection of water. 

Treatment. — Splints and entire rest, as in all chronic diseases of 




572 SUKGICAL DISEASES. 

the joints. Also a generous diet, and whatever is calculated to build 
up the health. For the tubercular variety an injection of iodoform 
dissolved in glycerine is most commonly used. 

Bunions. 

This is an inflammation, enlargement, and hardening on the inside 
of the ball of the great toe. It is frequently connected with a distor- 
tion of the toe, which seems partially out of joint. The projection 
of the joint exposes it to great irritation from the shoe, and to re- 
peated attacks of inflammation. It occasions great suffering. 

Treatment. — Remove the pressure from the part, and when there 
is inflammation, keep the foot quiet and elevated upon a chair, apply- 
ing leeches, poultices, etc. Another method is to cover the bunion 

with soap-plaster, spread on 
thick, soft leather, or, put the 
toe in a separate compartment 
of the stocking, like the finger 
of a glove. Then enclose it 
in a separate part of the shoe, 
which is contrived by fixing 
a piece of firm sole-leather in the bottom of the shoe, so as to make 
a separate compartment for the toe. By this means the pressure 
against the side is removed. Sticking plaster may be spread on 
wash-leather, and a piece cut out the size of the bunion. This will 
take off a portion of the pressure of the shoe, and will hasten the 
cure. 

Fig. 174 represents a ganglion or tumor formed upon the syno- 
vial sheath of the tendon which bends the finger. 

Whitlow. — Felon. — Paronychia. 

This is an abscess of the fingers, of which there are three kinds, — 
the first situated upon the surface of the skin, the secdnd under the 
skin, the third within the sheath which contains the tendons of the 
fingers, and sometimes involving the covering of the bone. 

The latter form of the disease is the most terrible, and begins with 
redness, swelling, and a deep-seated and throbbing pain, which grad- 
ually becomes so excruciating as to banish all sleep, and nearly drive 
the patient to distraction. Finally matter forms and burrows in the 
deeper parts of the finger, and at length finds an opening, which 
brings relief. 

Treatment. — Carry the hand in a sling ; apply a leech or two, 
and use poultices. A poultice made of equal parts of powdered slip- 
pery-elm bark, poke-root, ground flax-seed and lobelia-seeds, mixed 
with hot ley, and changed twice a day, is an admirable application. 



SURGICAL DISEASES. 573 

When these methods fail to stop the progress of the abscess, the 
finger should be laid open with the scalpel, cutting down to the bone. 
This will give vent to the matter, and the wound may be dressed 
with poultices, until the inflammation is subdued, and the healing 
process is well established., when some simple salve may be applied. 

Stiff Joint. — Anchylosis. 

This is of two kinds, complete and incomplete, — complete when the 
bones of the joint have become firmly united by bony matter, and 
incomplete when the motions of the joint are very much interrupted, 
but not entirely destroyed. The first is the result of ulcerations of 
the cartilages of the joints, and of the heads of the bones ; the latter, 
of fractures, sprains, bruises, thickening of the synovial membrane, 
and weakening of the muscles. 

Treatment. — No treatment is of much use in the first-named form 
of the disease. By sawing through the bone, and then daily moving 
the limb back and forth, a false joint may be made, but it is apt to 
grow together again, and finally defeat the purpose of the surgeon. 
When, however, stiffness arises from the weakening of the muscles, 
and some other causes involving the ligaments and tendons, something 
may be done by daily frictions with stimulating liniments, champooing, 
and warm fomentations ; and by gently bending the joint back and 
forth, several times every day, as much as can be done without pain. 

Tumors. 

A tumor is a swelling which consists of a new production, not 
constituting any portion of the original structure of the body. There 
are several kinds of tumors ; but it is sufficient for my purpose to 
follow Mr. Ferguson, and divide them into the malignant and non- 
malignant. 

Cancer. 

This belongs to the class of malignant tumors. It has two stages. 
The first is that of induration or scirrhus, during which it has, 
under the finger, the feeling of stony hardness. The second stage is 
that of ulceration or open cancer. 

Cancer most often attacks the female breast, the skin, the mucous 
membranes, the tongue, the stomach, the neck of the womb, the lips, 
etc. It rarely occurs in subjects under thirty years of age, and not 
often in persons under forty-five. 

The Symptoms of Cancer, when it appears in the breast, are, a 
puckered condition, and dull, leaden color of the skin ; a hard, knotty, 
and uneven feel ; and occasionally sharp pains. When it attacks 
the skin and mucous membranes, there is a hard, warty lump, which 



574 



SURGICAL DISEASES. 



ulcerates, after a time, producing an open sore, with a hard base. 

(Fig. 175.) 

The sore of a cancer discharges an 
irritating, excoriating matter, which has 
a peculiarly fetid odor, so offensive and 
so different from any other smell, that it 
is seldom forgotten. The bones of a 
cancerous person break with great ease. 
Unmarried females are much more liable 
to the disease than the married. The 
cancerous growth is composed, in part, 
of cells, rounded or caudate, containing, 
as seen under the microscope, nuclei, 

younger cells, and granules. (Fig. 176.) 




Fig. 175. 






Fig. 176. 



Fig. 177. 



Fig. 178. 



The difference between these cells and those of common pus-glob- 
ules may be seen by comparing Fig. 176 with 177, — the latter being 
pus-corpuscles highly magnified by a powerful microscope. Fig. 178 
represents pus-globules not so much magnified. 

Treatment. — There are but two methods of treatment which 
promise any success. The first is to extirpate the tumor by a surgical 
operation before the disease has so far invaded the constitution as to 
be sure of returning. The other is that adopted by Dr. J. W. Fell, 
an American physician, who was permitted to try his remedies in 
one of the English hospitals, and who drew from the surgeons in 
charge of it a favorable report of the results. 

Dr. Fell's remedies are mainly blood-root and chloride of zinc (336) 
made into a paste. The skin over the tumor is first destroyed, and 
this paste, spread upon strips of linen, is applied. This causes an 
eschar, into which incisions are made, half an inch apart, taking care 
to avoid the living tissue. The same paste spread in a like manner 
is then daily inserted into the furrows. By this means, which is 
original with Dr. Fell, the effect of the caustic penetrates through 
all parts of the tumor, causing the whole diseased mass to fall off, 
and leave a healthy, granulating surface. 

In incipient cancer, where the disease has not made much progress, 



SURGICAL DISEASES. 575 

Dr. Fell uses the above, which he calls a brown ointment (336), and 
in connection with it an ointment of the iodide of lead (337), using 
each twelve hours. With these, he claims that he cures incipient 
cancers with great readiness. He also employs, internally, half-grain 
doses of pulverized blood-root (143), with arsenic and cicuta. 

Dr. Fell claims that with these preparations, he has often cured 
lupus, and has been very successful with them in treating indolent 
ulcers. Of late a new treatment has sprung up — namely, the injec- 
tion of anti-cancer serum, but as yet a definite opinion cannot be 
given as to its results. 

Soft Cancer. — Bleeding Cancer. 

Medullary Cancer. — Encephaloid Tumor. — Fungus Hematodes. 

This varies in size from that of a nutmeg to a child's head. Its 
color varies from white to deep red. At times it is soft and elastic at 
first ; at other times, it is firm and tense. The patient is wan and 
pale from the beginning. The parts do not ulcerate, as in scirrhus ; 
but after the skin is broken, a spongy, bleeding tumor protrudes. 

Treatment. — Dr. Fell's method. 

Black Cancer. — Melanosis. 

This is an organic disease, in which the tissue of the disordered 
part is converted into a black, hard substance, which is converted 
into ulcerous cavities. This often appears in the lungs, and is met 
with in the liver and other parts. 

Its symptoms are, a sallow complexion, great debility, and dropsi- 
cal swelling of the limbs before the termination. 

Treatment. — When it appears externally, Dr. Fell's treatment is 
worth a trial. When in the lungs, the inhalation of tincture of blood- 
root and solution of chloride of soda (241) should be used. Two 
teaspoonfuls may be put in a Vapor Inhaler, — the instrument being 
filled half full of hot water, — and inhaled ten minutes, three times 
a day; the blood-root pills (143) being taken at the same time. 

Fatty Tumor. — Adipous Sarcoma. 

This is the most common of all the forms of tumor. These bodies 
generally have a soft and doughy feel, or as if filled with wool. 
They are the least inclined to become malignant, and consequently 
the least dangerous, of all the tumors. Whatever pain there is, is 
caused by their size, weight, and pressure. They are occasionally 
found a little below the point of the shoulder, in the deltoid muscle 
of females, and are caused by the unreasonable pressure of the dress 
at that point. 



576 SURGICAL DISEASES. 

Treatment. — They should be removed by an operation, which is 
easily performed, as they separate very readily from surrounding 
parts. 

Polypus. 

The polypi constitute a class of tumors growing from mucous 
membranes. They are of two kinds, — the soft, jelly-like polypus, 
and the fleshy or fibrous polypus. 

The Soft Polypus, which grows from the nose, has not much feel- 
ing, and is not particularly disposed to bleed. 

The Fleshy Polypus is firmer and harder than the preceding, and 
most generally connects itself with the womb. 

Treatment. — Both kinds of polypi are either twisted off with a 
pair of forceps, or strangled by putting a string, called a ligature, 
around their neck, which will cause them to fall off in a short time. 

Piles, — Hemorrhoids. 

These venous swellings often cause so much pain and trouble, are 
so often chronic and unyielding to medical treatment, that surgical 
interference becomes now and then a necessity. The operation for 
their relief and cure is an extremely common one, and nowadays is 
limited to a very few different methods. 

The carbolic acid treatment which has found favor with many 
consists in the injection into the pile of a small amount of carbolic 
acid dissolved in glycerine or water. The process is simple and 
almost painless, especially if done after numbing the parts with a three 
per cent cocaine solution. The carbolic coagulates the blood and al- 
bumen of the tissues and causes a death of the parts with a subsequent 
sloughing and puckering. The advantage of this procedure lies in 
the ability of the patient to be up and about. The danger lies in 
the risk of setting free a clot in the circulation, causing most serious 
consequences and even death. It should be used only in selected 
cases and then not too freely. 

A second method, and by far the oldest, is to encircle the pile with 
a ligature and allow it to eat through, thus destroying the pile and 
causing it to heal behind the ligatures. This method is painful, re- 
quires ether and necessitates rest in bed. A third way is to burn 
off the pile by means of a cautery and clamp. It is far preferable to 
the ligature, requiring but a few days' stay in bed, and is less painful. 
A fourth, and the most scientific method, is one just coming into 
prominence, and consists in dissecting out the pile area and sewing the 
flaps of mucous membrane and skin together. 

Numerous washes, ointments, and lotions have been used to tem- 
porize, but the only sure and thorough way to treat obstinate piles 
which remain after continued and unsuccessful attempts to remove 



SURGICAL DISEASES. 577 

the original cause, is to remove them once, for all. The following 
salve will be found useful : cocaine, eight grains ; gall ointment, 
half an ounce ; mix. Smear well over the piles and then push them up 
into the bowel. Piles should always be returned into the bowel 
when possible ; this of itself, when practicable, oftentimes constitutes 
a cure. 

Whenever a small, round, hard pile is seen on the outside and is 
very painful, it should be incised, after numbing with a cocaine so- 
lution, and the clot turned out. This simple and painless procedure 
works great relief and often a cure. 

The bowels are to be kept open daily by a solution of the citrate 
of magnesia (one-half bottle), which keeps the bowels loose and 
causes no pain in defecation. 

Wens. — Encysted Tumors. 

The most common situation of these is under the skin of the head. 
A wen is simply a sac full of various matters, which, when examined 
with a microscope, are found to be oil-globules, epithelial cells, and 
crystals of stearine. These contents are secreted by the internal 
surface of the sac. They sometimes look like curd or rice, sometimes 
like suet, and sometimes like honey. In other instances, they are 
mere water, and they have been known to consist of hair or horn. 
These tumors are round, elastic, and movable, and are without pain. 
They grow slowly, but steadily. 

Treatment. — The attempt to excite inflammation and conse- 
quently absorption, by punctures, setons, or injections, are danger- 
ous, and ought not to be resorted to. If the tumor is small, its 
opening, indicated by a small black spot, may be found, a probe be 
introduced into it, and the contents of the sac be squeezed out ; and 
this maybe repeated as often as necessary. But the proper and only 
real remedy for these tumors is their removal by a surgical operation, 
which, under aseptic rules, is painless, easy and sure. 



Fig. 179. 



Aneurisms. 



An aneurism is a tumor formed by arterial blood, and communi- 
cating with an artery. A true aneurism is formed by the coats of an 



578 SURGICAL DISEASES. 

artery getting weakened by some cause, and swelling out so as to 
form a pouch or sac. (Fig. 179.) There are other kinds of aneu- 
risms, which need not be described. 

Symptoms. — An aneurism may be felt as a tumor somewhere 
along the course of an artery, and it beats under the ringer like the 
pulse. The beating is caused by a fresh quantity of blood being 
pushed into this sac with every stroke of the heart. If it be small, 
pressure on the artery above it will so far shut off the blood from it, 
that it will feel flaccid or soft. The patient will often say that the 
tumor began to appear after some violent strain, when something 
appeared to give way. In the chest, aneurism will produce an un- 
natural pulsation felt by the patient. In the belly, it may generally 
be felt as a tumor through the abdominal walls. - 

Distinction. — Tumors which lie directly over arteries are lifted 
up every time the blood is driven along under them, and hence they 
pulsate like aneurisms ; but they do not pulsate when small, whereas 
aneurisms do from the beginning of their growth. Aneurisms are 
soft at first, and hard afterwards ; whereas tumors are generally hard 
at first, and finally soft. 

Treatment. — In some few fortunate cases, aneurisms get well 
spontaneously. If the flow of blood through them can be stopped, that 
which is within them will coagulate, forming a hard tumor, which 
will gradually waste away. To cure them, therefore, we must stop 
the circulation through them ; and this may be done, in some cases, 
by compression. The pressure upon the artery must of course be 
above the tumor, and should not be so great as to stop the blood 
altogether, but only very materially to diminish its flow. The pres- 
sure is applied by an instrument having two pads, an arc of steel, a 
joint in the middle, and a screw by which the padded extremities are 
pressed together. (Fig. 180.) 

When this mode of treatment is not practicable, the artery must 
be tied between the aneurism and the heart. The patient should be 
placed in bed, with the limb wrapped up to preserve its temperature, 
and placed in an easy position. Nothing cold should be applied to it. 

The force of the circulation should be reduced by the tincture of 
veratrum. 

Bronchocele. — Derbyshire Neck. — Goitre. 

Bronchocele is what is called an endemic disease ; which means, 
a disease which prevails in certain localities. This complaint is preva- 
lent in Nottingham and Derbyshire, England, among the Alps, and 
especially in the Tyrol and valley of the Rhone. It is thought to be 
produced by the use of melted snow, and water impregnated with 
lime and earthy matter. 

Symptoms. — A prominent, soft, elastic tumor, occupying the front 



SURGICAL DISEASES. 



579 



of the throat, in the situation of the thyroid gland, and like it in shape. 
It is not tender, and the skin is not discolored. In old cases, the 
tumor becomes hard. In Fig. 181 the tumor is so large as to have 
pushed the gullet to one side. 





Fig. 180. 

Treatment. — The usual and perhaps the best remedy for this dis- 
ease is iodine. It may be given as iodide of potassium, with a bitter 
or some other article (138), (145), (101). An iodine ointment may 
be applied to the tumor (185). 

The patient should move away from the infected district, and re- 
side, if possible, upon the sea-coast. 



Water in the Scrotum. — Hydrocele. 

As the name shows, this is a collection of water in the scrotum or 
bag which holds the testicles. 

Symptoms. — It presents a swelling, shaped like a pear, smooth 
on its surface, fluctuating if pressed, without pain, but causing a little 
uneasiness by its weight. On placing a lighted candle on one side 
of the scrotum, the light may be seen through it. 

Distinction. — This complaint may be distinguished from a solid 
enlargement of the testicle by its not being so heavy, solid, or pain- 
ful, and by its fluctuating and being transparent ; from rupture, by 
its forming slowly instead of suddenly, by the swelling beginning at 
the lower part of the scrotum instead of the upper, and by the en- 
largement not being increased by coughing as it is in rupture. 

Treatment. — In children, strong scattering washes (353) are some- 
times successful. But most commonly a number of punctures are 
made with a large needle, to cause the fluid to escape into the cell 
tissue of the scrotum, whence it is removed by absorption. 

To effect a radical cure in grown persons, the surgeon is to grasp 



580 M KGICAL DISEASES. 

the tumor behind, and introduce a trocar and canula into the sac, — 
being careful to point the instrument upwards, so as not to wound 
the testicle. The trocar is then withdrawn, — the canula being at 
the same time pushed well into the sac, so that none of the fluid may 
get into the cell-tissue outside the sac. The fluid runs off through 
the canula. When this has all escaped, some stimulating fluid, as 
common lime-water, or, still better, tincture of iodine, is to be injected 
through the canula into the emptied sac. After retaining this from 
two to five minutes, it is permitted to flow out. Inflammation fol- 
lows, which breaks up the secretion of water, and effects a cure in 
two or three weeks. The amount of fluid thrown in should be about 
one or two teaspoonfuls of a mixture of one part of tincture of iodine 
and two parts of water. If the first operation does not effect a com- 
plete cure, it may be repeated. The most successful of all treatments, 
however, is to open the scrotum and dissect out the greater part of 
the tissue which covers the testicle and which secretes the fluid. 



Blood in the Scrotum. — Haematocele. 

This is a collection of blood in the scrotum, from some injury. 

Treatment. — If the quantity of blood effused be small, cold ap- 
plications may cause it to be absorbed. If it be large, make a punc- 
ture, and apply a poultice for the blood to ooze into. 

Acute Inflammation of Veins. — Phlebitis. 

The veins are subject to attacks of acute inflammation, which con- 
stitutes a very dangerous, and often fatal, disease. 

Symptoms. — Fits of shivering, or perhaps fainting, a rapid pulse, 
anxiety of countenance, lowness of spirits, catching pains about the 
heart, and swelling, redness, tenderness and hardness along the course of 
the affected veins. Sometimes the tongue is furred brown or black, 
the skin is sallow, there is bilious vomiting, low delirium, and death. 
In cases less rapid, there are great swelling and redness over the dis- 
eased veins, and abscesses form, which, when opened, reveal clots of 
blood mixed with pus. Or, the patient, while remaining low, with a 
sallow countenance, and a yellow tongue, will complain suddenly of 
intense pain in some joint, as the knee or shoulder, — in which there 
will be a rapid formation of pus ; a similar suppuration will follow 
in other joints, as well as in the lungs, etc., until the patient sinks, 
and dies of exhaustion. 

Treatment. — Apply leeches freely over the inflamed veins, — also 
fomentations. Every abscess should be opened early. Keep the 
bowels moderately open with some preparation of salts, and allay 
pain and restlessness by morphia. Support the strength by beef -tea, 
etc. ; and, if the pulse be feeble, give wine or quinine. 



SURGICAL DISEASES. 581 

The suppuration may be checked, in this as in other complaints, 
by drinking freely of chamomile tea, The power to control suppura- 
tion has recently been discovered as belonging to chamomile flowers. 

Chronic Phlebitis. 

This is a far less serious disease than the preceding. It generally 
affects the veins of the legs. 

Symptoms. — Tenderness and hardness of the affected vein, with 
swelling around it, and of the parts below ; a general painfulness of 
the limb. After the inflammation has subsided, the vein feels hard, 
like a cord, because the inflammation causes the blood within to co- 
agulate, and harden, so that nothing can pass through the vessel. 

Treatment. — Leeches, fomentations or cold lotions, as the patient 
may choose, purgatives and rest, with the limb elevated. Subse- 
quently, when the inflammation seems completely subdued, friction 
with camphorated oil and bandages. 

Enlarged or Varicose Veins. — Varix. 

The veins which lie near the surface, especially those of the legs, 
are apt, by exhausting labor upon the feet, and by strains, to get 
weakened, so that their valves lose their tone, and their sides stretch 
and give way in certain places, letting the blood bulge out, and form 
purple bunches. These bags of blood, lying along upon the surface 
of the limb, form knotty tumors, looking like blood-boils. They oc- 
casion a kind of distress, but no sharp pain. 

Persons of weak, soft and relaxed muscles and blood-vessels are 
particularly liable to this complaint. It often attacks women in the 
family way. 

Treatment. — Where only a few veins are affected, it may be 
sufficient, in some cases, to apply firmly over them a few strips of 
leather, spread with soap-plaster. But generally it is better to sup- 
port the whole limb with a good woolen bandage, or with a laced 
stocking, which should be applied in the morning before the patient 
is up. It is generally well, also, to use friction, with some liniment, 
or iodine ointment. Lead-water, or alum-water, or an infusion of 
white-oak bark, may be used with advantage. Burdock and plantain 
leaves, bound upon the skin, and removed before they are dry, are 
useful. Showering with cold water strengthens the veins. An elas- 
tic silk stocking made for the limb is the best general measure. 

Rupture. — Hernia. 

Hernia signifies a protrusion of any internal organ from the cavity 
where it belongs ; but the term is generally restricted so as to mean 
no more than a protrusion of the bowel through the walls of the belly. 



582 SURGICAL DISEASES. 

When the abdominal walls are weak, from any cause, no matter 
what, — lifting, straining, or making violent muscular exertion of any 
kind, will then often cause the bowel to force itself through at the 
most debilitated spot ; and pushing the lining of the belly, the peri- 
toneum, along before it, a bag or sac is formed, in winch the project- 
ing bowel is enclosed, forming an external tumor. 

Divisions of Hernia. — Rupture may occur in several different 
places, and has accordingly received different names. 

Umbilical Hernia is a protrusion of the bowel at the umbilicus or 
navel. This is most common in children soon after birth ; and 
women who are often pregnant are liable to it. 

Ventral Hernia is that which occurs at any part of the belly where 
other forms of rupture do not appear. 

Inguinal Hernia is that in which the bowel protrudes at the groins, 
or through the abdominal rings. 

Scrotal Hernia is that in which the bowel descends into the bag 
or scrotum. 

Femoral Hernia is the dropping down of the bowel behind what 
is called Poupart's ligament, and appearing as a tumor at the upper 
part of the thigh. 

Reducible Hernia. — Rupture is said to be reducible, when the 
bowel, may be put back into the cavity from which it came. 

Irreducible Hernia. — Hernia is called irreducible when the pro- 
truding bowel cannot be returned into the belly. 

Strangulated Hernia is that form of the complaint in which the 
bowel is so pressed upon at the point where it passes through the 
walls of the belly that it is strangled or constricted so that its contents 
cannot pass through. 

Symptoms of Hernia. — A soft tumor, which may be compressed, 
appears somewhere about the belly ; and is increased in size when 
the patient stands up. It also swells when he coughs, or makes any 
exertion; and grows smaller, or entirely disappears, when he lies 
down. 

Treatment. — In a case of reducible hernia, the first thing to be 
done is to put the bowel back in its place, which is accomplished by 
gently pressing and kneading the tumor, and swaying it back and 
forth, — being careful to use no violence, — until it can be pushed 
within the abdominal walls. It is then to be kept in its place by the 
use of a truss, made expressly to fit the case. This instrument should 
be constantly worn by day, and by night, too, if not too irksome ; but 
if worn by day only, it should always be applied before rising in the 
morning. 



SURGICAL DISEASES. 583 

Irreducible Hernia may be palliated by wearing a truss with a hol- 
low pad, which will so evenly and firmly embrace the tumor as neither 
to irritate it, nor permit any further protrusion or enlargement. 

Strangulated Hernia. — If a person has worn a truss for some 
time, and suddenly leaving it off, makes some violent exertion, either 
the bowel or omentum is liable to be suddenly forced through a nar- 
row aperture, and to become strangled. In such case, the patient 
has flatulence, colicky pains, a sense of tightness across the belly, and 
a desire to go to stool, but no ability to pass anything. Then follows 
vomiting, first the contents of the stomach, then mucus and bile, 
and, lastly, the fecal matters from the bowels, which are not per- 
mitted to pass on to their natural outlet. The neck of the hernial 
sac now becomes swelled, tender and painful, the countenance is anx- 
ious, and the pulse small, hard and wiry ; and, after a time, the tu- 
mor begins to mortify, the patient expresses himself free from all 
pain, and soon after dies. 

In the treatment, the bowel is to be returned if possible. To do 
this, the bladder should first be emptied with a catheter, and the 
patient should lie down with his shoulders raised, and both his thighs 
bent towards the belly, and placed close to each other, so as to relax 
all the ligaments and muscles of the belly. The surgeon may now 
work gently for half an hour, if necessary, trying to put the bowel 
back, but must be very careful not to excite inflammation by any 
violence. 

If he does not succeed, efforts are next to be made still further to 
relax the muscles, as well as to reduce the force of the heart's action, 
and to diminish the size of the tumor. With the tincture or fluid 
extract of veratrum viride, the heart's action and force of the circula- 
tion may be reduced to any desirable extent. 

To reduce the tumor, apply pounded ice in a bag, or a freezing 
mixture (354.) If the pain be acute give large doses of opium or 
morphia. Ether is generally required to reduce a. hernia. 

If all these remedies fail, there is then no hope but in relieving the 
stricture by a surgical operation, which must not be deferred too long. 

General Directions. — Rupture is an exceedingly common affec- 
tion. Perhaps every third or fourth person suffers from it more or 
less. Females, from motives of delicacy, are apt to conceal the mis- 
fortune, and not seek advice. This exposes them to danger. Queen 
Caroline, wife of George II, lost her life by such concealment. 

A swelling coming on suddenly in the groin or at the navel, after 
considerable exertion, may be taken to be a rupture without much 
fear of mistake. 

The complaint being discovered, the bowel should be put back in 
its place, and a truss be put on at once. In the case of young per- 
sons, a truss may frequently effect a cure ; but, that it may do this, it 
should not be taken off, night or day, except to cleanse it, and then 
only when the wearer is in bed. 



584 



SURGICAL DISEASES. 



Those who can afford it should have two trusses of the same size 
and strength, so that if one get out of order, the other may take its 
place while it is being repaired ; for an hour's absence of the truss 
might occasion a mischief which it would require months to repair. 

Persons having a rupture must be very careful to keep costiveness 
at a distance ; for straining at stool is highly injurious. 

Varicocele. — Cirsocele. 

This is an enlargement or varicose state of the spermatic veins 
and may be mistaken for hernia, inasmuch as standing and coughing 
increase it. But it feels like a bag of worms ; and by this peculiar- 
ity may be distinguished from rupture. 

Treatment. — Wear a suspensory bandage. Have an operation 
done if this fails to relieve. 



Deformities and Irritations of the Spine. 

Lateral Curvature. — There are several varieties of curvature of 
the spine. Some of them are caused by the destruction of some por- 
tion of the spinal column by disease. It will not be necessary for me 
to treat of these forms of curvature, as they can only be investigated 
and treated by the most skilful surgeons. Those who will use this 
book chiefly, would hardly think of meddling with them. 

The curvature which arises from debility of the bones, ligaments, 
and muscles, and which is very common among females, has the fol- 
lowing 

Symptoms. — At first there is a projection of one collar-bone, or 

one side of the chest, or one shoulder is 
considerably elevated, and is popularly 
thought to be "growing out" On exami- 
nation, the right shoulder and the right 
side of the chest will be found, generally, 
to be rounded and lifted up, while the 
other is sunk down and concave. At the 
same time, the left hip sticks out, and the 
loins on the right side have an inward 
curve. The spinal column will have a 
curve, as in Fig. 182. 

Causes. — This affection is caused by 
occupations which keep the body in a 
laterally distorted position, and tax one 
side of the body more than the other. 
It is produced in children who study 
their lessons at school with one elbow 
resting on a high desk. The muscles, 
FlQ - 182 - too, get so weakened in many females of 




SURGICAL DISEASES. 585 

luxurious, sedentary and indolent habits, that they cannot hold the 
bony frame of the body in an upright position, and the jointed 
column of bones, called the spine, sags down to one side, and draws 
the whole skeleton of the trunk out of shape. 

Treatment. — The first thing to be done is to learn what particu- 
lar attitude of the body has occasioned the distortion. This discov- 
ered, every possible effort is to be made to break up the habit, what- 
ever it may be. If it be standing on one foot, or sleeping on one 
side, or reading or writing with the elbow high, keep a constant 
watch and strict rule over the patient. 

Exercise in the open air should be free, and taken daily. The use 
of the dumb-bells is excellent for both sexes ;• but girls should, in 
addition, have all the variety of elegant exercise furnished by calis- 
thenics. Wealthy parents, whose daughters are tenderly bred, should 
never let them grow up without the invigoration which these exer- 
cises impart. 

When the curvature is marked, and the debility considerable, these 
vigorous exercises should be taken for a time with moderation, and 
the patient should lie down and rest immediately after taking them. 

In many cases considerable benefit is derived from the mechanical 
support afforded by supporters of various kinds. These are now con- 
structed and adapted to the body, with considerable skill, by those 
who make their construction a study and a business. 

Spinal Irritation. — The spinal column is liable, at certain points, 
to become congested, and consequently sore and irritable. 

Symptoms. — The symptoms of this state of things are very varia- 
ble and numerous, as all sorts of sensations of the skin, from utter 
numbness and insensibility up to the most acute sensitiveness, de- 
scribed as creeping, shooting, coldness, tingling and the crawling of 
ants. There may be neuralgic pains, spasm, cramp, trembling or 
palsy of the voluntary muscles ; or a fixed pain and tenderness in 
some joint or other part ; or palpitation of the heart, dizziness and 
wind and pain in the stomach. 

When any of these symptoms appear, and cannot be traced to any 
other cause, we are to suspect some irritability of the spinal column, 
and to search, accordingly, in that direction. The proper method of 
search is, to make firm pressure on each of the projections of the 
spine, and to pass over the projections a sponge wrung out of hot 
water. If there be trouble here, the patient will now be likely to 
complain of severe pain at some one point. Or, the tender place 
will generally be found sooner, by tapping with the ends of the fin- 
gers, with quick and sharp strokes along upon the projecting bones 
of the spine. The patient will be pretty sure to wince when the ten- 
der point is reached. 

Treatment. — Apply leeches, and follow them with a blister, or 
stimulating liniment, or some strong, slightly irritating plaster, and 
the tenderness will be very likely to disappear, as if by magic. 



586 SURGICAL DISEASES. 



Wry Neck. — Caput Obstipum. 

In this complaint, the head is drawn over towards one of the shoul- 
ders, with the face generally turned towards the opposite side. This 
is caused Iw the rigid contraction of a particular muscle. In some in- 
stances, however, other muscles are affected, and the head may be 
drawn in other directions, or be twitched about in various ways. 

I had a singular case from New Hampshire, which, though not 
exactly wry neck, was a kindred disease, and is worthy of being men- 
tioned. The subject of it was a young lady of good physical develop- 
ment, but inclined to nervous complaints. Her head was chiefly 
drawn over backwards, sometimes so as to lie for a short time flat 
upon the back, with no power to raise it. She was obliged, ordinar- 
ily, to let her head lean a little to one side, and rest upon the hand, 
in order to keep it steady. When walking, with the head erect, with- 
out this support, it was every few moments jerked over backward 
and a little to one side, the chin being thrown up in a most unseemly 
way. The case partook of the nature of chorea. 

Treatment. — For the genuine wryneck, where the muscle which 
draws the head to one side is rigid and inflamed, the treatment should 
consist of leeches, poultices, purgatives, blisters and alteratives. When 
the muscles causing the distortion are not rigid, electro-magnetism, or 
the shower-bath may have a good effect. In some cases, strychnine 
will do well. 

The peculiar case mentioned above completely recovered, under 
the use of the extract of St. Ignatius' bean (95), one pill three 
times a day, and gradually increased to nine pills a day. She also 
took iron, and was put upon a most energetic system of out-door ex- 
ercise. Considering the stubborn and severe nature of the complaint, 
her complete recovery was as unexpected to her friends as it was 
gratifying. As the majority of wry neck cases are due to muscular 
contraction of a rheumatic type, the remedies employed for that dis- 
ease should be used here. In all cases the hot applications should 
not be lost sight of. 

Foreign Bodies in the Eye. 

When a person complains of some substance in the eye, the inside 
of the lower eyelid and lower portion of the ball should first be ex- 
amined, the person being directed at the same time to look up. If 
nothing be discovered there, the patient is then to be directed to look 
downward. This will expose to view the upper part of the globe. 
At the same time, the eyelashes should be taken between the thumb 
and finger, and the lid turned upward over some round smooth thing, 
as a pencil, which will turn the lid wrong side out, and bring to view 
whatever is on the inner surface. Any foreign body discovered may 



SURGICAL DISEASES. 587 

be removed by wiping it off with the head of a pin, having a silk 
handkerchief turned over it. If this fails to detach it, it may be 
carefully picked up by running under it the point of a wet tooth-pick. 

Stye. — Hordeolum, 

A stye is nothing more nor less than a small, painful boil at the 
edge of the eyelid. 

Treatment. — In severe cases, apply a poultice ; and open it as 
soon as it begins to point. After it has discharged all it is likely to, 
apply, on going to bed, for two or three nights, a little diluted nitrate 
of mercury ointment. Tonics and alteratives are frequently required 
to break up the formation of styes. 

Inflammation of the Edge of the Eyelids. 

Ophthalmia Tarsi. 

This inflammation often involves the Meibomian glands, which 
then secrete a sticky mucus, which, not being wiped away during 
sleep, glues the lids together, so that, on waking in the morning, the 
patient cannot get his eyes open. The complaint is generally chronic 
and obstinate, lasting a long time. Weakly persons, with disordered 
digestion, are most subject to it. In some cases the lids ulcerate, and 
the lashes fall out. Generally the lids are considerably inflamed for 
a few days, and then, the inflammation subsiding, branny scales, 
which may be brushed off, form along the borders of the lids, at the 
roots of the lashes. 

Treatment. — The health being generally disordered, needs first to 
be improved by all possible means, as by alteratives, tonics, bathing, 
exercise in the open air, travelling if practicable, and a generous diet. 

While the lids are inflamed, they should be bathed by a wash com- 
posed of sulphate of zinc, twelve grains ; laudanum, two drams ; and 
soft water, twelve ounces. The redness and heat having subsided, 
and the bowels being opened by a gentle dose of physic, an astrin- 
gent wash should be applied once or twice during the day (208), 
(209), and a small piece of the diluted nitrate of mercury ointment 
be rubbed along the borders of the lid, with a pencil-brush at night. 
This will generally effect an immediate improvement, and in time 
will bring about a cure. 

Disorder of the Lashes, 

Trichiasis. — This signifies a growing inward of the eyelashes. 

Dystrichiasis. — This is a double row of eyelashes, one of which 
grows inward. 

Treatment. — Pull out the misplaced hairs, and continue to do so 
as fast as they appear. 



588 SURGICAL DISEASES. 



Ptosis. 

This is a falling down of the upper eyelid, from palsy of the third 
nerve. It is sometimes attended with headache and dizziness, and 
may be the forerunner of apoplexy. 

Treatment. — Begin the treatment with purgatives, and then use 
every means to improve the health, especially exercise out of doors. 

Chronic Inflammation of the Lachrymal Sac. 

When the mucous lining of the nasal duct gets thickened and 
obstructed, the patient complains of great weakness of the eye, which 
is constantly weeping, — the nostril on the same side having a corres- 
ponding dryness. The tears not passing down through the obstructed 
duct, collect in the lachrymal sac, and form a small tumor by the side 
of the nose. By pressing the finger upon this, tl}e tears may be 
squeezed out through the upward passage, and glairy mucus along 
with them. There is generally tenderness of the sac, and sometimes 
redness of the skin. There is commonly inflammation of the mucous 
membrane lining the eyelids, etc. 

Treatment. — The acute inflammation of the sac must be treated 
by leeches, purgatives, and cold washes. 

Chronic inflammation of the sac requires a special attention to the 
general health. The diet should be carefully regulated, and the alka- 
line sponge-bath used every day, with brisk rubbing after it. When 
the sac gets very full, the patient should try gently to force the con- 
tents doion into the nose by pressing upon the upper side of the 
tumor ; and he may promote the same object by strongly drawing in 
his breath often with his mouth and nostrils both tightly shut. The 
so-called citrine ointment, full strength, may be applied to the eye- 
lids at bed-time, and a little of prescription (211) may be dropped 
once during the day into the inner corner of the eye. 

Purulent Ophthalmia. — Egyptian Ophthalmia. 

Owing to the glaring sunshine, and the particles of sand with 
which the air is loaded, this disease is endemic in Egypt. Hence its 
name Egyptian ophthalmia. 

Symptoms. — It begins with stiffness, itching, and watering of 
the eyes, and a feeling as if there were dust in them. The lids are a 
little swelled, and become glued together during sleep. The mucous 
marabrane which lines the lids and covers the ball is intensely red 
and swollen, and discharges a copious quantity of pus. There is a 
severe burning pain extending to the cheek and temple, with head- 
ache and fever. The eyes cannot be opened. It is both contagious 
and infectious. 



SURGICAL DISEASES. 589 

Treatment. — At the very beginning, apply a nitrate of silver wash 
(211) twice a day. With this application, a low diet, and five to 
ten-drop doses of fluid extract or tincture of veratrum viride, every 
hour, this terrible complaint may often be broken up. 

If the disease have reached its height, and there is great fever and 
headache, the patient may be freely purged (31), and the pain be 
allayed by cocaine applied with a camel's hair brush. 

The patient must be kept in bed, in a dark room, with the head 
elevated. 

The eyes should be frequently washed out gently with warm water, 
or a decoction of poppies, containing one grain of alum to an ounce. 
This must be done with a piece of fine sponge, or with a small 
syringe. Once or twice a day, a few drops of solution of nitrate of 
silver, two grains to the ounce of soft water, may be dropped in 
the e}^es from a camel's-hair pencil. As soon as the disease begins 
to give way, the alum in the poppy decoction may be increased a 
little. 

Purulent Ophthalmia of Children. 

This always begins within a short time after birth, — generally 
on the third day. 

Symptoms. — The edges of the lids at first become red, and glued 
together, and the membrane lining them is red and rough. The eye 
remains closed. The conjunctiva or membrane which covers the 
globe, next becomes intensely scarlet, and so much swelled, at times, 
that the lids turn out ; and it discharges a thick purulent matter. 
The child is feverish and restless. 

Causes. — Exposure to cold and damp, bad nursing, omitting to 
wash away from the eyes the cheesy secretions of the skin, and the 
contact of gonorrhceal and leucorrhoeal secretions of the vagina at 
birth. 

Treatment. — Wash out the eye frequently, and gently, with a 
weak astringent wash (207), (203), or put between the lids once a 
day, a large drop, with a camel's-hair pencil, of prescription (208). 
When the disease is declining, apply to the lids, with a camel's-hair 
pencil, the ordinary citrine ointment of the druggist. 

Catarrhal Ophthalmia, 

Symptoms. — In this complaint, the white of the eye becomes in- 
flamed and very red, the redness being superficial, so that the vessel 
can be moved by pulling the eyelids ; generally there is a thin mu- 
cous discharge, which, in severe cases, becomes thick and purulent. 
It is caused by cold and damp. 

Treatment. — If there be considerable pain and headache, give 
purgatives (31), (19), and continue them, once a day, till the symp- 



590 SURGICAL DISEASES. 

toms of active inflammation subside. Apply to the eyes a poultice 
of slippery elm, and bathe them frequently with a decoction of poppy 
leaves, lukewarm or cold, according to the choice of the patient. 
Smear the edges of the lids at night with fresh lard ; and when the 
inflammation begins to decline, use diluted nitrate of mercury oint- 
ment instead. Keep the eyes well protected from the light with a 
shade. A large drop of a solution of nitrate of silver, two to four 
grains to the ounce of water, may be put into the eye two or three 
times a day. Sometimes sulphate of zinc, four grains to the ounce 
of water, will do well, or cocaine solution, 4 per cent. 

When the disease reaches the chronic stage, — the pain and head- 
ache having passed off, — some astringent applications will be re- 
quired, as a very weak solution of nitrate of silver (208), or a dram 
each of powdered witchhazel leaves and golden seal, steeped for ten 
minutes in a gill of boiling water, and strained when cold. 

Scrofulous Ophthalmia. 

This disease is chiefly confined to children under eight years of 
age. 

Symptoms. — Entire inability to bear light ; the lids are spasmodi- 
cally closed, and the head constantly turned away from the light. 
The blood-vessels of the conjunctiva are not particularly injected, 
with the exception of one or two large ones which run towards the 
cornea, and terminate in one or more small opaque pimples. The 
cornea frequently ulcerates, and the complaint is very obstinate, — 
being liable often to recur. 

Treatment. — As in all scrofulous complaints, it is important in 
this to look after the general health. No more physic is required 
than to keep the bowels open; and even this, if costiveness exist, 
had better be done by bread made from unbolted wheat flour, by 
injections of cool or tepid -water, and by exercise. The health must 
be supported by iron, sarsaparilla, stillingia, and quinine. 

The eye is to be strengthened by cold water applied to the lids, 
the forehead, and the temples. The eyes may be bathed likewise with 
a warm decoction of poppies, or of chamomile flowers or cocaine. 

But one of the best applications. is a solution of nitrate of silver, 
one or two grains to the ounce of water, a few drops being put into 
the eye once or twice a day. Occasionally a solution of sulphate of 
copper, of the same strength, may be used with decided advantage. 

Both eyes should be protected by a shade. 

Inflammation of the Cornea. — Comeitis. 

Symptoms. — The cornea is rough, red, opaque, and generally 
prominent. There is some pain and inability to bear light, but not 
great. The pulse is frequent, and the skin dry. 



SURGICAL DISEASES. 591 

Treatment. — If the inflammation be acute, use leeches, purgatives, 
tincture of veratrum. Apply fomentations, and smear belladonna 
ointment on the eyebrows. 

For the chronic form, give quinine and other bitters, and put blis- 
ters upon the nape of the neck, and behind the ears. The wine of 
opium, and the diluted nitrate of mercury ointment, must be applied 
to the lids, or cocaine. 

Inflammation of the Iris. — Iritis. 

The iris is covered with a serous membrane, and is very liable to 
adhesive inflammation. 

Symptoms. — In the first stage, the iris changes its color, and the 
pup'l is contracted. In the next stage, lymph is poured out upon the 
surface in a thin layer, sometimes, which looks rusty, and sometimes 
in larger quantities, filling the whole cavity of the aqueous humor. 

Causes. — Injuries, or overworking the eye, but more frequently 
a taint of the system from gout or syphilis. 

Treatment. — If there be considerable inflammation, apply leeches 
to the temples, and keep down the circulation by tincture of vera- 
trum. To relieve pain, if any, paint with cocaine or morphia. 
The strength is generally to be supported by quinine ; and in many 
instances, iodide of potassium is to be given as an alterative. A little 
solution of atropia, one grain to the ounce of water, is to be dropped 
into the eye once or twice a day, and a warm infusion of slippery- 
elm bark, or of marshmallow, to be used as a wash. The bowels to 
be kept open by gentle physic. 

Weakness of Sight. — Muscce Volitantes. 

This is an affection to which persons of weakly constitution are 
liable, and those who write much, or examine very small objects. 

Symptoms. — Dimness of sight; uneasiness on exposure to a strong 
light ; and specks floating before the eyes, — often looking like flies. 

Treatment. — The complaint depends on debility, natural or ac- 
quired ; and tonics, as quinine and iron, and the shower or sponge 
bath, and out-door exercise, are the proper remedies. 

Imperfect Vision, — Amaurosis. 

The complaint here referred to is dependent on some change in 
the optic nerve or the brain, — most commonly the former. 

Symptoms. — In some cases the sight becomes suddenly dim, and 
is perhaps soon lost altogether; but more often it is impaired by slow 
degrees, — being only defective at intervals, as when the stomach is 



592 SURGICAL DISEASES. 

out of order, or the eyes have been fatigued. At one time, it will 
begin with objects appearing dim; at another, with their being 
double; at still another, with the ability to see only one half of 
objects. In some instances, the complaint begins with a crooked 
or disfigured or discolored appearance of things looked at. Again 
it will begin as near-sightedness, or far-sightedness ; or the patient 
cannot measure distances, and will miss his aim in pouring water 
into a glass, or in putting a match to the wick of a lamp. The flame 
of a lamp will appear split. At times the eye does not bear light ; 
at other times it longs for it, and objects do not appear illuminated 
enough. 

Distinction. — Amaurosis may be distinguished from cataract by 
there being no opaque body to be seen behind the pupil ; and by the 
light of a candle appearing discolored, split, or lengthened, or irides- 
cent ; whereas in cataract vision is only clouded, and a lighted candle 
looks as if surrounded with a mist. 

Chances of Cure. — These are generally not very favorable, unless 
the remedies employed very soon produce good effects. 

Treatment. — Electro-galvanism is one of the most promising reme- 
dies. Bayberry root, dried and reduced to an impalpable powder, and 
taken as a snuff, is occasionally useful. Cayenne, steeped in water, 
one grain to one ounce of water, and a little of it dropped into the 
eye, may stimulate the palsied nerve, and in some cases restore sight. 

Blisters may be applied behind the ears, or a seton may be tried 
upon the back of the neck, with some promise of success. 

But probably nothing will do better than cold bathing, — a shower 
bath if it can be borne, — out-door exercise vigorously pursued, and 
an adherence for a long time — perhaps a year — to a strictly vege- 
table diet, at the same time using nervine tonics, etc. (316). 

Short and Long Sight. 

Short Sight, called myopia, depends on too great a convexity of the 
cornea, or crystaline lens, or vitreous humor, — one or all, — and the 
consequent formation of the image of the object inspected a little in 
front of the optic nerve, or retina, — as at a (Fig. 183), instead of at 6, 




Fig. 183. 



where it should be formed. The rays of light are brought to a focus 
before they reach the retina. 



SURGICAL DISEASES. 593 

Children are either born with this defect, or it is brought on by too 
close study, or by long application of the eyes to minute objects. 

It may be remedied frequently by exercising the eyes in looking at 
distant objects. Children afflicted in this way should have their 
studies abridged, and their exercise in the open air increased. While 
studying they should have some apparatus applied to them which 
shall keep the chin elevated, so that the head cannot be dropped too 
low, and the eyes brought too near the book. And the book should 
each day be placed a very little further from the eyes. 

Glasses worn by persons having this defect of vision should be 
concave, as at c. 

Long Sight, or presbyopia, depends on the humors of the eye not 

being convex enough. In this case, the image of the inspected object 
is formed beyond the optic nerve, as at d (Fig. 184). This is one of 
the earliest signs of advancing age. 




Fig. 184. 

This defect is to be remedied by glasses which are convex, e. Per- 
sons in the early autumn of life must not resort to glasses too hastily, 
or, indeed, until they are compelled to, nor should they change those 
first used too soon. Glasses should make objects look distinct and 
bright, but not larger than natural. 

Squinting. — Strabismus. 

In strabismus, the eyes are not parallel in their position and mo- 
tion. 

It is supposed that one eye may become weaker than the other, or 
that the visual axis of the two may not be adjusted alike, so that one 
eye — perhaps the more defective one — turns aside to escape the 
distorted vision, or possibly the injury to itself which would follow 
the attempt to make eyes of unequal power work evenly together. 
The opposing muscles lose their counterbalancing force, and the in- 
ternal rectus, gaining the preponderance, draws the eye inward, — for 
the squint is more often convergent than divergent ; that is, the eye 
turns in more often than out. Both eyes sometimes squint. 

Treatment. — In recent cases there is some chance of curing this 
complaint without a surgical operation. The patient should not be 
in the society of other squinting persons, so as to learn it by imitation. 

In the first place care should be taken that the bowels are kept in 



594 SURGICAL DISEASES. 

good condition, and that the general health is well fortified by bath- 
ing, tonics, and exercise. The patient should be made to stand 
before a glass, and Avhile he closes the sound eye, look steadily at 
some object with the squinting eye. Let him do this till the eye is a 
little tired; then let him open the sound eye, when the squinting one 
will turn aside. But by compelling it, in this way, several times a 
day, to work in a straight line, it may, perhaps, be taught to remain 
parallel with the other. 

Nervine tonics, as strychnine (86), (94), (95), (316), will some- 
times do good service ; and electro-galvanism has been found useful 
in many cases. 

But in old and obstinate cases, the only cure is found in dividing 
the muscle which pulls the eye to one side, — the internal rectus, if 
the eye is drawn in, — the external rectus, if it is drawn out. 

Affections of the Ear. 

These are so common, that, in almost every family, they require 
attention, at one time or another. And deafness, which so often 
results from these disorders, is so serious a misfortune that every 
affection of the ear should receive early attention. 

Examination of the Meatus. — For examining the meatus, or ex- 
ternal passage of the ear, there is perhaps no better instrument than 

a simple silver or glass tube, of the size 
and shape represented in Fig. 185. 

To make the examination properly, 
place the patient either in a sitting, 
kneeling, or standing posture, as may be 
fig. 185. most convenient, with the ear directly 

under a good stream of gas- or lamp- or 
sun-light. Then take hold of the ear with the thumb and finger, and 
gently draw it outward and backward, and with the other hand in- 
troduce the small end of the tube or speculum, and carry it forward 
as far as it will go without producing pain. Then by gently swaying 
the large end of the tube back and forth, a stream of light may be 
made to illuminate all sides of the passage. If the lining of this 
passage is smooth, dry, pearly-white, and shining, and is without wax, 
it may be regarded as healthy. At the close of the passage, the 
tympanum may be seen, and should be semi-transparent, dry, and 
grayish- white. Within this may be seen the handle of the malleus, 
coining from above downward and forward. This bone runs about half 
way across the tympanum, and divides it into an upper front, and 
a lower back part. This lower back portion, when viewed through 
the speculum, is more glistening than the upper and front part, and 
a bright spot of light is seen on its most rounded portion, which is 
just below and behind the point of the malleus. Inflammation causes 
this innermost part of the meatus to become thickened, vascular, or 




SURGICAL DISEASES. 595 

granular, — like the conjunctiva of the eye when it is inflamed ; it 
also causes it to secrete and discharge matter. 

Inflammation of the Meatus. — Otorrhea. 

This is quite a common complaint among delicate children ; and 
may occur as the result of scarlet fever, or be excited by currents of 
cold air, by rotten teeth, or by deranged stomach and bowels. 

Symptoms. — Fever, headache, intense pain in the ear, and swell- 
ing of the glands of the neck. After a time, a reddish, watery dis- 
charge comes on, which soon grows thicker and mattery. The fever 
disappears with the appearance of the thick matter. An examination 
with the speculum shows the whole meatus to be swollen, vascular, 
and covered with a slimy matter. 

Unless great attention be given to cleanliness, the discharge be- 
comes very abundant and fetid, and lasts for a long time ; and if 
neglected, will be likely to lead to very serious consequences, even 
the decay of some of the bones of the head. 

Treatment. — While the inflammation is acute, and there is fever 
and pain, the diet should be confined to mere liquids, — as rice-water, 
gruel, etc., and the bowels should be opened with some preparation of 
salts, the ear being gently syringed, occasionally, with warm water 
or decoction of poppies, and being covered with a warm poultice of 
flax-seed or bread and milk. In place of a poultice, a soft linen bag, 
filled with bran, and dipped in hot water, may be kept on the ear. 
If there be great pain and headache, put leeches behind the ear. 

The pain and fever being gone, and the mattery discharge having 
come on, the case is to be treated like other chronic diseases of mu- 
cous membranes in scrofulous constitutions, by tonics, alteratives, 
warm baths, and out-door exercise. 

The ear may now be gently syringed out with castile soap and 
water, and immediately after with a weak solution of alum, or sul- 
phate of zinc, one grain to a dram. This may be done twice a day. 
Or, a little of a mixture of two drams of solution of sugar of lead 
and half a pint of water may be dropped into the meatus, and, after 
remaining two or three minutes, be allowed to run out. If the dis- 
charge be very fetid, two drams of solution of chloride of lime, with 
half a pint of water, will make a suitable wash with which to syringe 
it, applying, once a day, a solution of nitrate of silver, five grains 
to the ounce of water. 

Should the discharge stop at any time, and pain and fever come 
on, lay aside these astringent applications, and go back at once to the 
leeches, purgatives, poultices and fomentations. 



596 SURGICAL DISEASES. 



Wax in the Ear. 

The ear sometimes becomes completely filled with wax, mixed 
with hairs and flakes of scarf-skin, impeding greatly the sense of 
hearing. 

Treatment. — Let the ear be gently syringed each morning with 
warm soapsuds, so as to thoroughly clear out the whole mass of 
matter, after having dropped into the ear the night before four or five 
drops of oil. The water may be quite warm, and a little cotton should 
be loosely inserted after the syringing. 

Earache. — Otalgia. 

Symptoms. — This is simply neuralgia of the ear, and comes on in 
fits of excruciating pain, which shoots over the head and face. It 
may be distinguished from inflammation of the ear by the sudden- 
ness and intensity of the pain ; by its not throbbing, not increasing 
in intensity, not being attended by fever, and not coming and going 
without apparent cause. 

Treatment. — Fill or remove all rotten teeth, which may be sus- 
pected as the cause of the suffering. Give iron, particularly the 
citrate combined with strychnine (316). The core of an onion after 
being baked, applied to the ear as hot as it can be borne, will often 
give relief. The onion is to be baked whole. The core then is taken 
out while hot and inserted in the ear. 

Inflammation of the Tympanum. — Deafness. 

Otitis. 

Symptoms. — In the acute form of the disease, there is violent 
pain, ringing noises in the ear, and delirium. When the suppuration 
takes place, there is a chill, and a heavy, tensive pain. 

' In the chronic form of the complaint, the lining membrane of the 
tympanic cavity has its vessels a little enlarged, with blood some- 
times effused into its substance, or lymph upon its surface, or the 
membrane is thickened, and sometimes covered with tuberculous 
concretions, or there are fibrous bands occupying nearly the whole 
of the cavity. 

Symptoms. — These are slight, — the first perceptible change being 
generally deafness in one or both ears. There may be a woolly sen- 
sation, with noises or ringing, and slight aching pains. 

Treatment. — As the deafness in these cases generally depends on a 
chronic inflammation of the tympanic membrane, the best remedies are 
those which improve the condition of the digestive organs and gen- 
eral health, as regular diet, bathing, pure air, and exercise, with tonics 



SURGICAL DISEASES. 597 

and alteratives. Occasionally, a leech or two, or a blister behind the 
ear will be serviceable. But generally dry cupping behind and in 
front of the ear will answer the purpose for calling the blood away 
from the thickened membrane. 

If the inflammation be acute, it must be combatted with purging 
blisters, poultices and fomentations. 

When deafness is caused by inflammation in the Eustachian tubes, 
or from enlargement of the tonsils, etc, the tonsils must be cut off, 
and a solution of nitrate of silver, twenty grains to the ounce, must 
be thrown upon the mouths of the tubes with a shower syringe. 

Bleeding from the Nose. — Epistaxis. 

Treatment. — In full-blooded persons, with redness of face, and 
subject to headache and dizziness, bleeding from the nose may be 
salutary, and necessary to ward off apoplexy, and should not be too 
suddenly stopped. 

When the bleeding is such as to require to have it arrested, plug 
the nostrils with the scraping from a fur hat, or with lint, dipped in 
a strong solution of alum or tannin or Monsel's persalt of iron, one 
part to ten parts of water. To give immediate relief, press up under 
the upper lips or apply something cold to the back of the neck. 

Ingrowing Toe=Nail. 

To most persons, the above words will suggest some unpleasant 
associations, for there are few but have had some painful experience 
with this affection. It is usually* like corns and some other trouble- 
some things, the penalty inflicted for wearing tight shoes. It gener- 
ally appears upon the great toe. The constant 
pressure of a narrow boot or shoe against the side 
of the toe, causes the edge of the nail to sink into 
the flesh, producing inflammation and pain, and 
finally ulceration. Nature, attempting to repair 
the mischief, sends out granulations, which, being 
perpetually irritated, shoot up into unhealthy 
growths, called proud flesh. Thenceforward, the 
sufferings of the patient become incessant ; and he 
cannot now even compromise, as he would be glad 
to do, by putting on shoes of ample dimensions, but 
is obliged to negotiate a peace by putting away the 
shoe altogether, or by cutting a hole through it to 
take off the pressure. At the risk of giving the reader a few dismal 
twinges every time he looks upon this page, we place here, in Fig. 
186, a good representation of this tormenting disorder, as a suit- 
able warning against the folly of giving the toes narrow quarters. 

Treatment. — Make a lye by putting half a pint of hard-wood 




598 • SURGICAL DISEASES. 

ashes into a quart of hot water; bathe the toe in this, while warm, 
twenty minutes, every day. Immediately after each bathing apply a 
poultice made of ground slippery elm and weak lye, changing the 
poultice twice a day. As fast as the inflammation is subdued by 
„this, press a little fine lint gently under the edge of the nail. At each 
subsequent dressing, cut off as much of the nail as is raised out of the 
tender flesh, with the keen point of a penknife. Continue to do this 
till the whole offending portion is cut away. 

If the above treatment does not reduce the inflammation and great 
tenderness, spread some extract of belladonna upon lint, — lay this 
upon the diseased part, and put a poultice over it. 

When the disorder begins to make its appearance, it is a good plan 
to scrape the nail very thin on top ; this will cause it to grow upon 
the upper surface, and to give way at the tender part, so as to obvi- 
ate, sometimes, the necessity of any other treatment. 

The following is the best treatment. Wash the toe in warm water, 
and make the parts dry with cotton wool. Then gently press cotton 
wool in between the toe-nail and the tender projecting flesh, and ex- 
tend it along the groove back between the skin and nail. Next, wet 
the end of a piece of nitrate of silver, and rub it thoroughly upon the 
nail, close to the cotton, not allowing it to touch the tender flesh; 
then put on a thin layer of cotton wool, and, in two or three hours, 
a poultice around the toe. 

In two days, the nail will be perfectly black, and, as far as the ni- 
trate was well applied, will be separated from the parts underneath, 
and may be taken off without pain. 

If the nail is very thick, scrap off the black and deadened part in 
two days, and apply the nitrate again. This treatment is a vast im- 
provement on the old and cruel practice of tearing off the live nail. 

Chafing and Excoriation. 

When the neck, arm-pits, thighs, etc., of children, get chafed or 
excoriated, a remedy may be found by keeping the parts clean, and 
by dusting them with powdered slippery elm, starch or talcum pow- 
der. If this does not effect a cure, apply Turner's cerate, or wash 
the parts with a solution of sulphate of zinc, or nitrate of silver, five 
grains to the ounce of soft water. 

Grown persons may treat these troubles very much in the same 
way, or by wearing cotton between the parts which rub together. 

Foreign Substances in the Nose. 

When any foreign substance gets lodged in the nose, close the 
mouth and the opposite nostril, and then blow forcibly through the 
obstructed side. If this is not successful, press the thumb against the 
nose above the obstructing body, and then make a hook -of a piece of 



SURGICAL DISEASES. 599 

wire or knitting needle, and pressing it up over the offending sub- 
stance, pull it down. 

Foreign Substances in the Ear. 

If flies and other insects get into the ear, fill the ear with sweet 
oil, and then syringe it out with warm water. Sometimes it will be 
sufficient to hold the head down on one side, and have the ear filled 
with water, — remaining quiet in this position for a short time, when 
the insect will rise to the surface. If any hard substance be got into 
the ear, lie down quietly upon the affected side, and send for a phy- 
sician. 

Foreign Substances in the Gullet. 

If the substance have not gone beyond the reach of the thumb and 
finger, thrust them down as far as possible, and try to pull it out; or, 
a small curved pair of forceps will reach still lower than the fingers. 
Or, this failing, let some one place one hand firmly on the chest of 
the choking person, and give him a smart blow or two between the 
shoulders with the other hand. If the substance be down some way 
in the gullet, it may be pushed along into the stomach by some 
smooth, blunt instrument. 

Foreign Bodies in the Windpipe. 

Sometimes foreign bodies will remain a long time in the windpipe, 
and will only create some inflammation and cough, but not any im- 
mediately dangerous symptoms. When the body has gone entirely 
below the epiglottis, out little can be done, except to give a pinch of 
snuff to cause sneezing, and to direct the patient to expel the air ex- 
plosively from the lungs by a few energetic and sudden coughs. This 
may drive the offending body out. 

Bleeding from Wounds. 

If bleeding occur from any part where a bone lies near the surface, 
as the head or* face, it may generally be stopped by pressing firmly 
against the bone with a finger, or a piece of cork, or by binding on 
tightly a hard pad. If this does not succeed, lift up each edge of the 
wound, and examine carefully to see if any small stream of blood is 
spouting out in jets. If so, an artery is wounded, and the point of 
small forceps or tweezers must be dipped in where the jets come 
from; the spouting mouth taken hold of and drawn out; and a 
strong silk thread passed around it, and tied below the forceps. The 
white and gaping mouth of the vessel may then be seen. 

If the bleeding be profuse from an arm, the whole current of blood 
to that limb must be cut off, which may be done by some person 
pressing a thumb firmly into the neck behind the middle of the col- 



600 SURGICAL DISEASES. 

lar-bone. This will dam up the blood in the great artery of the arm, 
as it comes out of the chest. The handle of a door-key, wrapped in 
several folds of linen, may be pressed upon this place for a long time 
until medical assistance can be had. 

Dangerous bleeding from the thigh or leg may often be stopped by 
pressing the great artery just below the crease of the groin. 

If the bleeding be below the middle of the upper arm, or middle 
of the thigh, pass a handkerchief once or twice around the limb, as 
far above the wound as possible, and tie it tightly. Slip a stiff stick 
under this*, and turn it round, like the handle of an auger, until the 
handkerchief becomes so tight as to stop the bleeding. This arrange- 
ment is called a stick-tourniquet, and is intended to answer the same 
purpose as the instrument represented by Fig. 155. 

One of the best methods now in use, of arresting hemorrhage in 
cases of accidental injuries of the large arteries of the extremities, is 
by surrounding the limb above with two turns of a piece of rubber 
tubing about three-fourths of an inch in diameter, and tying it tight. 
This safely and effectually controls all bleeding. 

Advantage is taken of this elastic property of rubber in controlling 
hemorrhage, in performing what is called bloodless operations of sur- 
gery. It is called Esmarch's method, from the name of the origina- 
tor. It may be resorted to in all operations on the extremities, whether 
of amputations, the removal of tumors, or in the minor operations of 
removing needles, and whenever the bleeding interferes with the per- 
formance of the operation. 

It is applied as follows : The limb should first be tightly bandaged 
with an elastic rubber bandage about three inches wide, from below 
upwards, and then surrounded at the highest 'point with a band or 
tube of rubber in the place of a tourniquet. The bandage is then to 
be removed, when the operation may be performed in temporarily 
bloodless tissues. 

An amputation of the thigh may be thus performed without loss of 
any blood of consequence. 

Anaesthetics. 

In these days when so much wonderful surgery is done and when 
everybody desires to have the advantage of all modern methods being 
employed in the treatment of their case, a little knowledge of anaes- 
thesia will be of service to the reader. Before the discovery of ether 
an operation meant torture to the patient. If you should visit some 
of the old operating-rooms you would find rings in the floor to which 
ropes used to be attached in order to hold down the patient. Ether 
is the most commonly employed anaesthetic, and is safe to inhale, sure 
in its action and gives the least mortality. Something like one per- 
son in 50,000 dies from the inhalation of ether against one in 15,000 
to 30,000 when inhaling other anaesthetics. It is not over pleasant 



SURGICAL DISEASES. 601 

to inhale, as it is somewhat pungent and choky to breathe when first 
inhaled. This sensation soon passes off. A longer time is required 
to produce anaesthesia with ether than with chloroform, but its greater 
safety overbalances this slight disadvantage. Vomiting more fre- 
quently occurs after ether than after chloroform. 

Chloroform is the next most commonly employed anaesthetic. It 
is agreeable, quick in its action, and very little is required. It is 
the common anaesthetic in European practice, yet its greater mortality, 
the sudden change in heart and lung action, render its usefulness 
much more limited in this country than that of ether. It is employed 
especially in cases complicated by lung and kidney disease in the 
young and very old. 

The A, 0. U. mixture, so-called, is still a third anaesthetic, and is 
composed of a mixture of alcohol, chloroform and ether, and is fre- 
quently given to start a case with, as its inhalation is pleasant and 
its anaesthetic properties quick. Its mortality rate lies between that 
of ether and chloroform. Some people take these anaesthetics with 
perfect comfort; others, being timid, require a larger amount and 
give in to its soporific effects very slowly. 

Of late Cocaine has been introduced into medical practice as a 
means of rendering the flesh numb and painless when injected under 
the skin about the site of the part to be operated on. It has the great 
advantage of maintaining the senses other than that of sensation and 
pain perfectly intact. By its use large operations may be done, and, 
in the case of minor operations, time and money are saved and bad 
after-effects are avoided. Sometimes a temporary faintness occurs 
from the use of a too strong solution, but this can always be avoided 
by weaker solutions and overcome at the time by a little stimulant. 

There is a popular feeling that ether and chloroform leave their 
traces in the system for a long time afterward ; such is not the case, 
however, and fear need never be entertained that the system will be 
left the weaker for it. 

In the use of anaesthetics proper, certain rules are to be observed. 
Nothing solid is to be eaten for a number of hours previous to the in- 
halation. All artificial teeth must be removed and all waist-bands 
and tight clothing should be loosened if not removed. 

A little strong coffee or a little brandy and hot water may be given 
by mouth to prevent the subsequent vomiting and nausea. 

Care of the Teeth. 

Decay and loss of the teeth is common even among the young. 
Few persons at the age of twenty have sound teeth, and the ten- 
dency to decay is no doubt to some extent inherited; but with care- 
ful attention they may be preserved in good condition till late in life. 
Parents should inculcate in their children the habit of cleanliness of 
the teeth. 



602 SURGICAL DISEASES. 



Rotting of the Teeth.— Cams. 

This is not confined to any age, temperament, or condition of 
society. 

The teeth become diseased, die, and drop away, while all the other 
organs are sound and active. 

The Creator doubtless intended that all the members of the same 
body should be equally durable ; but certain laws of nature, violated 
by us habitually, turn upon us, as it were, in anger, and smite us full 
in the face, breaking our teeth, and robbing us of the means of pre- 
serving the health which we do not appear to prize. 

When rotting begins iu the teeth, its progress is more or less rapid, 
and their destruction is certain, unless it is arrested by artificial 
means. 

The enamel is nature's fortification to protect the teeth against ex- 
ternal injuries. When this is broken, or worn away, the bone of the 
tooth becomes exposed, and rotting begins immediately. Whatever 
has a tendency to crack, break up, or destroy the enamel, therefore, is 
to be carefully avoided. 

Hot Drinks, or hot food, coming suddenly in contact with the en- 
amel, are liable to crack it, and expose the bony substance of the 
tooth. The enamel is exceedingly brittle, much like glass in its 
structure, and is easily cracked when exposed to sudden transitions 
from heat to cold, and from cold to heat. 

Luxurious Living often deranges the general health, and causes 
acid and unhealth}^ secretions in the mouth, which act injuriously 
upon the enamel. 

Acids are injurious to the enamel ; and when taken as medicine, 
should be well diluted, and in some cases, drunk through a tube, so 
as not to come in contact with the teeth. Sugar is not directly inju- 
rious to the teeth, as many suppose ; but if allowed to remain about 
and between them, it may generate an acid which is destructive to 
the enamel. 

A Crowded Condition of the teeth in the mouth causes the enamel 
to wear away, and leads to rotting ; in which case, early attention 
and advice from a dentist is quite important. 

Food Lodged Between the Teeth, and in their depressions, is a 
cause of extensive decay. Animal and vegetable matter, when ex- 
posed to warmth and moisture, soon generate an acid which corrodes 
the enamel. The teeth, consequently, often begin to decay in parts 
where one presses upon another, and in depressions, where food lodges 
and remains. This shows the necessity of cleansing the mouth and 
teeth often, — particularly after meals. 



SUKGICAL DISEASES. 603 

Mercury, when taken to the extent of salivation, — whether it be 
calomel, corrosive sublimate, blue pill, or any other form of it, — 
causes inflammation of the membranes about the teeth, and indirectly 
produces caries. 

Acidity of the stomach, the contact of decaying teeth and dead 
stumps with sound ones, diseased and ulcerated gums, and, above 
all, a filthy, unclean and unwholesome condition of the mouth, are 
active causes of diseased teeth. 

Improper Tooth-Powders, as those containing gritty particles, are 
to be avoided. 

Tobacco, by deranging the general health, may be indirectly inju- 
rious to the teeth. Smoking blackens the teeth; and though chewing 
may be useful in deadening the sensibility of the nerve of a decaying 
tooth, this alone is not a sufficient reason for so uncleanly and disa- 
greeable a habit, while so many agents may be found to produce the 
same effect. 

Tartar. — This is derived from the saliva, and is found, when ex- 
amined by the microscope, to be composed of myriads of living 
animals. When first deposited around the teeth, it is in a soft state ; 
but, when not brushed away, it soon hardens, and changes from a 
yellow to a brown, and sometimes to a black color ; and often in 
children it becomes a dark green. It destroys the beauty of the 
teeth, giving them a filthy and revolting look ; the setting of the 
teeth in their sockets is weakened ; their appearance is elongated ; 
the periosteum or covering of the fang becomes inflamed and tender ; 
and, if the proper remedy be not applied, the teeth will become loos- 
ened, and finally fall from their sockets. It causes the gums to be- 
come inflamed, swollen, tender, and ulcerated, and loads the breath 
with a disagreeable fetor. Its direct influence on the teeth is not 
great ; but it vitiates all the secretions of the mouth, and is thus a 
very efficient, though an indirect cause of decaying teeth. In all 
cases, it should be immediately and carefully removed, and some 
astringent wash, made from Peruvian or oak bark, be applied to 
reduce the inflammation and swelling of the gums. 



Tooth=Ache. 

This is generally caused by an exposure of the nerve which fills 
the internal cavity of the tooth. This exposure is caused by a frac- 
ture, or, more commonly, by the rotting away of a part of the tooth. 
This nerve is extremely sensitive ; and, by coming in contact with 
the air and acrid substances, inflammation is excited, and tooth- 
ache is the consequence. 

Teeth sometimes ache when they are, to all appearance, perfectly 
sound. This may be caused by bony enlargements of the ends of 



604 SURGICAL DISEASES 

the fangs, inflammation of the periosteum, a peculiar irritability and 
ague of the face, which excite neuralgia, etc. 

Pain of a sound tooth is sometimes caused by sympathy with a 
decaying one, by a disordered stomach, or by scurvy, pregnancy, tar- 
tar, or whatever excites painful sympathetic action in the nerves of 
the face. 

Treatment- — Tooth-ache may be quieted by placing a drop of oil 
of cloves, or cajeput, or a drop of creosote upon a piece of cotton, 
and inserting it into the cavity of the tooth, and bringing it into con- 
tact with the exposed nerve. A few drops of a five per cent solution 
of cocaine placed in the tooth by means of absorbent cotton, or even 
wiped around the gum, acts very beneficially and usually quiets the 
worst tooth-ache. Chloroform likewise is often good. 

Pains of the face and jaw, when not the consequence of rotten 
teeth, may be relieved by holding brandy, or whiskey, or rum, or 
diluted tincture of cayenne, or hot water, in the mouth, and by ex- 
ternal applications of laudanum, Oliver's plaster, a mustard plaster, 
or hops steeped in alcohol, or a blister behind the ear. But for teeth 
too much decayed to bo saved by filling, there is no remedy so proper 
as extraction. 

Filling Teeth. 

There is no operation of the dentist of more real and lasting 
benefit to the patient than that of filling rotten teeth. 

A tooth that is well filled before its nerve is exposed, is as service- 
able as a sound one, and nearly as durable. Its preservation for 
many years is perfect and complete. 

It is necessary, in the performance of this operation, to remove 
very carefully all rotten and foreign matter lodged in the cavity ; to 
make the cavity of a dovetail shape, so as to retain the filling ; to wipe 
it perfectly dry; and to press the gold in so as to make the cavity 
perfectly water and air tight. A tooth filled in this way may be 
preserved many years, and in many cases during life. 

When decay has gone so far as to expose the nerve and render a 
tooth painful, the nerve, in all cases, should be destroyed before the 
cavity is filled ; otherwise there may be soreness, and sometimes ex- 
treme pain making the extraction of the tooth absolutely necessary. 

A tooth filled after the nerve is destroyed is not as good as if filled 
before the nerve was exposed ; the walls of the cavity are thinner and 
weaker, and consequently are more liable to break and crumble away 
when brought into contact with hard substances ; and the filling will 
be more likely to be loosened. There is likewise some danger of ulcer- 
ation and absorption at the root of a tooth, when filled in this condition, 
which makes it very important that teeth should be filled early. 

Gold foil is preferable to all other substances for filling teeth. If 
it is properly dressed and polished, it will remain in the mouth for 
many years without any sensible loss of its substance. 



SURGICAL DISEASES 605 



The First Teeth. 

It is an imperative duty of parents to see that their children's teeth 
have early and careful attention. 

The health and durability of the permanent teeth depend materi- 
ally on the healthy condition, regularity and durability of the tempo- 
rary ones. It may seem strange that diseases of the first set of teeth 
should influence the set which is to follow ; but when we consider 
that the rudiments of the second set already exist when the first are 
cut, it is not unreasonable to suppose they may inherit disease from 
their predecessors. 

Cleaning the Teeth. 

The most important rule to be observed in the preservation of the 
teeth is to keep them perfectly clean, and never to allow any foreign 
substance to remain on or about them. A decaying tooth should 
never be allowed to remain in the mouth ; it causes others to decay. 

If tartar has been allowed to collect, have it removed immediately. 
The teeth should be carefully and thoroughly brushed daily with 
warm water, and the occasional use of a dentifrice that is impalpably 
fine, and that contains no acid. 

A Brush has no bad effect upon the teeth, as some suppose, for 
the parts of the teeth most exposed to the friction of a brush are 
never the first to begin to decay. This beginning of decay takes 
place in their depressed surfaces, and where they touch each other. 
A soft brush is better for the teeth than a stiff one, because the lat- 
ter is apt to fret the gums, and cause them to recede, which gives 
the teeth a lengthened appearance. 

Teeth in a crowded condition should never be filed, unless they 
begin to decay. 

Tooth-Picks, made of quill, or wood, or ivory, should be used after 
meals, and all particles of food lodged between the teeth should be 
removed. 

In Sickness, the rules for cleanliness of the teeth should be more 
rigidly enforced than at any other time, as then they are more ex- 
posed to destructive agents, and are liable to participate in the gen- 
eral debility and disease of the system. 

Influence of Diseased Teeth upon the Health. 

The bad effects of a diseased and unclean mouth upon the general 
health are of more serious consequence than most people are aware. 
In twenty-four hours, we breathe twenty thousand times ; and what 
must be the effect upon the delicate structure of the lungs, when, 
for days, months and years, the air we breathe is drawn through a 



606 



SURGICAL DISEASES. 



depository of filth, and is poisoned by being mixed with effluvia 
arising from decayed and diseased matter in the mouth. 

The intermittent fevers of the West are caused by the effluvia 
arising from the decaying matter of low grounds and marshes, which 
can hardly be more pernicious than the effluvia from the impurity 
and corruption generated in an unclean mouth, filled with decaying 
teeth. Dr. Hays says " no species of animal matter is so offensive to 
the health and vitality of the adjoining substance, whether nerve, or 
membrane, or any part or portion of the living body, as decaying 
bone." 

Dr, Ira Warren's Paracentesic Instrument. 

Puncturing the chest for drawing off water in extensive pleuritic 
effusion, as practised of late, has proved one of the most valuable 
operations in modern surgery. Like most new operations, however, 
it has been embarrassed by imperfect instruments. 

The annexed cut represents an improved instrument which I have 
just invented, by which this operation is made extremely simple and 
easy. At the right hand is the puncturing instrument, including the 




1 



I 



external canula, and the trochar inserted «in it. At the letter i is a 
sliding guard which moves back and forth, and may be set at the 
point of desired depth to which it is desirable to puncture, and made 
fast by a screw. By this arrangement it may be driven home to the 
desired depth, without any fear of going too far, or of falling short 
of the mark. The guard also serves in a measure to keep the instru- 
ment steady during the operation, and to prevent inflicting pain by 
having it oscillate about. At b is a tubular attachment opening into 



SURGICAL DISEASES. 607 

the eanula ; to this an india-rubber hose is attached, which connects, 
at the other end, with the cock a, upon the exhausted receiver o. 
To a cock, <?, on the other side of the receiver, another rubber hose is 
fastened, which connects at the other end with an air-pump. 

The mode of operating is exceedingly simple. First, exhaust the 
receiver; then quickly, yet gently, plunge in the instrument, and, 
leaving the canula, withdraw the trocar till the point passes the con- 
necting tube at b, when the water will immediately flow, in a full 
stream, into the exhausted receiver o. The working of the appara- 
tus is extremely beautiful. Five pints of water may be taken away 
with it in five minutes, — an amount which cannot be got with the 
old instrument in much less than half an hour. If the patient can- 
not bear to have it drawn so rapidly, the stream may be wholly or 
partially arrested, at any moment, by entirely or partly closing the 
cock a. 

The reader will see that the apparatus is so arranged that the ad- 
mission of air into the chest is entirely impossible. 

The artist, in making the drawing for me, has inserted the instru- 
ment much farther forward than the point usually selected. 

My apparatus has a second puncturing instrument, a little larger 
in size, for the purpose of operating in ascites, or dropsy of the belly. 

This, or similar instruments, can be bought of any good dealer in 
surgical instruments. 



A BRIEF TREATISE ON THE 

HOMOEOPATHIC TREATMENT OF 

DISEASES. 

BY A. E. SMALL, M.D., 
President of the Hahnemann Medical College, Chicago. 



In the following pages will be found a reliable guide in the ad- 
ministration of homoeopathic remedies for the various ills known to 
occur in almost every-day life. Nearly every disease incident to the 
human family is briefly considered, and the corresponding treatment 
explicitly stated. It must be borne in mind that homoeopathic 
remedies are addressed to vital forces, whose derangement may be 
seen in the manifold forms of disease. But, in order to obtain the 
desired effect from the administration of any remedy for a given case, 
a certain principle must be observed in its selection. This princi- 
ple is believed to be a competent guide in affiliating remedies to dis- 
eased conditions. The discovery of a universal law of cure, which 
points out the direct relationship between all diseases and their 
remedies, is ascribed to Hahnemann, the founder of the homoeopathic 
system of medicine. By numerous experiments with drugs upon 
healthy individuals, he ascertained that diseases are curable by such 
medicines as are capable of producing similar characteristics : as, for 
instance, chamomile will produce a colic, and will cure a similar one 
from some morbific cause; hence, the formula, "Similia similibus cu- 
rantur" is the principle that guides in the administration of remedies. 
Every medicine has a specific range of action in the body : one will 
act on one set of organs, and another on another set ; some will direct 
their energies so as to affect one locality, and others to another. 
The only way, therefore, of ascertaining how a remedy will direct 
its action to any local or general disease is by trying it first upon 
healthy persons in order to ascertain its range of action. As disease 
manifests its action by symptoms, so remedies show their action by 
symptoms, in a similar manner ; and, when a disease presents itself 
for treatment, a remedy must be selected whose pathogenetic effects 
upon those in health resemble the phenomena of the disease. The 
homoeopathic materia medica is made up of a collection of remedies 
that have been thus tried. Those employed in this treatise are of 
this character, and are comprised in the following 

608 



HOMOEOPATHIC TREATMENT OF DISEASES. 



609 



1. Aconite. 3. 

2. Aloes. 6. 

f3. Alumina. 6. 

t4. Ammonium carb. 6. 

t5. Antimonium crud. 6. 

6. Apis mellifica. 6. 

7. Arnica montana. 3. 

8. Arsenicum album. 6. 
19. Aurum metallicum. 6. 

10. Anacardium. 3. 

11. Baptisia. 1. 

12. Belladonna. 3. 

f 13. Bismuth subnit. 3. 
14. Bryonia alba. 3. 
fl5. Calcarea carb. 6. 

16. Calendula. 1. 

17. Camphora. 3. 

18. Capsicum. 3. 

19. Cantharis. 3. 

20. Cannabis sat. 3. 
f21. Carbo animalis. 6. 
t22. Carbo veg. 6. 

23. Causticum. 6. 

24. Chamomilla. 3. 

25. China. 3. 

26. Chelidonium maj. 3. 

27. Cimicifuga racem. 1. 

28. Cicuta virosa. 3. 

29. Cina. 3. 

30. Cocculus indicus. 3. 

31. Coffea cruda. 6. 

32. Colchicum. 3. 

33. Colocynthis. 3. 

34. Conium mac. 3. 

35. Crocus sativa. 3. 

36. Cuprum acet. 6. 



* LIST OF REMEDIES. 

37. Digitalis. 3. 
f38. Dioscorea villosa. 2. 

39. Drosera rotundifolia. 3. 

40. Dulcamara. 3. 
f41. Elaterium. 3. 

42. Euphorbium. 3. 

43. Euphrasia. 3. 
f44. Ferrum redact. 3. 

45. Gambogia. 3. 

46. Gelsemium. 1. 
t47. Graphites. 6. 

48. Glonoinum. 6. 

49. Helleborus nig. 6. 
f50. Hepar sulph. 6. 

51. Hyoscyamus nig. 3. 

52. Hamamelis. 1. 

53. Ignatia amara. 3. 

54. lodium. 6. 

55. Ipecacuanha. 3. 

56. Iris versicolor. 3. 
f57. Kali carb. 6. 

t58. Kali bichromicum. 3. 

59. Lachesis trig. 6. 

60. Ledum palustre. 3. 

61. Laurocerasus. 3. 
f62. Leptandria. 3. 

f63. Lycopodium clav. 6. 

64. Lobelia inflata. 3. 

65. Mercurius corrosivus. 6. 
f66. Mercurius vivus. 6. 
f67. Mercurius iod. 3. 

f 68. Mercurius biniod. 3. 

69. Mercurius sol. 6. 

70. Mezerium. 3. 

71. Moschus. 6. 

72. Natrum muriat. 6. 



73. 

74. 
75. 

76. 

77. 
78. 
79. 
80. 
81. 
f82. 
83. 
84. 
85. 
86. 
87. 



90. 

91. 

92. 

93. 
t94. 

95. 

96. 
t97. 

98. 

99. 
flOO. 
101. 
102. 
103. 
104. 
105. 
106. 
fl07. 



Nitrum. 6. 
Nitric acid. 6. 
Nux vomica. 6. 
Nux moschata. 6. 
Opium. 3. 
Oleander. 3. 
Petroleum. 6. 
Phosphorus. 6. 
Phosphoric acid. 6. 
Platina. 6. 

Phytolacca decandra. 1. 
Pulsatilla. 6. 
Podophyllum pelt. 3. 
Rhus tox. 3. 
Ruta graveolons. 3. 
Sabina. 3. 
Sambucus nig. 3. 
Sanguinaria. 3. 
Secale cornutum. 3. 
Senega. 3. 
Sepia succus. 6. 
Silicea. 6. 
Spigelia. 3. 
Spongia. 3. 
Stannum. 6. 
Staphysagria. 3. 
Stramonium. 3. 
Sulphur. 6. 
Sulphuric acid. 6. 
Tartar emet. 6. 
Uva ursi. 1. 
Urtica urens. 3. 
Veratrum album. 3. 
Veratrum viride. 1. 
Zincum met. 6. 



TINCTURES FOR EXTERNAL USE. 



1. Aconite. 

2. Arnica. 

3. Baptisia. 

4. Calendula. 



5. Cantharis. 

6. Conium. 

7. Causticum. 

8. Hypericum. 



9. Ruta graveolens. 

10. Staphysagria. 

11. Urtica urens. 



RULES FOR THE ADMINISTRATION OF REMEDIES. 

As specific directions will be found in the treatment of each dis- 
ease treated of in this work, only a few general rules are necessary. 

1. In acute cases, the chosen remedy may be repeated every hour 
or two hours, until a change occurs ; then it is prudent to wait awhile 
for the result. 

2. If there is no favorable reaction within a few hours, or in very 
acute pain, within half an hour, select another remedy according to 
the indications ; and, should no favorable reaction follow the adminis- 
tration of this, select another, and so on. 

3. When convalescence follows the administration of a remedy, it 
need not be repeated unless the recuperation reaches a certain point 
and then ceases ; in which event, select a remedy according to indi- 
cations. 

*The remedies marked f should be bought as triturations. Ask the pharmacist to pre- 
pare them all on the decimal scale, and so, also, the dilutions. The triturations may be 
given dry on the tongue, a small powder the size of a pea ; or the same amount or more 
dissolved in half a tumblerful of water, a teaspoonful at one dose, when it is desirable to 
repeat the medicine at short intervals. 



610 HOMCEOPATHIC TREATMENT OF DISEASES. 

4. The same remedy may be repeated in case of continued con- 
valescence becoming interrupted, provided there is no change other 
than amelioration of symptoms. 

5. A change of remedies is admissible in obstinate cases, when one 
has been employed for some time without the desired effect. In 
chronic cases, it is well to try the remedy at least a week before 
changing. 

6. In chronic diseases, the remedies need not be repeated oftener 
than once or twice in twenty-four hours, and even at longer intervals. 

FORMS OF MEDICINES FOR ADMINISTRATION. 

There are four forms in which homoeopathic medicines are pre- 
pared for use : 1. Mother tinctures prepared from fresh plants; 2. 
Triturations prepared from metals, salts, earths, and herbs ; 3. Dilu- 
tions prepared from the tinctures;* and, 4. Globules medicated with 
the solutions. The last two are generally employed, and the first 
two occasionally, in household practice. When water is employed 
as a medium for the administration of either form, five drops of the 
tincture or dilution, or ten globules (use size No. 30), or three or 
four grains of the trituration, may be thoroughly mixed in half a 
tumbler of water, and a dessertspoonful of this mixture will suffice 
for a dose. The tumbler containing the medicine should be care- 
fully covered, and kept away from the light and from any cor- 
rupting odor; and all other medicines, teas, tonics, and stimulants 
are strictly prohibited during its administration ; and all medicated 
poultices, lotions, and the like, must be avoided, because of their 
interference with the medicinal action of the remedy. 

RULES FOR PRESERVING THE PURITY OF MEDICINES. 

1. The medicines should be kept in a small box or chest, exclu- 
sively for this use, carefully closed, and in a cool place. Examine 
the corks often to see that they are perfectly tight. 

2. Be careful to keep the vials corked always with the same cork, 
or one that has never been used for any other purpose ; and be par- 
ticularly careful not to misplace the corks, or fail to replace the 
identical one each time when a vial is uncorked for use. 

3. Never put medicine into a vial that has been already used for 
one of a different kind, unless it be thoroughly washed and baked. 

4. Every vial should be labelled, to prevent mistakes ; and every 
glass, spoon, or cup should be carefully cleansed before using it in 
the preparation of a remedy. 

5. Never use the same spoon in giving medicines of a different 
kind to different persons sick in the same house. 

* Dilutions are recommended to be prepared on the decimal scale. 



HOMCEOPATHIC TREATMENT OF DISEASES. 611 



ANTIDOTES TO MEDICINES. 

In some exceeding impressible conditions, the remedy chosen may 
produce intense aggravation of suffering, which may be relieved by 
the administration of a drop of Spirits of camphor. If Belladonna 
should provoke an aggravation, Aconite will antidote its effect, and so 
will Camphor ; and this latter is regarded as the general antidote of 
homoeopathic remedies, two of which should seldom be given in alter- 
nation, because of the liability of their neutralizing the effects of 
each other. For the same reason it will not do to change from one 
remedy to another suddenly. A period of from four to six hours 
should intervene in acute cases, except in emergencies of great pain, 
and from one to two days in chronic affections. 

EXTERNAL APPLICATIONS. 

Compresses wet with cold water, covered with a dry bandage, are 
always a convenient and successful resort for bruises, sprains, and 
injuries in general. Tepid applications, or cold when agreeable, in 
the same way, may be applied to local inflammatory affections. Warm 
poultices, to hot and inflamed surfaces, will often exert a salutary 
influence. The tinctures named for external use may at times be 
employed in full strength ; but lotions made of a teaspoonf ul of any 
one of them, to a cupful of cold water, is the usual form of applying 
them. Mustard poultices may be employed, either in full strength, 
or tempered by adding to the ground mustard a due proportion of 
meal. Simple cerate, cold cream, and healing salves may be em- 
ployed when needed ; but any strongly medicated poultice, plaster, 
salve, or ointment must not be used when taking homceopathic reme- 
dies. 

BATHING. 

Persons of debilitated constitutions should not bathe too frequently; 
for those of robust constitutions, this luxury may be indulged in to 
almost any extent. Bathing in very cold water is not recommended. 
Tepid baths are the most beneficial, and should be taken regularly 
throughout the year. Hot baths are weakening and relaxing. They 
may be employed for children in convulsions, and to overcome rigid- 
ity of the skin, or for a cold. Sulphur baths are sometimes recom- 
mended for rheumatism; but they should be taken with caution ; and 
this remark is applicable to all vapor-baths. Sea-bathing is good for 
dyspepsia, and those inclined to biliary derangements. Consump- 
tives derive but little benefit from any kind of bathing aside from 
necessary ablutions. The addition of salt to the water is recom- 
mended in cases of debility. 



612 HOMCEOPATHIC TREATMENT OF DISEASES. 



DIET AND REGIMEN. 

But little need be said about diet here, as that which is appropriate 
is pointed out in the following pages, as a part of the treatment for 
each individual case. It may be remarked simply that no medicinal 
condiment or food, no stimulant or other medicinal beverage, can be 
employed when taking homoeopathic remedies ; and, further, all pa- 
tients must be placed in the best possible condition for recovery. 
They must have clean and well-ventilated apartments, and plenty of 
fresh air. They must have clean and well-aired bedding. They 
must have proper clothes and food to correspond with the appetite 
and wants of the system. An experienced nurse is of great impor- 
tance, especially in fevers. 

For description of diseases, see first part of this book. It is unneces- 
sary to duplicate the descriptions and symptoms, as they are the same 
for any school of medicine, the remedies and manner of treatment 
only differing. 



. 



DISEASES OF THE HEAD. 



Headache. — Cephalalgia. 

This affection is usually attendant on other difficulties, and must 
be treated with reference to the cause. If from cold, affecting the 
entire system, and accompanied by pains in the back, give Nux 
vomica. If from heat, or determination of blood to the head, Bella- 
donna. If from chilliness, Arsenicum. For rheumatic headache in 
cold, damp weather, Bryonia. For that produced by constipation, 
Nux vomica. Bilious, Merc. viv. Sick-headache, Iris versicolor, Sepia, 
Pulsatilla, or Sulphur. Nervous headache, Coffea. For headache 
caused by suppressed eruption, Oalcarea or Sulphur. From sup- 
pression of the menses, Pulsatilla. From a fall, or fatigue, Arnica. 
From simple cold in the head, Aconite. A dose of four globules, of 
any remedy selected, may be repeated every four hours until relieved. 

Vertigo, Swimming of the Head. 

This uncomfortable feeling consists in a sensation of the head 
whirling around, causing one to stagger, and sometimes to fall. If 
from a deranged stomach, Nux vomica. If from a cold, Gelsemium 
or Arsenicum. From derangement of the biliary system, Aconite, 
Pulsatilla, or Bryonia. Vertigo produced by rush of blood to the 
head, Aconite or Belladonna. The remedy indicated may be repeated 
in the usual dose every two hours. For vertigo from riding in a 
carriage, Cocculus. From a shock or fall, Arnica. Dose and ad- 
ministration as above. 

Ringworm of the Scalp. 

This is a pustular eruption, that begins at one or more points upon 
the hairy scalp, and spreads sometimes so as to involve much of the 
surface. When there are a number, they spread until they coalesce 
and form a continuous eruption, from which exudes a greenish or 
sanious matter, that mats the hair, and renders the whole appearance 
of the head disgusting. Great care is required to keep the surface 
clean ; and, for this purpose, no soap should be used. Water, softened 

613 



fil4 DISEASES OF THE HEAD. 

by the white of a raw egg, is a better wash. Calcarea may be ad- 
ministered in the usual dose every morning and evening. If this 
remedy does not prove efficient, give Sulphur in the same way, and 
also Hepar sidph., or Lycopodium. The head ma}^ be, at the same 
time, washed once or twice a day with a lotion made of twenty drops 
of the tincture of Sulphur in a half-tumbler of water. 

Scald =head. — Tinea Capitis. 

This is also an eruption upon the scalp, that may be dry or humid. 
For the dry scald-head, Natrum muriaticum or Sulphur may be ad- 
ministered twice or three times a day. For the humid scald-head, 
Lycopodium, Arsenicum, Conium, or Graphites may be given twice a 
day. The same restriction as to the use of soap must be observed, 
and the same measures for cleansing may be recommended, as in the 
case of pustular ringworm of the scalp. 

Ulcers of the Scalp. 

In scrofulous children, these ulcers sometimes occur in the form 
of small furunculi, or boils, exceedingly sore and painful. The best 
remedies are Arsenicum, Hepar sulph., Nitric acid, and Silicea. They 
may be given as required in daily doses of four globules. The ulcers 
may be wet with Hamamelis Virginica, after having been pricked with 
the lancet. 

Baldness. 

When the hair falls from the head by reason of debility, the reme- 
dies to be given are China and Ferrum ; when in consequence of 
perspiration, Mercurius ; from the use of quinine, Belladonna, or 
Pulsatilla ; if from the abuse of mercury, Carbo. vegeta. ; if from 
grief or trouble, Phos. acid. If baldness occurs after protracted 
inflammatory diseases, and nervous and typhoid fevers, give Calcarea 
in daily doses, or Hepar sulph. and Silicea. For dandruff, give Ly- 
copodium. 



DISEASES OF THE BRAIN AND NERVES. 



Brain Fever. 

This disease comes on with more or less pain in the head, attended 
with heat and delirium ; the eyes also exhibit a red or fiery appear- 
ance : and this pain, heat and delirium are sometimes followed by drow- 
siness and inclination to vomit. The pulse is usually rapid and feeble. 
In brain fever, there is loss of appetite, great restlessness, short, com- 
atose naps, and frequent inclination to cry out with pain. Aconite is 
useful to commence with, and this may be followed with Belladonna. 
If respiration is hurried and labored, give Arsenicum. If brain fever 
is brought on by a fall, or a blow upon the head, give Arnica ; and if 
no relief follows in twenty-four hours, Glonoin. If from trouble or 
grief, Ignatia. If from intoxicating drinks, Nux vom. If at the men- 
strual period, Pulsatilla. If from intense study, or close application 
to business, Sulphur and Nux vomica. 

Rush of Blood to the Head. 

The signs of this occurrence are intense headache or vertigo at 
first, which is followed by fainting, and often with loss of conscious- 
ness ; at times there will be twitching and spasms. The difficulty 
may occur from various causes, and is common with females and 
those of nervous temperament. Aconite, in solution, may be put in 
the mouth of the patient, and also the head may be wet with cold 
water. The head should be laid a little lower than the body ; the 
lower extremities should be rubbed, and friction should be applied to 
the arms and hands. Belladonna may be given after Aconite, or, in 
grave cases, Glonoin. If the rush of blood has been caused by run- 
ning and getting heated, give Arnica, and bathe the temples with a 
solution of twenty or thirty drops in half a tumbler of water. If at 
the menstrual period, give Pulsatilla. In plethoric persons, exposed 
to the heat of the sun, give Nux vomica, and apply friction to the ex- 
tremities. If in consequence of having drunk stimulating beverages, 
Arsenicum and Nux vomica. If from indigestion, Pulsatilla. If from 
fright, Aconite. If from exposure to winter cold, Camphora. The 

615 



616 DISEASES OF THE BRAIN AND NERVES. 

dose of any of the remedies selected may be repeated every fifteen 
minutes until the patient is better. 

Sunstroke. — Coup de Soleil. 

Protracted exposure to the heat of the sun will sometimes pro- 
duce a sudden prostration of the nerves, and an intense headache, 
causing blindness, vertigo, and extreme sensitiveness to the glare of 
light, and sometimes a sudden chilliness and shuddering, extremely 
alarming. This is termed sunstroke, and frequently is so intense as 
to prove fatal in a few hours. The remedies that have been found 
the most useful are Glonoin, Belladonna, Phosphorus. These may be 
given singly, and repeated, until relief is obtained, every thirty min- 
utes. As soon as the patient recovers consciousness, give China, in 
the usual dose, several times a day ; or, if there be disturbance of di- 
gestion and feeble voice, or entire loss of voice, Antimonium crudum. 
The patient, when convalescent, should be kept out of the sun, and 
away from strong light. After one has suffered from sunstroke, it 
may be several weeks before he really recovers. When it occurs in 
summer, his system will be exceedingly impressible to the sun's rays 
until cold weather, or until his nerves regain their normal vigor. 
Great care should be exercised in reference to the diet. For after 
treatment, Lachesis or Nitric acid often indicated. 

Apoplexy. — Apoplexia. 

This alarming disorder is the result of a sudden determination of 
the blood to the head, which produces a rupture of some one or more 
of the blood-vessels of the brain, and a hemorrhage in the nervous 
centre. When only the left side of the brain sustains this injury, 
the right, upper, and lower extremities are liable to paralysis. When 
the right is similarly effected, the left side usually becomes paralyzed. 
When both hemispheres of the brain become implicated in the hem- 
orrhage, there usually occurs general paralysis, and the patient falls 
entirely senseless. There are premonitory symptoms of this disorder, 
which, if carefully heeded, may suggest a treatment that will ward 
off the difficulty. These symptoms are vertigo, fullness, and dull 
headache, and sometimes nose-bleed. When one feels an uncomfort- 
able fullness of the head, under which he walks with an unsteady 
gait, he may find relief by one or two doses of Aconite ; or if he finds 
this uncomfortable fullness takes the form of a dull, stupefying head- 
ache, Belladonna may be preferable, and is the leading remedy. If 
there is vertigo and fullness, with prostration, JVux vomica is indicatedo 
In case of nose-bleed, give Aconite, Bryonia or Pulsatilla. These pre- 
liminary symptoms may be made to disappear with these remedies, 
when otherwise they might augment until an apoplectic attack set 
in. Then is the period of danger. But few cases of sanguinary 



DISEASES OF THE BRAIN AND NERVES. 617 

apoplexy are cured ; and yet some do recover. When the clot pres- 
sing upon the brain is of small size, and the hemorrhage comparatively 
light, an absorption of the clot may take place, and the patient re- 
cover ; but, when the clot is too large to be disposed of by the pro- 
cess of absorption, it becomes an obstacle in the way of recovery : 
and yet active measures should in all cases be called into requisition. 
Aconite should be placed in the mouth, and the face should be bathed 
with it. The bowels should be moved by an enema, and cold appli- 
cations, or rather applications of tepid water, should be made to the 
head. Friction should be applied to the surface of the entire body 
and the extremities. Belladonna is also a remedy that may be ad- 
ministered, if possible, and repeated every half-hour or hour. Ignatia, 
in persons of lymphatic temperament, may be given in the same way. 
Arnica may be administered internally and externally. The skin 
may be rubbed with it ; the usual doses may be given every hour, by 
placing the globules in the mouth. If the attack follows the nose- 
bleed, and there is heavy or labored breathing, Arsenicum or Pulsatilla 
may be used. It is important to get an action on the bowels as soon 
as possible. 

Epilepsy, Fits. 

This disease is termed the falling sickness, as, without warning, 
the patient loses consciousness, and falls insensible to the ground or 
floor, with convulsive motion of the limbs, distortion of the muscles 
of the face, frothing at the mouth ; and sometimes the mouth, lips 
and jaws are spasmodically closed, the hands clinched, and a general 
rigidity of the muscles of the entire body. After a time, the rigidity 
passes off, and all the muscles become relaxed ; the patient then ap- 
pears to be in a deep slumber, and remains so for a longer or shorter 
period, and then awakes to consciousness, feeling wearied, but totally 
unaware of anything unusual having occurred. Confirmed epilepsy 
is rarely, if ever, cured. When the disease is not congenital, the in- 
cipient stage may be overcome. Sulphur, or Calcarea carb., may be 
given when the first signs of the difficulty occur ; and this may be 
followed with Belladonna, Hyoscyamus or Ignatia. When epilepsy is 
brought on by intemperance, its first signs may be attacked with Nux 
vomica, and the sooner the patient can be brought into a state of total 
abstinence the better. Cuprum met. may be given to this class of 
patients when there is pain in the head, and nausea, attending the 
incipient stage. Opium, when there is inclination to sopor, may be 
given every two hours. Stramonium, also, when there is deep sleep 
and loss of consciousness. When there is loss of memory following 
one of these falling or unconscious fits, give Sulphur, China, Ferrum 
and Nux vomica, — all are required to effect a cure ; the only hope 
for which is in preserving the patient in a condition for the curative 
action of the remedies. In all cases, between the attacks, no fat 
food should be eaten ; but a simple, nutritious, and spare diet should 
be adhered to. 



618 DISEASES OF THE BRAIN AND NERVES. 



Acute Inflammation of the Spinal Cord. — Myeletis. 

This is denoted by pain in the back, along the course of the spine, 
which also effects the spinal nerves, and results in general suffering 
of the trunk. When the cervical or neck portion of the cord is im- 
plicated, there is pain and stiffness of the neck, and pain in the back 
part of the head ; and sometimes the accessory nerves become so af- 
fected as to produce derangement of the organs of speech and deglu- 
tition. Aconite is one of the remedies that must be employed to re- 
move the inflammation when in this location. Hypericum is another ; 
and this may be used internally and externally three times a day. 
Verat. virids is considered by some a specific remedy. When the 
dorsal portion of the spinal cord is beset with inflammation, there is 
shortness of breath, dyspnoea, or fainting, and a sense of suffocation. 

There is, at the same time, pain in the back and chest, and rapid ac- 
tion of the heart. The spinal accessory nerves, that supply the in- 
tercostal muscles, partaking of the difficulty, renders the function of 
lungs, diaphragm and heart, severally, impaired. Aconite, for the in- 
flammation in this locality, may be given at first, and repeated every 
hour; and a lotion of, twenty drops of the tincture in half a tumbler 
of water may be applied to the spine. Belladonna may be given 
when there is intense pain between the shoulder-blades. Bryonia is 
quite essential when every motion of the patient aggravates the suf- 
fering ; Oonium, when the pain is not so marked, but the respiration 
is difficult ; Cocculus, also, when the pain in the back affects the stom- 
ach, producing nausea and prostration ; Pulsatilla, when this occurs 
in young women and children, or in those of lymphatic temperament. 
The patient should take but little exercise, if any. If only the lower 
portion of the spinal column is affected, there will be pain in the 
small of the back. The secretion of the kidneys may be diminished 
or increased ; the bladder, also, may be implicated. The womb may 
be subject to neuralgic pains ; the nerves accessory may implicate the 
abdomen, and cause severe pains. Nux vomica, when the pain is the 
most prominent in the small of the back, and when there is pain in 
the bowels, and constipation. When the bladder is implicated, or 
spasmodically closed, Hyoscyamus is the remedy. When there is too 
great secretion of the urine, Nux vom. and /Sulphur will obviate the 
difficulty. When this portion of the spinal cord is affected, the 
womb may become subject to neuralgic pains. Belladonna, Oicuta, 
Ignatia and Nux vom. are all valuable remedies. Conium, to remove 
the inflammation of the cord, may be given every three hours, until 
the pain ceases. If spasms attend the difficulty, give Hyoscyamus 
every two hours, as long as they last, or else Ignatia or Belladonna. 
If the inflammation is brought on by a fall, or shock upon the nerves, 
give Hypericum every two hours, and bathe the back with a lotion of 
the tincture, — forty drops in half a tumbler of water. Bryonia is 



DISEASES OF THE BRAIN AND NERVES. 619 

also good for inflammation of the cord in the lumbar region, and es- 
pecially when motion augments the suffering. The diet for all per- 
sons having the nervous centres implicated must be simple and nu- 
tritious. 

Paralysis, Palsy, 

When the whole muscular system becomes so feeble and trembling 
as to be no longer controlled by the will, it is a case of palsy; and 
this is brought on by some trouble in the nervous centres. It attends 
apoplexy, epilepsy and other affections incident to the nervous cen- 
tres. Inflammation of the spinal cord will often produce the affec- 
tion. The palsy may affect only one hand or one cheek ; or it may 
be more general, and all the muscles may be smitten with paralytic 
weakness. Belladonna is often indicated for right-sided paralysis, 
and is, perhaps, the best remedy, in the majority of cases. Pulsatilla 
is one of the best remedies for this disorder : give a dose of it three 
times a day. If this does not cure, give Oocculus, in the same way, or 
Nux vomica, China or Ignatia. For palsy of the tongue, give Calearea ; 
for palsy of the face, Pulsatilla ; for palsy of the arms and legs, give 
Mercurius viv., Nux vomica, Pulsatilla and Bryonia. If the palsy is the 
result of a shock or fall, give Arnica. If great weakness and slow 
fever, give Rhus tox. Strong tea and coffee are not advisable bever- 
ages for those threatened with palsy. Water, milk and black tea of 
moderate strength may be allowed. 

Lockjaw, Trismus. 

One of the most painful affections that can assail human nature is 
the shock upon the nervous system produced by a wound. Lockjaw 
is a rigid stiffness of the muscles of the jaws, by some irritation from 
a wound being first sent to the brain, and thence, by some nervous 
channel, to the muscles that control the jaws ; causing them to as- 
sume a painfully rigid hardness, closing them beyond the possibility 
of opening them. Pain oftentimes is felt in other muscles, at the 
same time causing them to be rigid. One of the common resorts to 
control traumatic fever, or the fever produced by a wound, is brandy 
or whiskey. It is said that large drafts of either will have no intoxi- 
cating effect when this fever is present. Tincture of Opium, Black Drop 
and Opium itself, have been given to antidote it, and sometimes with 
success. One of the best remedies for traumatic fever, or that pro- 
duced by a wound, is Arnica. It may be given every hour or two 
hours, internally ; or applied, in the full strength of the tincture, to 
the wound. There can be no other remedy more likely to produce 
pleasant results, unless, from actual injury of some nerve, Hypericum 
is made to take the place of Arnica. If the patient is nourished 
through a quill, and the circulation is made vigorous by stimulants, 
and the intensity of the pain is kept under by anodynes, the remedial 



620 DISEASES OF THE BRAIN AND NERVES. 

effects of Arnica and Hypericum may cure. Lachesis has benefited 
some cases. 

Tetanus. 

This is the general disease of which the foregoing is a part. A 
wound either in the ball of the foot or palm of the hand may so for- 
cibly transfer its irritability to the brain, that the brain distributes 
the effect to the whole system, producing that most painful of all mor- 
tal sufferings, — the lockjaw or general tetanus. Belladonna, Nux 
vomica, Ignatia, Mercurius viv. and Sulphur may be employed in the 
general form of the disease, in addition to the treatment for lockjaw. 

Delirium Tremens. 

This disease is the sequel of persistent inebriation. When a man 
forgets the extremity to which his appetite may lead, and keeps his 
nervous system excited even to intoxication, after a while his stomach 
will lose its tone, and become extremely irritable ; his system conse- 
quently gains but little support from food: and, what is still worse, 
his strength leaves him ; his mind, operated upon by his weakened 
nerves, is filled with fancies, and he is unable to sleep. Even before 
he becomes delirious he has what in common parlance is termed " the 
horrors," which seem to be a wretched, nervous agitation and fearful 
foreboding of trouble. Finally, the mind becomes so unsettled as to 
be totally deranged. Illusory pictures present themselves continu- 
ally ; such as serpents and other reptiles, with other hideous sights 
too numerous to particularize. Unless some remedial measures are 
made available in procuring sleep, his life in this world will soon ter- 
minate. Bryonia once cured a case of delirium tremens in an army 
officer, who, in delirium, had passed eight successive nights without 
sleep. Nux vomica will often quiet the nerves, and bring about a cure. 
Opium is a valuable remedy, and, in large doses, has been employed 
for many years. Arsenicum is a valuable remedy to allay the irrita- 
bility of the stomach ; Ignatia, also, when there is much inclination 
to weep. The dose of any of the remedies may be four globules, or 
from one to five drops of the dilution in a spoonful of water ; re- 
peated at intervals of one or two hours. As soon as the patient can 
eat, give him the lightest kind of food, gradually increasing its 
strength until he is able to take full meals. 

Neuralgia. 

This disease is a simple pain in the nerves, and manifests itself in 
various parts of the body, — most frequently in the face ; and may 
be caused by decayed teeth, or any weakening influence, such as loss 
of blood, diarrhoea or dysentery. A torpid liver or feeble digestion 
may be the source of the pain. It is usually a stubborn disease, and 



DISEASES OF THE BRAIN AND NERVES. 621 

proves in some cases an agony of suffering for years. It accompanies 
spinal irritation. It often follows miscarriages in females, and is too 
frequently an accompaniment of other female diseases. When diseased 
teeth are evidently the cause, Arsenicum or Belladonna may afford re- 
lief ; or else let the tooth or teeth be extracted. If from extreme de- 
bility, China and Arsenicum. Chamomilla, when there is a flushed 
face and much restlessness and extreme inquietude. Conium, when 
it accompanies spinal irritation. Sepia and Calcarea, when depen- 
dent upon uterine derangement. For neuralgia of the stomach and 
bowels, give Cocculus, Ignatia or Pulsatilla. That which occurs after 
miscarriage, dysentery or diarrhoea, requires China, Ferrum, Nitric 
acid or Sulphur. Avoid rich foods. Live on a plain, nourishing diet 
and keep out of doors as much as possible. 

St. Vitus's Dance, Chorea. 

A debilitated condition of the nervous system may show itself 
in involuntary twitchings of the muscles of the face, extreme rest- 
lessness of the limbs, involuntary movements of the hands, arms, and 
the entire body. Nux vomica, Ignatia and Cocculus are remedies that 
will cure a majority of cases. China is best for debilitated persons ; 
Belladonna, for those of nervous temperament ; Sulphur, when there 
has been suppressed eruption. One remedy should be selected and 
tried first, and repeated every three hours until the patient is better ; 
or, in case of no change, select another, and so on. Children afflicted 
with chorea should not be confined in school or be tasked with 
studies. 

Stammering. 

This is but another form of chorea, affecting the organs of speech. 
Belladonna, Sulphur, Hyoscyamus and Causticum have been employed 
against this difficulty and with success. The training of young boys 
or girls addicted to stammering, to be deliberate in their efforts to 
express themselves, will often accomplish more than remedies. It is 
remarked that stammerers can sing or utter any sentence in song. 
This would indicate the propriety of enjoining upon all thus affected 
to practise slow and deliberate speech. Cuprum met. is a remedy that 
has cured many cases ; and so has Ferrum, Ignatia and Belladonna. 
Employ each remedy singly and repeat every three hours. 

Loss of Memory. 

Fokgetfulness may be the result of nervous disease, as well as 
of heedlessness. Great and debilitating losses often impair the mem- 
ory; so does a resort to Opium to destroy pain. Excesses of any 
kind may result in this difficulty. The remedies that have been em- 
ployed are Phosphoric acid, Sulphur, Nux vomica and Ignatia. Of 
the remedy selected, prepare twenty drops in half a tumbler of water 
and give a tablespoonful twice a day. 



DISEASES OF THE EYE AND LIDS. 



Stye. 

This is a small tumor on the lid, about the size of a pea, which is 
quite painful. Aconite will often cure in a day ; Pulsatilla, also, af- 
fords speedy relief ; Belladonna, when the inflammation of the stye 
causes redness of the eyeballs; Staph, prevents their recurrence, 
taken once daily for a while. 

Inflammation of the Eyelids. 

When the entire lids become involved in acute inflammation, 
Aconite, in the usual dose, may be given every two hours until re- 
lieved ; Puis., the same way, when there is burning, with flow of 
tears. If the lids become congested, red and swollen, give Bella- 
donna. If the inflammation is chronic, give Calcarea once a day, 
or else Sulphur or Hepar sulph. If dependent upon gastric or 
bilious derangement, give Nux vomica or Mercurius every two hours 
until relieved, the latter especially when there are cutting pains, 
worse nights. 

Iritis, Inflammation of the Iris. 

The little circle in the front of the eyeball, which we call the iris, 
is subject to inflammation. It may result from a cold, or from in- 
jury, or from some impurity of the blood. When from a cold, Aco- 
nite speedily affords relief. If very painful, Belladonna. If from 
injury, Arnica or Aconite. The patient must be kept in a dark room 
until the inflammation passes off. To relieve acute pain, resort has 
been had to Morphine, in one-eighth of grain doses, repeated every 
four hours if necessary. It is doubtful if any external applications 
in iritis ever prove beneficial. If any are used, none are better than 
water in which six grains of Opium to a gill has been boiled. 

Scrofulous Sore Eyes. 

In persons of a strumous constitution, a cold, or any undue ex- 
posure of the eyes, may cause them to be the seat of scrofulous in- 



DISEASES OF THE EYE AND LIDS. 623 

flammation; in which event, there will be a redness of the eyeballs, 
and swelling and ulceration of the lids, and a greater or less accumu- 
lation of matter beneath the lids. This disease is often very painful, 
and destructive to the coats of the eye; and, what is worse, it be- 
comes the fruitful source of cataract and blindness. When the eyes 
first become inflamed and burning, Arsenicum may be given ; when 
the lids are implicated, give Oalcarea ; when the inflammation passes 
off, leaving white spots on the cornea, give Sulphur, Hepar sulph. 
or Conium. Daily doses of the remedy selected will be sufficient. 

Syphilitic Sore Eyes. 

Sometimes syphilis will affect the eyes and threaten the destruc- 
tion of sight. The lids will inflame ; the cornea will be congested, 
and of a bluish red ; the conjunctiva will become the seat of inflam- 
mation, and sometimes of ulceration. Mercurius iod. may be given 
first, while the patient is kept in a quiet and dimly illuminated room, 
two doses daily. If the patient has already been treated with Mer- 
curius, give Nitric acid or Hepar sulph. If considerable matter ex- 
udes from under the lids, give Aurum once a day ; and if the eyes 
itch continually, give Sulphur. 

Cataract. 

This film that obstructs the sight of the eye is undoubtedly the 
sequel of scrofulous inflammation or injury of the crystalline lens. 
It is simply an abnormal growth of a film over the pupil of the eye, 
partially if not wholly obstructing the sight. Conium mac, given 
twice a day. Merc. iod. is also a good remedy ; Phosphorus, Causti- 
cum or Sulphur may be indicated. Either may be repeated twice a 
day when selected. 

Rheumatic Sore Eyes. 

Rheumatism of an inflammatory character may fall with great 
force upon the eyes, and produce severe pain and temporary blind- 
ness. Nux vom., Belladonna, Bryonia and Aconite are remedies that 
may be consulted. Bryonia may be given three times a day, when 
every effort to open the eyes is attended with pain; Belladonna, 
when the pain is such as to give the sensation of the eyeball being 
too large for the socket; and also when there is a feeling as if the 
eyeball would burst. Sulphur, for dull pain in the eyeballs, and the 
sight impaired. Rhus when the eyes are pink and lame on moving 
them. 

Gonorrhoea! Sore Eyes. 

When the eyes become inoculated with gonorrhoeal matter, there 
will be smarting, and then inflammation and swelling of the lids, and 



624 DISEASES OF THE EYE AND LIDS. 

such serious infiltration as to close the eyes; and, in a very brief 
period, a perfect disorganization of the texture of the eye will take 
place. As soon as the character of the inflammation becomes known, 
it is well to make some compresses of linen a half-inch thick, and 
bind them tightly over the eyes, and then give Cannabis every three 
hours for two or three days ; afterwards, give Cantharis in the same 
way ; and, after the smarting pain begins to cease, carefully remove 
the compress, keep the patient in a dark room, and Sulphur, in daily 
doses, may complete the cure. 

Specks on the Cornea, 

Little opaque spots on the cornea may be left after scrofulous in- 
flammation has passed away. These may be removed by daily doses 
of Sulphur or Euphrasia. 

Watery Eyes. 

When the eyes are watery, or prone to become so, from slight ex- 
posure to wind or cold, the difficulty may be obviated with daily 
doses of Pulsatilla, Mercurius vivus or Lachesis. Blood-shot eyes 
will be relieved by daily doses of Euphrasia. 

Squinting, Strabismus. 

What is termed cross-eyed in persons is usually the sequel of some 
cerebral disturbances that have deranged the normal action of the 
little muscles that regulate the position of the eyeballs, and give 
them an abnormal or squinting appearance. Sometimes daily doses 
of Hyoscyamus or Belladonna will entirely remedy the difficulty. 
Short-sightedness may be remedied by daily doses of Sulphur, 
Lycopodium or Pulsatilla. 



DISEASES OF THE EAR. 



Inflammation of the Ear. 

When there is inflammation and swelling of the external ear, and 
it has a red and fiery appearance, Pulsatilla may be administered 
twice a day. If the swelling and inflammation extend within, so as 
to close the external orifice, give Belladonna twice a day until the 
difficulty passes away. If suppuration threaten, Hepar sulph. 

Earache. 

This may result from cold, or from gatherings within the ear ; or 
it may possibly be neuralgia, or proceed from decayed teeth ; or, in 
children, from teething. When from cold, give Chamomilla or Dul- 
camara three times a day ; if from injury, Hypericum or Arnica; if 
from gatherings, Hepar sulph. or Calcarea ; if from decayed teeth, 
Mercurius viv. ; if in teething children, Pulsatilla, two doses a day ; 
if the pain is neuralgic, give Nux vomica or Belladonna. The core of 
an onion baked, applied to the ear as hot as it can be borne, will often 
give relief. 

Running of the Ears. — Otorrhcea. 

Otorkecea may be occasioned by a cold, when there are no sores. 
For this, give Pulsatilla; when from sores in the ears, Calcarea. If 
this should fail to cure, try, in succession, Sulphur, Mercurius viv. 
and Silicea, 

Deafness, Hardness of Hearing. 

To remedy this difficulty when produced by a cold, give Nux vom- 
ica every night until relieved. For that which occurs after scarlet 
fever, Calcarea, and for that after measles, give Pulsatilla ; from 
hardened wax, Sulphur ; if from rush of blood to the head, or con- 
gestion, Aconite or Belladonna ; Causticum, if these fail. The reme- 
dies may be repeated every four hours until relieved. 

625 



626 DISEASES OF THE EAR. 



Nervous Deafness. 

When the nerves of the ear lose their vitality, and deafness re- 
sults as the consequence, Phosphoric acid may be given, in drop 
doses, twice a day ; or Sulphur may be given every night, or Nux 
vomica or Causticum, in like manner. When deafness occurs from 
Rheumatism, Pulsatilla may be given three times a day. Arsenicum, 
Nitric acid, Calcarea and Mercurius viv. may likewise be consulted. 
If deafness occurs, from suppressed eruption, the remedies are Sul- 
phur, Calcarea, G-raphites or Causticum in daily doses. If deafness 
is the sequel of malarious fevers, Phosphorus or Phosphoric acid, in 
daily doses ; if from sudden check of nose-bleed, or discharges from 
the nose or ears, Hepar sulphur or Lachesis ; if from enlargement of 
the tonsils, Nitric acid, Mercurius or Aurum. 



DISORDERS OP THE NOSE. 



Nose-bleed . — Epastaxis. 

This trouble arises from various causes and must be treated ac- 
cordingly. When it arises from arterial excitement, Aconite ; from 
an injury, Arnica ; from rush of blood to the head, Belladonna ; if 
from inflammation of the lungs, Bryonia; in typhoid fever, Rhus 
tox. ; if caused by worms, Cina or Spigelia; if from weakness or de- 
bility, China or Carbo veg. ; if from cold or coryza, Nux vomica. Dose, 
three times a day. To give immediate relief press up under the up- 
per lip or apply something cold to back of neck. 

Obstruction of the Nose. — Ozoena. 

Ozcena is an entire obstruction of the nasal ducts, from thickening 
of the mucous membrane or other causes. If from accumulation of 
the mucus, Pulsatilla ; if from suppressed eruption, Sulphur, Lyco- 
p odium and Calcarea ; if from scorbutic tendency, Bryonia ; if with 
dry crusts, Aurum. The usual dose, three times a day. 

Polypus of the Nose. 

Not infrequently a morbid growth attached to the mucous mem- 
brane of the nose will fill the entire nostril. This is termed a poly- 
pus and is perfectly curable. Calcarea, when the disease appears in 
scrofulous subjects ; Sanguinaria, when a cold has been the exciting 
cause ; Sepia, when there is a pain in the head and nausea ; and Sta- 
physagria, when it is the sequel of other disorders. The medicines 
may be given in the usual dose and repeated every four hours. 

627 



DISEASES OF THE RESPIRATORY 
ORGANS. 



The organs of respiration embrace the nose, larynx, trachea, bron- 
chia, lungs, pleura, heart and their appendages. We will, therefore, 
consider the diseases that affect them in their order. 

Coryza, Cold in the Head. 

When, from exposure to cold, the nose becomes stopped, and there 
is an inclination to sneeze, and the eyes become more or less affected, 
the following remedies, as indicated, will prove useful : Nux vomica at 
night, should the coryza be more apparent in the afternoon or even- 
ing, and particularly if it is attended with cold affecting the entire 
system. Stibium, or Tart, em., is a good remedy to lubricate the 
stoppage of the nasal passages ; Hepar sulph. also, when this stop- 
page is painfully disagreeable ; Arsenicum or Euphrasia, when there 
is a thin, acrid discharge from the nose. Pulsatilla is best for chil- 
dren and ladies when suffering from nasal catarrh. Coryza is syn- 
onymous with acute catarrh, as both affect the mucous membrane 
that lines the cavities of the nose. 

Chronic Catarrh is much like the acute, only all the symptoms 
have become persistent. Acute catarrh is often cured in a few days 
by Mercurius, Nux vomica, Belladonna, Pulsatilla, Tart, em., Hepar 
sulphuris and Sulphur; Mercurius, for stupefying headache with ca- 
tarrh ; Nux vomica, when the catarrh occasions nausea ; Belladonna, 
when there accompanies the difficulty pain over and in the eyes; 
Pulsatilla, when there is depression of spirits ; Tart, em., Hepar 
sulph. and Sulphur, to remove obstructions in the nasal ducts, and 
to subdue irritation and soreness of the external orifices of the ducts. 
Doses as usual, repeated three times a day. 

In the treatment of chronic catarrh, other remedies are called into 
requisition. Aurum metallicum, if there is a heavy yellow discharge 
from the nose, or crusts form at night; Mercurius iodatus, in scrofu- 
lous persons ; Aurum muriaticum, if there is any affection of the 
vomer or partition of the nose ; Sulphur and Hepar sulph. are both 
valuable remedies, as are Arsenicum and Lachesis, when the peculiar 
symptoms are such as to indicate their affiliation. The remedies for 

628 



DISEASES OF THE RESPIRATORY ORGANS. 629 

the chronic form need not be repeated so often ; once in twenty-four 
hours, in the usual dose, is sufficient. 

Inflammation of the Larynx. 

The upper part of the windpipe or trachea is termed the "larynx" ; 
and, when inflamed, it is said to be affected with laryngitis : and this 
may be acute or chronic. 

Acute Laryngitis, or Inflammation of the Larynx. — This trouble 
is denoted by cough, hoarseness and sore throat, affecting the voice, 
and rendering respiration somewhat difficult and conversation fa- 
tiguing or painful. It comes on from a cold and may be the continua- 
tion of a nasal catarrh. With the cough there is usually some expec- 
toration, or else a dry, uncomfortable sensation and inclination to be 
clearing the throat. If the pulse is febril or full, give Aconite in the 
first stage ; and, if there is painful soreness of the larynx, give Bella- 
donna. Aconite will remove the fever, and Belladonna the congestion 
of the capillary vessels of the mucous membrane, which causes the 
soreness. Mercurius viv. often follows Belladonna well. If, after the 
employment of these remedies, expectoration of mucus occurs from 
coughing, give Phosphorus or Sanguinaria. If the cough is tight, as 
if the larynx was closing up, give Sambucus. The remedies, in the 
usual doses, may be repeated every two hours. The diet should be 
simple, but nutritious. 

Chronic Laryngitis, or Inflammation of the Larynx. — The 

symptoms of this form of the disease are similar to those of the acute 
variety, only the cough and irritation are constant and the expecto- 
ration sometimes great. The disease becomes chronic from the 
weakening of the organ after one or more acute attacks of the dis- 
ease. It sometimes mitigates in warm weather, and returns again 
in winter. Argentum metallicum is a good remedy for the chronic 
form when characterized by soreness of the throat. Belladonna is al- 
ways useful when the difficulty is aggravated by a cold ; Phosphorus, 
when there is considerable collection of mucus, and Hepar sulph. 
when there are excessive dryness and hoarseness. Causticum is par- 
ticularly useful when the inflammation is persistent, and the cough 
constantly excited, and when it resembles a croupy cough, and comes 
on spasmodically or in paroxysms. When chronic laryngitis is not 
kept in check or cured, it soon runs into that formidable disease 
known as laryngeal consumption or becomes attended with hectic 
fever. In such a case, give Stannum or perhaps Sulphur ; but in no 
case more than one dose a day. The patient should be warmly clothed 
and should always provide for tempering cold air before it is inhaled 
into the lungs. The diet must be nutritious, and strictly non-medi- 
cinal. 



630 DISEASES OF THE RESPIRATORY ORGANS. 



Croup. 

Ceoup is of two kinds, spasmodic and membranous. The spas- 
modic is the result of a cold ; and it comes on with a hoarse, rough 
cough which is often spasmodic and suffocating. The catarrhal or 
membranous comes on like a cold, and then supervenes a crowing 
cough and copious collection of mucus ; and sometimes an exudation 
of a membranous character fills the larynx and upper portion of the 
trachea. For spasmodic croup, Tartar emetic is undoubtedly the best 
remedy ; Aconite, when there is fever ; Belladonna, if the throat is 
sore ; Ipecac, if the breathing is asthmatic. In membranous croup, 
a resort must be had to Aconite at first, to induce perspiration; if 
this fails, give Bryonia, and then Spongia, Iodine, Bromine and Hepar 
sulph., in the order mentioned. The usual doses may be given every 
fifteen or twenty minutes when the symptoms are alarming. Croup 
goes under the technical name of Cynanche Trachealis, because it im- 
plicates both the larynx and windpipe. 

Inflammation of the Windpipe. — Tracheitis. 

There is some resemblance of this disease to croup; and yet it 
may occur and not manifest that peculiar character. It is denoted 
by cough, sometimes exceedingly tight, at others looser, greater or less 
obstruction of the breathing, and some pain and soreness of the throat 
above and a tickling, raw feeling below, towards the bronchial tubes. 
Aconite is essential in the treatment of this difficulty, and also Bella- 
donna, Bryonia, Phosphorus, Causticum, Hepar, Sanguinaria and Spon- 
gia. It is to be observed, however, that only one of these remedies 
must be given at a time ; five drops in half a tumbler of water and a 
teaspoonful every thirty minutes. Diet simple and non-medicinal. 

Acute Bronchial Inflammation. — Bronchitis. 

As the name implies, the bronchial tubes become highly inflamed 
in this disease, or rather, the mucous membrane that lines them. 
There is much cough and expectoration. This disease is called ca- 
tarrhal fever in its acute form ; and, when the substance of the lungs 
becomes affected, it amounts to pneumonia. Acute bronchitis re- 
quires, for the reduction of fever, Aconite or Bryonia ; Belladonna 
may follow ; and when copious expectoration commences, give Phos- 
phorus ; and, some time after, give Ryoscyamus, especially for the 
cough at night, and also Calcarea carb. for the soreness and cough 
that may be created. Repeat the medicines, in the usual doses, three 
times a day. Diet as in all febrile diseases. Barley or flaxseed tea 
for drink and a light diet of toast is best. 



DISEASES OF THE RESPIRATORY ORGANS. 631 



Chronic Inflammation of the Bronchia. 

Like the acute form of the disease it has its seat in the mucous 
membrane that lines the bronchial tubes, and it is believed to be the 
sequel of acute bronchitis. It is always accompanied by a cough, and 
more or less expectoration ; now and then a paroxysm of fever. It 
is a tedious and troublesome disease ; and, when not cured, is always 
better in warm weather, and much aggravated in cold ; and this 
would point to a perpetual warm climate as its cure. When there 
are paroxysms of fever, give Aconite; if there is pain in the chest, 
Belladonna ; profuse expectoration, Phosphorus or Lycopod. ; hectic 
fever, Stannum ; when the throat is sore, give Causticum. Great care 
must be taken in the treatment of this malady, if a cure is expected, 
or otherwise it will terminate in a lingering consumption. The most 
generous living the patient's appetite will admit of must be supplied, 
but free from medicinal condiments. 

Lung Fever. — Pneumonia. 

Lung fever is indicated by pain in the chest, cougn, flushed face, 
quick pulse, rusty expectoration, headache, loss of appetite and op- 
pressed breathing. Aconite or Bryonia may be given, in the usual 
dose, every hour until the skin becomes moist ; Belladonna, if the 
pain continues in the chest, every hour until relief or a change is 
necessary ; Bryonia may follow Belladonna, if heat in the chest is a 
prominent symptom ; and Phosphorus may follow Bryonia, provided 
the expectoration has changed and a more plentiful secretion of mucus 
is thrown off. Each medicine may be given in hourly doses when 
called for. 

This disease becomes typhoid pneumonia when the fever accom- 
panying the inflammation is typhoid ; in which event Bryonia may 
be given in the first stage and Belladonna if there is a manifest in- 
clination to sleep. When the patient begins to cough up mucus 
tinged with blood, give Phosphorus ; and, if very much prostrated, 
give Rhus tox. As to diet in pneumonia, give the patient any light, 
nourishing and soothing drinks, as jelly-water, barley-water, rice-water, 
etc. Application of warm compresses to the chest is recommended. 

Whooping Cough. — Tussis Spasmodica. 

This disease often comes on like an ordinary cold and the victims 
are observed to have frequent coughing fits ; and when there is no 
fever or loss of appetite and the fits of coughing continue to be re- 
peated, it may fairly be inferred that whooping cough is progressing. 
Soon the child or patient will begin to whoop and to experience fre- 
quent paroxysms, and draw in a long breath or whoop, which is fol- 
lowed by numerous short expirations. Drosera will mitigate the 



632 DISEASES OF THE RESPIRATORY ORGANS. 

severity of the paroxysms, and so will Hyoscyamus, Corallia rubra, 
Sanguinaria and Causticum ; Chelidonium, if there are symptoms of 
pulmonary congestion ; but there is no remedy known that will break 
it up at once. Give a dose of the selected remedy immediately after 
each paroxysm. 

Pleuritis. — Pleurisy. 

Iistflammation of the pleura is denoted by sharp, shooting pains 
in the sides of the chest that interfere with respiration ; quick pulse, 
flushed face, great heat over the chest, etc. Aconite, in the usual 
dose, may be given every twenty minutes, and a cloth compress of 
warm water may be applied to the region of the pain. Aconite may 
be followed with Phosphorus, given every hour until relieved. Bryo- 
nia is good. 

Asthma. 

Difficult and laborious breathing may be hereditary or be brought 
on by a cold, over-exertion or exposure of some kind. It comes on 
in paroxysms that sometimes interfere with the respiration to so great 
a degree as to oblige the patient to sit or stand in order to get breath. 
Many cases are entirely curable with Ipecac, Arsenicum, Apis melli- 
fica, Apocynum, Lobelia and Tart, emetic. When one remedy fails, try 
the next until a fair warfare with the disease has been encountered. 

Bleeding from the Lungs. 

This trouble is occasioned by the rupture of some of the blood- 
vessels in the bronchial tube, caused either by mechanical injury or 
tubercles. If from the former, Arnica is the remedy; if from the 
latter, Hamamelis. In case of pain and inflammation, give Phospho- 
rus ; and if motion aggravates, give Bryonia. Let the patient sit up, 
if able, in an easy-chair until the bleeding ceases. If fever and ex- 
citement of the circulation exist, give Aconite often. Once in a half 
hour at first. To give temporary relief give strong salt and water. 

Consumption, 

This formidable disease may be hereditary or result from acci- 
dental causes. When hereditary, it may not develop itself until adult 
age ; and one of the first signs is extreme sensitiveness to cold, a 
slight cough, defective nutrition and extreme emaciation ; night- 
sweats come on subsequently, with hectic fever; and, at a later stage, 
there may be diarrhoea, which resists remedial measures and exhausts 
the life of the patient. That kind brought on as the sequel of pri- 
mary affections usually supervenes upon bronchitis or some other 
exhaustive disease that proves destructive to nutrition. In the first 
stage, or when chilliness, debility and loss of flesh become apparent, 



DISEASES OF THE RESPIRATORY ORGANS. 633 

much benefit can be obtained from the use of good old Bourbon or 
rye whiskey: from half to a whole wineglassful may be taken twice 
a day. The introduction of carbon into the system in this way has 
often proved of great service. When there is deep-seated pain in the 
lungs, especially in the upper portion, Lycopodium ; the usual dose 
may be given every day and continued as long as any benefit is per- 
ceived. Lycopodium may be followed by Stannum or Sulphur, pro- 
vided there is any hectic fever; by Oarbo animalis when there are 
night-sweats. If the cough becomes troublesome and the expectora- 
tion muco-purulent, Phosphorus in the usual dose may be given 
twice a day. If occasional hemorrhage, Belladonna may be given, if 
there is pain ; Ipecac, if there is asthmatic breathing ; and Hamame- 
lis vir., if there is bleeding from the lungs without much pain. For 
the first stage of bronchial consumption, see the treatment directed 
for bronchitis. After tubercles become manifest, the same remedies 
may be indicated as for the hereditary disease. The diet for con- 
sumptives should be fish, game, beef, mutton and vegetables such as 
potatoes, beans and egg-plant ; butter and cream, with toast, are also 
allowable. Let the diet be as generous as the patient can take. And, 
if possible, live in the open air. 



DISEASES OF THE URINARY ORGANS. 



The urinary apparatus includes the bladder and kidneys, and their 
appendages, all of which are subject to inflammation. 

Inflammation of the Bladder. — Cystitis. 

When urination becomes painful and difficult, and the orifice of 
the bladder seems to be insufficient for voiding the urine, we have 
indications of inflammation of the bladder ; and also when there is 
frequent inclination to urinate, with ability to pass but little at a 
time. Aconite maybe given at first if fever attend the difficulty; 
Belladonna might follow Aconite if there should be any congestion; 
Cantharis, however, is one of the best remedies, if there is tenesmus 
or straining. Cannabis sativa, also, is a good remedy, and with old 
people, Arsenicum is often beneficial. It is well to drink mucilagi- 
nous drinks, and subsist mostly on gruel, until the severe symptoms 
subside. All this trouble may pass from the acute to the chronic 
form of the disease, and be an entailed difficulty. The best way to 
prevent it is to have the first acute stage well attended to. The fre- 
quent desire to urinate, which we sometimes find in aged persons, 
may be due to chronic inflammation of the neck of the bladder. 
Sulphur, given every night, may mitigate the disease materially; and 
so also a decided benefit may be gained from the use of Conium 
maculatum. The same diet found beneficial for the acute form of 
this disease will be found beneficial for the chronic. 

Strangury. 

This affection consists in being unable to void the urine, and is 
believed to be the result of inflammation of the neck of the bladder, 
or some mechanical pressure upon the urethra. It often proves to 
be quite painful, and attended with fever. Aconite may be given 
every hour when the skin is hot, dry, and feverish, or Spirits of Cam- 
phor in drop doses every twenty minutes until relieved. Hyoscyamus, 
if the stoppage appears to be unattended with fever ; Cantharis, if 
there is an ineffectual urging to urinate ; and Cannabis^ also, when 

634 



DISEASES OF THE URINARY ORGANS. 635 

there is inability to evacuate the bladder. Dose and administration, 
four globules every hour. 

Stone. 

When one is voiding urine, and some obstacle to its passage sud- 
denly interferes, and the stream is cut short, we may infer that a 
stone has interposed at the orifice of the bladder. The symptoms 
are like those of strangury. Oftentimes there is pain in passing 
urine, inclination to pass it often, and straining to keep the stream 
flowing. Against the ill effects of stone in the bladder, Cantharis or 
Cannabis are among the prominent remedies. Lycopodium, Calcarea, 
and Phosphorus are also good remedies. The two remedies first 
named may be given in drop doses every hour, and the three last 
only three times a day. The patient should drink soft water, Poland 
water in large quantities, if possible, and live upon a moderate non- 
medicinal diet, avoiding malt and distilled liquors as a beverage. 

Gravel. 

This is indicated by violent, cutting, intermittent pains in the re- 
gion of one or the other hip and kidney and extending down the 
ureter to the groin or down the thigh, frequent but scanty urine, 
fever, and nausea. The most useful remedies, in the order of their 
importance, are Uva ursi, Belladonna, Ohamomilla. and Nitrum, re- 
peated often. 

Retention of Urine. 

This difficulty results from fever or some local irritation, and con- 
sists simply in disinclination to evacuate the bladder, not from ina- 
bility on account of inflammation, or some obstruction, but because 
there is an irresistible proneness to retain the urinary secretion, 
either from nervous weakness or spasm of the neck of the bladder. 
The remedies found most useful are Cina, Spigelia, Hyoscyamus, Bel- 
ladonna, and Rhus tox. Either of these may be given and repeated 
until the patient is relieved. Hyoscyamus and Qina are preferable. 
With old people, Arsenicum or Secale. 

Suppression of Urine. 

In some fevers the kidneys do not perform their office, and the uri- 
nary secretion is suppressed and thrown back upon the system ; and, 
as a consequence, the blood fails of being defecated, and the result, in 
a short time, must prove quite disastrous. A dose of Sulphur may 
sometimes overcome this difficulty, and set the organs of secretion at 
work. Baptisia, Nitrum, Pulsatilla, Bryonia, Mhus, Cantharis, and 
any of the remedies that act specifically upon the renal region, will 
be likely to afford relief. The remedies may be repeated every two 



636 DISEASES OF THE URINARY ORGANS. 

hours, and the diet should be mucilaginous drinks. Poland water 
taken in large quantities is good in all cases of urinary diseases. 

Incontinence of Urine. 

Some persons cannot help urinating at once as soon as the bladder 
fills. Their incontinence becomes manifest when no opportunity 
offers for immediate resort to the water-closet, and in many instances 
becomes painfully mortifying, and renders the victim an object of 
sympathy. Mercurius vivus may be given in the usual dose, three 
times a day. If, after a trial of a few days, the patient is not im- 
proved, give either Opium, China, Calcarea, Causticum, or Sulphur 
in the same way. 

Wetting the Bed. — Nocturnal Enuresis. 

Children addicted to this habit from some diseased condition may 
be cured by daily doses of Sulphur or Carlo animalis, or perhaps 
Silicea, or Causticum. But some children get the habit and become 
confirmed in it from no physical cause whatever ; and, if no measures 
are taken to reform them, they will grow up under the impression 
that they cannot help it. The best way to treat such is to impress 
upon them that they can and must banish the habit. Let them be 
impressed even to shame and a threat of chastisement if they keep 
up the practice ; and in most cases, this is all that is necessary. 

Diabetes. — Immoderate Flow of Sweet Urine. 

There is no disease that resists more stubbornly the action of 
remedies than diabetes. It consists in a copious secretion of sweet 
urine, that contains many grains of solid material passing away from 
the tissues every twenty-four hours. This disease will emaciate a 
fleshy subject in six weeks, and give him a pale and sickly look. The 
disease has been palliated, but never cured permanently that we find 
any record of ; and yet Phosphoric acid, given three times a day, has 
diminished the amount of the secretion from twelve to two quarts in 
twenty-four hours ; and apparently this remedy, with Nitrate of ura- 
nium, has effected temporary cures. Muriatic acid. Sulphur, and Kali 
earb. have also been esteemed as valuable remedies, all of which may 
be given in the usual doses, three times a day. I would also recom- 
mend Poland water in large quantities. 

Bloody Urine. 

As gravel is believed to be one of the causes of this difficulty, and 
inflammation of the bladder is believed to be another, the same reme- 
dies applicable to the one will serve for the other. Arsenicum may, 
however, be added to the remedies, particularly if there is any burn- 
ing at the neck of the bladder and tenesmus. 



DISEASES OF THE URINARY ORGANS. 637 



Inflammation of the Kidneys. 

When there is pain in the back, and increased flow of urine, and a 
desire to urinate frequently, and sometimes severe pain in the hip and 
side, nausea, vomiting, and fever, there is undoubtedly inflammation 
of the kidneys. In the treatment of this painful difficulty, we find 
Arnica the best remedy if the inflammation has been produced by a 
mechanical injury. If from a cold, Rhus tox. or Nux vomica. If 
there is much fever, Aconite ; chilliness down the spine, Belladonna. 
When there is obstinate vomiting, Bismuth. The patient should lie 
in bed, and not try to exercise much till the inflammation passes off. 
The medicine should be given every hour or two hours, according to 
the severity of the inflammation. Use Poland water in large quan- 
tities. 



DISEASES OF THE ORGANS OP 
GENERATION. 



The organs of generation in the male are the penis, testes, and 
their appendages. Those of the female are the vulva, vagina, womb, 
ovaries, and their appendages. 

Inflammation of the Urethra. 

The urethra is the common passage through which the urine passes 
from the bladder, and the semen from the testes. When it becomes 
inflamed from cold, or as the sequel of some acute disease, Pulsatilla, 
Cannabis, Mercurius viv., or Sulphur may cure the difficulty by being 
given every two or three hours. One remedy only must be given ; 
if this fails, try another; but if the disease is the result of impure 
connection, and is the gonorrhoea (or clap), give Cantharis, and after- 
wards Cannabis. If there is painful smarting, give these remedies 
every hour in alternation until the discharge ceases. Give Pulsatilla, 
also, every hour, if the other remedies fail, and use a solution of 
Hamamelis in water as an injection. 

Syphilis. 

Nearly allied to gonorrhoea is syphilis ; only the latter is a more 
formidable result of impure connection, which inoculates the blood. 
It becomes manifest in discharge from the urethra, chancres, buboes, 
etc. When there is a purulent discharge from the urethra, Mercu- 
rius viv. may be given persistently for several days, and this may 
arrest the further progress of the disease ; but should it not, and 
chancres make their appearance on the prepuce or foreskin, or on the 
glans, burn them with Nitric acid, full strength of the stores, and 
then give Mercurius corrosivus every six hours for several days ; 
dressing the sores with lint wet with cold water and Calendula. If 
the chancres heal, it is well and good, if they do not, give Mercurius 
iodatus three times a day. Let the patient avoid drinking any in- 
toxicating beverage whatever, and abstain from all medicinal articles 
of diet. 

638 



DISEASES OF THE ORGANS OF GENERATION. 639 



Inflammation of the Testicles. 

Sometimes a suppression of gonorrhoea will cause inflammation and 
swelling of the testicles. Both may be implicated, and become ex- 
ceedingly painful and enormously swollen. For the first stage be- 
fore the swelling, Aconite may be given every two hours to reduce 
the general febrile condition of the system. Afterwards Arnica may 
be given to remove the soreness, and Pulsatilla to remove the swell- 
ing. Either of these remedies may be given every day, three times, 
until the object for which they are given is accomplished. Let the 
patient lie in bed, and apply warm compresses to the part. Let him 
subsist upon a spare diet, and drink no exciting drinks. Let him 
wait with patience for a subsidence of the swelling and inflamma- 
tion. 

Dropsy of the Scrotum. — Hydrocele, 

Sometimes inflammation of the testes will result in hydrocele, and 
the scrotum will become filled with water. Helleborus nig., Apis mel., 
and Arsenicum are remedies that have been employed to cure the 
difficulty ; but sometimes remedies prove unavailing, and the water 
has to be drawn off by a trochar, in which event consult an experi- 
enced surgeon. But try the remedies first, and give each named in 
succession (provided the first or second does not prove effectual), 
every three hours during the day, 

Inflammation of the Vulva. 

This may occur from acrid leucorrhoea, or cold, or from gonorrhoea ; 
and, from whatever cause, it requires the application of warm water 
and compresses, and a dose of Aconite or Belladonna every hour until 
relieved. 

Inflammation of the Vagina. 

The vagina is lined by a mucous membrane, which sometimes 
becomes inflamed; and when from a cold, producing an ordinary 
catarrh, give Nux vomica or Sulphur, night and morning, until better. 
If from chronic irritation of the membrane there is a leucorrhoeal 
discharge from the vagina, give Sepia night and morning. If this 
fails, give Calcarea carb.; and if this fails, give Sulphur in the same 
way. Leucorrhoea may be occasioned by falling of the womb, which 
irritates the mucous membrane of the vagina, in which event Sepia or 
Nux may be given every night, with full prospect of a cure. 

Inflammation of the Womb. 

This painful malady is often the result of protracted labor, and is 
known by great thirst, pain over the region of the womb, and great 



640 DISEASES OF THE ORGANS OF GENERATION. 

tenderness of the touch. Arsenicum, given every three hours at first, 
and followed by Belladonna, generally proves successful ; but Bry- 
onia and Rhus tox. or Verat. viride may be resorted to, and repeated 
every three hours, if found necessary. Inflammation of the womb is 
a painful difficulty and a dangerous one, and should be treated with 
great care. Warm bran poultices, if the patient can bear them, may 
be applied while giving the remedies. Injections of hot water, 110 
degrees, taken at night, will often give great relief. Would recom- 
mend patient to consult a physician. 

Falling of the Womb. 

The womb is said to fall, when from debility, or a relaxed condi- 
tion of its ligaments, it sinks down into the vagina ; and this is indi- 
cated by pain in the back, and a dragging sensation over the hips, 
and bearing-down pains. These are often attended with headaches 
and other derangements, which must be considered. Nux vomica, 
every night, is one of the most valuable remedies for prolapsus uteri. 
Sulphur sometimes does well. Sepia every morning has often cured 
and relieved the headache, nausea, and other concomitant symptoms. 
Calcarea has relieved when the pain is most prominent about the hips ; 
Ignatia, when the difficulty has been brought on by grief. Patients 
of this description should not drink coffee or strong green tea. Black 
tea, cocoa, and milk may be allowed, with a moderately generous diet. 

Inflammation of the Ovaries. 

This difficulty is denoted by sharp pains, either in the right or left 
side, or both, just front of the upper edge of the hip-bone. It some- 
times is very painful, and requires rest and the best treatment and 
nursing to subdue it. Conium, in daily doses, has relieved some ; so 
has Pulsatilla, Belladonna, and Ignatia. Some remedies relieve for 
a time, such as Bryonia and Rhus tox. Belladonna will cure when 
the inflammation is attended with headache and considerable neu- 
ralgic pain in the region of the glands ; if much fever attends the 
affection, give Aconite three or four times a day. Now, as all these 
affections disturb the nervous system, and give rise to various forms 
of nervous complaints, such remedies as Pulsatilla, Ignatia, Hyoscy- 
amus, Nux vomica, Moschus, and Caulophyllin will be constantly 
needed, and stimulants need to be taken with great caution. Cold 
compresses in acute attacks. A piece of flannel soaked in hot 
laudanum laid over the ovary, covered with a dry flannel, will give 
relief and enable the patient to sleep. 

Ulceration of the Womb. 

Anything that irritates the mouth of the womb may occasion, first, 
inflammation of the os tincae, and then ulceration. Frequent mis- 



DISEASES OF THE ORGANS OF GENERATION. 64 J 

carriages will so weaken the organ, and especially its ligaments, as 
to admit of its being easily misplaced, or turned backwards or for- 
wards. These misplacements are often the cause of ulcerations, and 
almost always the source of weakening leucorrhoea. The medical 
treatment of this difficulty is of the first importance. Sulphur every 
night may commence the treatment. If, after using the Sulphur for 
a week, the purulent discharge becomes less, and there is less pain 
and soreness in the region, and still considerable pain remaining in 
the back, give Nux vomica every night for a week. If these two 
remedies fail of bringing about a cure, then drop twenty drops of the 
tincture of Calendula (Marigold flowers) in half a tumbler of water 
and inject it into the vagina every day, and at the same time take a 
dose of Sepia every morning. Continue this treatment as long as 
useful. Calcarea, taken every night, sometimes has a good effect. 
Local applications to the ulcers are sometimes made, but this is the 
business of the surgeon. 

Leucorrhoea. — Whites. 

When the mucous membrane lining the womb and vagina becomes 
irritated or inflamed, it undergoes solution, and there is a white dis- 
charge. This is of frequent occurrence, and in some instances is such 
a drain upon the system as to weaken the function and tone of the 
nutritive organs. Any treatment that will strengthen the whole 
system will generally cure the derangement. China, Ferrum, and 
Aurum are remedies that may be employed, either of which, in daily 
doses, will prove sufficient. In the mean time, let the patient refrain 
from over-exertion. A more aggravated form of leucorrhoea attends 
falling of the womb, and this perhaps is the cause of the difficulty. 
The remedies which will best meet this difficulty are Sepia and Cal- 
carea carl. ; the former may be given every morning, and the latter 
every evening ; or perhaps Nux vomica may be given in the evening, 
and Calcarea in the morning. If there is sick headache attending 
this form of leucorrhoea, Sepia is still the remedy. If other biliary 
derangements Nux vomica is equally applicable. Ladies afflicted 
with any of these uterine difficulties must not drink strong tea or 
coffee ; but mild black tea, cocoa, and milk should be the chief 
beverages, and, if the appetite permit, a moderately generous, but 
non-medicinal diet may be added. 



DISEASES OF THE SKIN. 



Boils. — Furunculi. 



These are small, circumscribed, and painful tumors,, which begin 
in the form of a pimple, and then grow until they acquire the size 
of acorns. They are several days in coming to maturity; and some- 
times their painl'ulness excites fever and chilliness, loss of appetite, 
and other derangements. When suppurating, the pain in them is 
intense and pulsating just before the crisis. As soon as they break, 
the pain diminishes, and very soon the injury is repaired. Aconite 
may be given two or three times a day to subdue any fever that may 
be present. Belladonna also will remove the pain of congestion ; and 
this may be given several times during the day. Arnica tincture may 
be applied externally to remove the soreness, and with great advan- 
tage it may be taken internally; and in the same way Hamamelis Vir- 
ginica may be employed. Wet a compress, and apply directly over 
the boils, and renew several times a day, and the pain will be very 
greatly diminished. Poultices, in case of very large boils, may prove 
of service, — bread and milk or flaxseed ; and, when employed, give 
at the same time Hepar sulph., four globules, and repeat twice a day. 
Arsenicum often prevents their recurrence. When the boil first ap- 
pears drink quantities of Indian-meal water, It will usually blast the 
boil and prevent others coming. 

Carbuncle. — Anthrax. 

The difference between a boil and a carbuncle is this ! a boil is 
circumscribed, but a carbuncle travels, or moves along the subcu- 
taneous tissue ; and, when it breaks, it seems to have several open- 
ings instead of one as in the case of the boil. Anthrax is a trouble- 
some disorder ; sometimes it is attended with active inflammatory 
fever and sometimes with low fever. It is far more common among 
old than young people and sometimes very difficult of cure. A car- 
buncle upon the back of the neck, accompanied by fever, requires 
Aconite during the time of its development and afterwards Hepar 
sulphuris. The effect of this latter remedy is to hasten suppuration. 
Phosphorus is also employed to promote the same end. Bread and milk 

642 



DISEASES OF THE SKIN. 643 

poultices may be employed ; and a dressing of adhesive plaster, with 
apertures for the pus to discharge, may be applied after the poultice. 
The sore should be dressed every day ; and, if very painful, compresses 
wet with Hamamelis may be resorted to. To remove great soreness, 
Arnica may be used in the same way. Sometimes in aged people a 
carbuncle becomes gangrenous ; and then Arsenicum should be em- 
ployed, a dose every three hours. When the disease, or carbuncle, 
comes on the back, either to the right or left of the spine, it is liable 
to make its way downwards ; and, in order to prevent its doing- so to 
any extent, compresses bound tightly beneath may keep them where 
they begin. In all cases where there is active fever accompanying 
carbuncle, Aconite may be necessary; for so long as there is great 
arterial excitement, it will tend towards the carbuncle and greatly 
augment its severity. Slow fever, or a lassitude and stupor, attends 
the discrasia, give Bryonia and repeat every three hours ; or perhaps 
Rhus tox. ; Arsenicum, if the pus is of an offensive smell. Carbuncles 
are supposed to originate from low conditions of the circulation, and 
therefore a generous diet is suggested. Avoid medicinal food and 
condiments, except salt. Animal food is most commended for a diet. 

Abscesses. 

Abscesses generally form in the subcutaneous tissue, but manifest 
themselves through the skin. Generally there is some protuberance 
or swelling upon the surface ; sometimes there is none. Frequently 
there will be some redness to indicate that an inflammatory process 
is going on ; and, at other times, there will be no indication of the 
kind. An abscess, then, is simply a circumscribed collection of pus, 
formed from broken-down tissues or blood corpuscles. They are sub- 
ject to medical treatment. Oalcarea, for abscesses in scrofulous per- 
sons, may be given every day, and especially in cases of scrofulous 
children. Abscesses upon the arms or hands may be cured by the 
use of Pulsatilla or Nux. Abscesses on the face require Bryonia and 
Oalcarea ; abscesses from the bone require Silicea. Abscesses should 
be relieved of their pus by the lancet as soon as sufficiently ripe. 
They may be washed with Calendula tincture. Persons prone to 
suffer from abscesses should subsist upon a spare diet, and should 
avoid rich gravies or great quantities of butter. Bread, potatoes, 
beans and peas, beef and mutton may constitute about the range of 
diet ; and coffee, ale, cider and distilled spirits must not be touched. 

Corns. 

The feet appear to be the only locality affected by corns ; and they 
occur frequently upon the toes. A corn is simply hardened cuticle or 
skin, rendered so by some pressure or irritation upon the surface, such 
as a tight boot or shoe. Those who subject the feet to such treat- 



644 DISEASES OF THE SKIN. 

ment must suffer the consequences. The best treatment for a sore 
corn is to shave off the hard skin and apply the tincture of Arnica 
or perhaps the tincture of Causticum. It is said, however, that Gra- 
phites, Silicea, Sulphur and Antimonium crud. are remedies that may- 
be taken internally to cure corns. Either of the remedies may be 
taken in daily doses. A corn-salve is sometimes applied, made of 
pine-pitch or diachylon. Any plaster that will protect the tender 
and irritated spot from the pressure of the boot will be found useful. 

Ulcers. 

Ulcers are included among skin-affections because they break the 
continuity of the skin and manifest themselves upon the surface. An 
ulcer is formed generally by the disorganizing influence of inflamma- 
tion which affects the membranes and skin. Ulceration of the soft 
parts and ulceration of the stomach and intestines are of frequent oc- 
currence; and an ulcer is slow to heal and constantly discharges pus. 
Ulcers of the legs, toes, feet, hands and arms are met with exten- 
sively. Ulcers of the lower extremities or legs and feet can be cured 
by a daily dose of Silicea or of Sulphur. Ulcers of the upper extrem- 
ities, or the arms and hands, can be cured by daily doses of Calcarea 
and Graphites. Ulcers of the soft parts require Phosphorus or China. 
Ulceration of the stomach requires Conium or Phosphorus. Ulceration 
of the bowels requires Arsenicum. Each of these remedies may be 
given in daily doses, and continued as long as observation teaches 
their utility. Ulcerations are supposed to result from low states of the 
blood; and, therefore, stimulants must be employed to tone up the 
system. A generous diet is generally to be commended. There is no 
use in trying to heal over the surface of an ulcer ; for, in so doing, it 
may work out deeper mischief in the economy. The only safe way is 
to build up the most healthy state of the system, and let the ulcer dis- 
charge itself and heal from the bottom. Persons subject to ulcers are 
evidently scrofulous or the victims of some other taint. If scrofu- 
lous, Arsenicum, Silicea or Calcarea may benefit the condition. Ulcers 
arise also from hereditary syphilitic taint. Mercurius viv., Mercurius 
iodatus and Mercurius corr. are competent to eradicate this taint 
from the constitution; so is Hepar sulph. or Nitric acid. If the ul- 
cers arise from this taint, alcoholic stimulants must be avoided and 
the most generous meat diet must take their place. Whatever be 
the predisposing cause of ulceration known in a family, it should be 
carefully watched. Avoid eating pork and lard in any form. 

Chilblains. 

Frosted feet, as this complaint is termed, occurs mostly in cold 
weather, and most frequently in persons susceptible from some con- 
stitutional taint. It has been observed that chilblains will assume the 



DISEASES OF THE SKIN. 645 

character of painful sores in those known to be of a scrofulous habit. 
The feet being very susceptible to cold, become chilled, and after- 
wards the heels, and sometimes the toes, become painfully tender. 
Croton tig. or Arsenicum, in the usual dose, may be administered 
twice a day when there is burning heat and swelling ; Nux vomica, 
in the same way, when attended with rheumatic pains. Pulsatilla is 
a better remedy for females of delicate constitution and subject to 
colds. When the chilblains assume a bluish appearance, Phosphorus 
and Sulphur may be given ; either of which, in the usual dose, may 
be given twice a day. Externally the tincture of Arnica may be ap- 
plied to remove soreness. Tincture of Cantharis, if there is an incli- 
nation to blister; Rhus tox., if they are red and inflamed. A solution 
of glue, in warm water, has been found a good palliative as a foot- 
bath. 

Whitlow. 

This is an inflammation and suppuration around the nails of the 
ringers ; sometimes slight and at other times exceedingly painful. 
Hepar sulph. taken internally will hasten to a crisis ; G-raphites or 
Mercurius is sometimes used for the same purpose ; Silicea will has- 
ten suppuration and a cure. Rhus or Lachesis, if the system is in a 
low condition. Either remedy may be administered twice in twenty- 
four hours. 

Itch. — Scabies. 

This cutaneous eruption consists of small pimples, or pustules, 
which make their appearance in clusters upon the skin and itch and 
burn continually. They are believed to result from the acarus or 
itch-mite imbedded in the cuticle. These pimples usually break out 
between the fingers, on the hands and wrists, and over the body. Sul- 
phur has ever been found a salutary remedy, taken internally, and ap- 
plied as an ointment daily. In many cases, Calearea, Hepar sulph., 
Mercurius and Rhus have been found useful. For what is termed the 
prairie itch, which is very stubborn, Mercurius viv., taken internally, 
and an ointment of the red oxide of mercury, used with care, exter- 
nally, has proved effectual. Sulphur ointment has been in general 
use, and is of great service if used sparingly and with caution. 

Itching of the Skin. — Prurigo. 

Sometimes there will be intense itching of the skin, without any 
apparent eruption. Scratching or rubbing does not relieve ; every 
attempt to relieve in this way aggravates the difficulty. There is no 
disease of the skin apparently more superficial, nor yet more annoy- 
ing. As there is no prominent symptom but itching, we would nat- 
urally suppose that some simple remedy would antidote it. But not 
so. In bilious temperaments, Mercurius is the best remedy. In san- 



646 DISEASES OF THE SKIN. 

guine temperaments, Nux vomica, or perhaps Sulphur. In the ner- 
vous, Pulsatilla, Ignatia, Sepia, Calcarea and Oonium. The remedy 
selected to meet the case may be given twice a day until relieved, 
unless there is found a necessity for change. 

Ringworm. — Herpes Circinnatus. 

This troublesome disorder usually manifests itself upon the face, 
and is, at first, a small circular eruption that enlarges in the form of 
a ring. The cause is believed to be a minute itch-mite which lives 
in the skin and commits its circuitous mischief. Sometimes only 
one ring appears ; at other times there are several, each enlarging its 
area until the face becomes nearly covered. A frequent cause of 
their appearing is by being shaved with a razor that communicates 
the infection. A strong tincture of Hyoscyamus applied to the sur- 
face, will generally extinguish them ; but there must be some consti- 
tutional predisposition that favors them; and therefore internal reme- 
dies must be employed. In case of syphilitic taint, daily doses of 
Mercurius viv. will be required. In those of strumous constitutions, 
Calcarea, Arsenicum and Sepia. In those constitutionally inclined to 
erysipelas, Rhus tox., Dulcamara, Hepar sulph. and Bryonia will be 
found of use. Two or three doses of the remedy selected may be 
administered every day; and, at the same time, the Hyoscyamus 
tincture may be applied externally. This treatment has been found 
efficacious in most cases. A dilute tincture of Qantharis, applied 
locally, is a specific. 

Hives. 

Small red blotches upon the skin, that burn, itch and sting, are 
usually called hives. They are believed to result from some de- 
rangement of nutrition, caused by certain articles of diet. But lit- 
tle danger attends the difficulty, unless, by exposure to cold, the 
eruption is made to recede, and it falls upon the bowels : this, some- 
times, in children, results in diarrhoea. Pulsatilla may be given in 
the usual dose, three or four times a day. In young children, who 
may be teething, Chamomilla will be found useful. If there is any 
nausea, give Bryonia or Ipecac, and the derangement will be cor- 
rected very soon, Croton tig. is a fine general specific. 

Varicose Veins. 

The external veins upon the lower limbs sometimes become con- 
gested and enlarged, and are termed " varicose." Inflammation 
sometimes attends this difficulty, and terminates in varicose ulcers. 
The best remedy known for simple varicose veins is Hamamelis Virg. 
Pulsatilla is believed to be useful, and also Lachesis. Either of these 
remedies may be administered three times a day. The Hamamelis 



DISEASES OF THE SKIN. 647 

may be applied externally when administered internally. For vari- 
cose ulcers, Arnica may be given in the inflammatory stage, and 
Hepar sulph. after : when ulceration takes place, Arsenicum and Car- 
bo vegetabilis may be called into use. A dose every day will hasten 
a cure. 

Felons. 

Felons commence at the bone, beneath the periosteum or mem- 
brane that surrounds it. They are very painful, and most commonly 
make their appearance on the fingers or thumbs ; at first a prickling 
sensation is experienced, as from a splinter, and then a sensation of 
heat attended with intense pain, depriving the sufferer of rest or 
sleep. The skin becomes changed in color at the surface, and there 
is painful throbbing and swelling. The most speedy cure for a felon 
is to thrust in the lancet to the bone, and give vent to the matter 
beneath the membrane ; and, afterwards, an application of warm flax- 
seed poultices will keep the sore discharging. Previous to lancing, 
resort has sometimes been had to soaking the part in hot water to 
which Ammonia has been added, to ripen and prepare the way for 
the matter to come to the surface. Hepar sulph., taken internally, 
exerts a beneficial influence in hastening suppuration. After a resort 
to the lancet is had, Silicea is a valuable remedy to hasten a cure. 
For the constitutional disturbance which felons excite, Aconite may 
be given to reduce arterial excitement ; Arnica, to remove soreness ; 
Nux vomica, to allay an irritable condition of the stomach ; and Sul- 
phur, to fortify the system against the recurrence of the difficulty. 
It is always well to keep the hand at rest until the pain and inflam- 
mation has subsided. 

Tetter. Salt Rheum. — Herpes. 

Tetter is an inflammatory disease of the skin, which, for the most 
part, appears upon exposed surfaces, — the hands and the face, — 
though sometimes it comes on the arms and legs. It is a red, scaly 
or burning eruption, very stubborn in its character, and painful. It 
sometimes becomes complicated with constitutional erysipelas and 
causes swelling and infiltration of the cellular tissues around the 
eyes ; affects the ears and nose ; breaks out on the backs of the 
hands and arms, and in the bend of the elbow-joint, causing the skin 
to crack and become exceedingly sore. Sometimes the tetter is dry, 
sometimes humid ; and at others scaly. For dry, burning tetter, Ar- 
senicum is a valuable remedy. If there is feverish heat in the skin 
generally, Aconite and a lotion of tincture of Aconite may be ap- 
plied externally. When the skin cracks and is dry, it may be 
anointed with the glycerole of Aloes. The burning may be some- 
what allayed by applying, with a down-brush, a little rye-flour. Sepia, 
Calcarea and Dulcamara are also valuable remedies for dry tetter. 



648 DISEASES OF THE SKIN. 

The remedies, when selected, must be used persistently, two or three 
doses a day. For humid tetter, Rhus tox., Conium and Sulphur may 
be employed. The Rhus tox. may be given at first and repeated 
every six hours. A lotion of twenty drops of the tincture in half a 
tumbler of water may be applied externally ; and a similar prepara- 
tion of Conium may be used externally when this remedy is adminis- 
tered internally. When humid tetter smarts, and the skin is broken, 
cold cream may also be applied. For the scaly tetter, Calcarea carb. 
may be given persistently three times a day ; if this fails, Sepia, es- 
pecially if the face is implicated. When the eyes or ears are affected 
and swollen Rhus tox. and Belladonna may be given alternately every 
three hours until better. In all cases of tetter of the furfuraceous 
type, Natrum muriaticum may be found of service when other reme- 
dies fail. Cantharis is accounted a general specific. All persons af- 
flicted with the disease should refrain from the use of salt provisions, 
pork, rich gravies and the like ; for these articles of diet heat the 
blood and augment the suffering. 

Scrofula. 

This disease shows itself in swelling of the glands and sores upon 
the face, neck and extremities. To rid the blood of this discrasia, 
Arsenicum may be given when there are sores or ulcers affecting the 
soft parts. Sores around the mouth and upon the faces of scrofulous 
children may be cured with Pulsatilla or Bryonia. For swelling of 
the glands, give Mercurius three times a day ; and, if there is a ten- 
dency to suppuration, give Hepar sulph. In some children of scrofu- 
lous taint, vaccination will bring out sores on the face, hands and 
arms. This has been ascribed to impure vaccine matter ; but this is 
not usually the case, as the best virus ever used will often be fol- 
lowed with this result ; and, when it is, Calcarea carb. or Silicea may 
be given in daily doses till the humor disappears. Ointments that 
simply drive these humors from the surface are pernicious and often 
result in producing worse forms of the disease. Great care in refer- 
ence to diet is necessary when these sores break out upon children. 
They should be fed mostly upon farinaceous food. Avoid pork in 
all its forms. 

Eczema. 

This is a disease of the skin, that may be brought on by working 
in smelting-furnaces, where the victims are all the time exposed to 
much heat, and are obliged to work among cinders and steam. The 
appearance of this skin-disease is that of red and inflamed spots cover- 
ing the entire body. The biliary system seems to be much deranged, 
and nutritive system impaired. Persons thus affected become very 
much prostrated, and suffer intensely from the burning and smarting 
of the eruption. Almost any severe exercise that heats the blood of 



DISEASES OP THE SKIN. 649 

those usually forced to live upon an indifferent diet of unwholesome 
food will become subject to eczema. To treat this difficulty success- 
fully is, first to regulate the biliary system by three or four doses of 
Nux vomica or Mercurius viv., for several days ; and then follow with 
Arsenicum, Tartar emetic, Petroleum or Antimonium crudum, three or 
four doses every day ; and, as soon as the appetite and stomach will 
permit, furnish the patient with a generous diet, and let him change 
his employment for one of less exposure. 

Liver Spots. — Maculce, Moss. 

This affection consists of discolored spots upon the skin of the 
face, sometimes covering the surface of the forehead with dark dis- 
colorations of the skin. Derangements of the liver are believed to be 
the cause ; and, although these discolorations are not painful (except 
to the mind), they often mar the countenance and annoy those smit- 
ten with these marks. They can be removed with appropriate reme- 
dies. Sepia is one of the most prominent. Chelidonium, given the 
same, is useful. A dose should be given morning and evening per- 
sistently, until the color fades and the spots disappear. To facilitate 
this, let the patient avoid coffee, milk, eggs and all oily food. An 
animal diet, of the lean of well-fed beef and mutton, is preferable, 
with bread. Potatoes, and esculents of every kind, may be allowed ; 
but gravy and much butter are pernicious ; as are stimulants, such 
as malt liquors and highly seasoned soups. 

Scurvy. 

Persons so situated as to be obliged to subsist upon salt provi- 
sions are liable to become affected by a disease termed " scurvy." It 
manifests itself in scorbutic eruptions upon the skin, and by an in- 
flamed and sore condition of the gums, which sometimes become so 
much affected as to cause the teeth to become loose. The want of 
fresh vegetables or lemons, oranges and other fruits, is believed to be 
sufficient to cause the difficulty. To cure the disorder, a wholesome 
diet must be provided, with plenty of fruit, fresh provisions and vege- 
tables. The only remedy necessary to carry off the difficulty, after 
providing the proper diet is Natrum muriaticum, three doses a day, 
— morning, noon and night. Mercurius viv., Nitric acid and Muri- 
atic acid are also remedies that have been employed. 

Barber's Itch. — Sycosis Mentagra. 

This is exclusively a disease of the male sex and occurs about the 
time the beard begins to grow thick and hard. The disease is sup- 
posed to be contracted by using bad soap upon the face, when shav- 
ing or washing the beard. A dull razor, that pulls and irritates the 



650 DISEASES OF THE SKIN. 

skin, may form the nucleus of the difficulty. In laboring people, ex- 
posed to dust, especially of tobacco, and where there is not particular 
pains in washing out the dust frequently, the disease is likely to be 
generated. The disease resembles, in some degree, the herpes of the 
lips, makes its first appearance on the chin in small clusters of red 
pimples, or tubercles, each of which is perforated with a hair. These 
pimples increase in size and disgusting appearance, though not pain- 
ful, until arrested by some remedial means. Graphites, in daily 
doses, has often cured. Nitric acid, also, twice a day, has proved ef- 
ficient. Aurum muriaticum, alone, will cure cases in those having 
psoric or syphilitic taint. Silicea, Carlo animalis, Hyoscyamus tinc- 
ture (externally), are also good remedies. Nitric acid may be ap- 
plied in a diluted form, externally, and also Sulphur ointment. A 
solution of Iodide of Potass., two grains to an ounce of water, applied 
several times daily, cures stubborn cases. 



DISEASES OF THE ORGANS OF 
CIRCULATION. 



The heart, its appendages and valves ; the pericardium or mem- 
brane that covers the heart ; the nerves that are distributed to the or- 
gan, as well as the arteries and veins, — are embraced in the organs 
of circulation. 

Inflammation of the Heart. — Endocarditis. 

When a sharp pain is sometimes felt in the region of the fifth rib, 
with quick pulse, flushed face, and hurried respiration, there are in- 
dications of endocarditis. Aconite in the usual dose may be given 
every hour until the frequency of the pulse is diminished ; Verat. 
viride, if Aconite fails to reduce the pulse in twenty-four hours. If 
the disease has been brought on by a shock or injury, Arnica ; if from 
excessive grief, Ignatia ; if from cold, Arsenicum ; if it is the sequel 
of inflammatory rheumatism, Pulsatilla ; if the disease terminates in 
dropsy of the pericardium or chest, Apis mellifica. Let the diet be 
simple and easy of digestion. 

Inflammation of the Pericardium. — Pericarditis. 

Acute inflammation of the pericardium is denoted by symptoms 
much the same as those attendant on endocarditis, and may be 
brought on by a cold, a sudden check of perspiration, or simultane- 
ously with a sudden attack of inflammatory rheumatism. Aconite re- 
peated every hour. Pulsatilla or Bryonia may follow in the usual 
dose, and be repeated every hour until a change occurs. The peri- 
cardium, being a serous membrane, is liable to a profuse collection of 
serum about the heart. Apis mellifica in the usual dose every two 
hours will be likely to give relief ; Apocynum and Helleborus nig. are 
also remedies that may be employed in curing this trouble. If the 
heart palpitates severely, give Pulsatilla or Digitalis. Diet simple 
and nutritious and free from any exciting stimulants. 

Chronic Inflammation of the Pericardium has similar symptoms, 
but not so severe. It often attends the gout, and is treated with the 
same remedies. Oolchicum is a valuable remedy, and may be given 
three times a day, in usual doses. Sulphur is often useful. 

651 



652 DISEASES OF THE ORGANS OF CIRCULATION. 

Chronic Pericarditis may sometimes be cured by Calcarea or Ly- 
copodium. Aurum muriatieum and Spigelia are called into requisi- 
tion when there is irregulatity of the heart's action, Arsenicum when 
there is a burning sensation accompanying the pain. Diet, if the 
stomach will bear it, may be quite generous. 

Dilatation of the Cavities of the Heart. 

This trouble is manifest from a more perceptible action of the 
heart than is normal ; its motion being more violent. Lachesis when 
there is a disposition to sigh ; Belladonna if there is a tendency of 
blood to the head ; Digitalis if there is a quick, full pulse ; or Verat. 
viride ; Aconite if there is fever ; Pulsatilla if there is rheumatism of 
the joints at the same time. 

Imperfect Action of the Valves of the Heart. 

A difficulty such as this is not denoted by any one set of symp- 
toms, but it may give rise to various sufferings, such as fainting, 
rush of blood to the head, apoplexy and convulsions. Fainting re- 
quires Pulsatilla, China, Bryonia and Rhus. Rush of blood to the 
head, Belladonna ; apoplexy, Aconite, Belladonna and cold applica- 
tions to the head ; convulsions require Chamomilla, Belladonna, Hyos- 
cyamus and Digitalis. Whichever remedy is selected may be given 
every half-hour until relief is obtained, or change. Spasmodic pains 
about the heart from some sudden excitement, G-elsemium, 

Aneurism of the Aorta. 

This is a rupture of some of the coats of the great artery, and 
which so weakens the rest that they lose their tenacity, and bulge 
out so as to impair its function. It often is very painful and pulsates 
in a frightful manner. Aconite, Bryonia, Digitalis, Zinc, Lachesis 
and Rhus tox. are remedies that may be consulted. Either will re- 
lieve, under certain conditions. The usual dose may be repeated 
every two hours. 

Inflammation of the Arteries may be relieved by the persistent 
use of Aconite, and inflammation of the veins by Phosphorus, Hama- 
melis or Rhus tox. Arteritis and phlebitis are both formidable dis- 
eases, and require the attendance or care of a physician. 



DISEASES INVOLVING THE VARIOUS 

ORGANS. 



Simple Fever. 

This disease is a simple acceleration of the pulse, with flushes of 
heat ; and when brought on by fatigue, give four globules of Arni- 
ca ; if from cold, Aconite; if from grief, Ignatia ; if from indiges- 
tion, Belladonna ; if from dampness and chill, Gelsemium or Rhus 
tox. 

Inflammatory Fever. 

In most cases this disease commences with pain in the head and 
full pulse, more or less thirst, loss of appetite, constipation of the 
bowels and dry, hot skin. One drop of the dilution, or four globules, 
of Aconite may be given in the first stage, every hour, until the skin 
becomes moist, and the pulse somewhat reduced. Belladonna may 
follow Aconite, and be given in the same doses and intervals, until 
there is a mitigation of the pain in the head ; or if the patient becomes 
weak and subject to aggravation of suffering from the slightest 
motion, give a drop, or four globules, of Bryonia, every hour, 
until there is a change ; with restlessness and when from checked 
perspiration, Rhus tox., same dose as Bryonia. In the case of uri- 
nary obstruction give four globules of Cantharis ; or of flatulent colic, 
four globules of Chamomilla. The diet should be farinaceous gruel 
or toast. 

Typhoid Fever. 

In general, the commencement of this disease is denoted by lassi- 
tude, headache and considerable acceleration of the pulse. Then fol- 
low stupor or delirium, coldness of the surface and great prostration. 
Four globules, or one drop, of Aconite may be given at first, every 
two hours ; to reduce the pulse and moisten the skin (by many Bap- 
tisia, in drop doses, hourly, of the tincture, is preferred to Aconite), 
Bryonia may be used after Aconite, a dose every three hours. If the 
patient becomes drowsy, give Rhus tox. ; cleanse the surface of the 
patient daily with a towel wet with tepid water ; and, if he will take 
any nourishment, give him beef-tea or mutton-broth ; milk is allow- 
able, and rice gruel. When convalescent, allow some light wine 

653 



654 DISEASES INVOLVING THE VARIOUS ORGANS. 

three times a day. For the diarrhoea of typhoid, Arsenicum, four 
globules, after each discharge, is good. 

Bilious Remittent Fever. 

This disease is so named because it comes on by considerable gas- 
tric derangement, headache and fever, which appears to be subject to 
elevations and depressions, without any distinct intermissions. In 
the first or inflammatory stage, give four globules, or a drop, of the 
dilution of Aconite, and follow it with a like dose of Ipecacuanha, and 
repeat every hour, until the nausea and vomiting are better. If the 
bowels are constipated, give Nux vomica at night, — a single dose of 
four globules. If there is colic, give Colocynth. If there is vomit- 
ing of greenish bilious matter, give Bryonia or Pulsatilla. Diet 
same as in inflammatory fever. 

Intermittent Fever. 

The symptoms by which this fever is distinguished are yawning, 
stretching, shuddering and chilliness, followed by heat, pain in the 
back, limbs, head, etc.; and afterwards a copious perspiration, and 
then an interim of complete intermission. Arsenicum, where the 
chilliness and heat are simultaneous, and where, during the cold 
stage, there is intense thirst for cold drinks ; Arnica, where there is 
soreness of the flesh, as if bruised; Belladonna, where headache and 
chilliness down the back ; China, where there is ringing in the ears ; 
Sulphur, in cases of long standing, where much Quinine has been 
given; Bryonia, where there are glairy vomitings during the chill 
and fever, and where all the sufferings are aggravated by motion. 
Apis, attacks chronic, and preceded by nettle-rash, — followed well 
by Nat. mur., either to be given three times daily. All the medi- 
cines may be administered in drop doses of the dilutions, or four 
globules ; and repeated every two hours between the paroxysms. 

Yellow Fever. 

Common to the Southern States during the warm season. Nearly 
all the symptoms of an ordinary bilious fever, in an aggravated form, 
characterize this disease ; and the victims become so sallow, and the 
surface so yellow, as to give rise to the name " yellow fever." When 
the stage of febrile excitement exists, give Aconite. When the nose 
bleeds, give Belladonna. When vomiting of black or dark bilious 
matters occurs, give Arsenicum. For the prostration or diarrhoea, 
give Carbo vegetabilis, and when the most offensive odor comes from 
the breath, give Baptisia. Arsenicum and Carbo vegetabilis are the 
most prominent remedies. The usual drop or four globule doses 
may be repeated every two hours, and sometimes every hour. Diet, 
— barley-water and gruel. 



DISEASES INVOLVING THE VARIOUS ORGANS. 655 



Eruptive Fevers. 

Nettle-Rash is a pale-red, stinging eruption, that sometimes is at- 
tended with vomiting, and sometimes with some other derangement 
of the stomach. Ipecac, and Nux vomica are indicated for the vom- 
iting, and Apis mellifica, Rhus tox. and Sulphur for the burning, itch- 
ing and stinging ; Croton tig. cures nearly all cases, a favorite remedy 
with physicians. Doses as usual, and repeated every hour or two 
hours until relieved. 

Scarlet=Rash is the roseola, or red eruption, and is much like the 
nettle-rash, only less annoying. Bryonia, Pulsatilla, are the ordinary 
remedies ; and either may be given in doses of four globules every 
two hours ; Aeon., if wakeful and restless. 

Scarlet=Fever usually begins with vomiting, quick pulse, sore 
throat, headache and great restlessness. Belladonna, when there is 
a bright, scarlet eruption ; Calcarea carbonica, when the child is of a 
scrofulous habit ; Arsenicum, when there is great prostration ; Helle- 
borus, when there are dropsical symptoms ; Bryonia, when the erup- 
tion is slow coming out. Repeat the medicines in the usual doses 
every hour. Diet, — nourishing drinks, toast and tea. 

Measles come on with cough, pain in the head, sneezing, redness of 
the eyes, and sometimes attended with nausea and vomiting. Bryo- 
nia will hasten the appearance of the eruption ; Ipecac, should it 
disappear too suddenly, with consequent increase of cough or vomit- 
ing ; Phosphorus will obviate the inflammatory effect upon the lungs; 
and Drosera will cure the entailed cough. Diet, simple and light. 

Erysipelas, either vesicular or phlegmonous, is denoted by a red, 
burning and fiery appearance of the face, and sometimes by a bullar 
eruption, resembling fly-blisters. Rhus tox., Belladonna and Bryonia 
are prominent remedies, — Belladonna, when the head and face are 
most implicated; Rhus tox., when there is eruption on the extremities 
and great weakness ; and Bryonia, when the suffering seems greatly 
aggravated by motion; Arsenicum, should there be great prostration, 
thirst and restlessness, — one of the best remedies in severe cases. 
Any of these remedies may be repeated every hour. Diet, — barley- 
gruel, rice-water, beef-tea, mutton-broth, toast and tea. 

Chicken=Pox. — - A pustular eruption, attended with slight fever 
and gastric derangement. One or two doses of Pidsatilla will gen- 
erally remove all the suffering attendant on this disease. 

Varioloid is another pustular disease, more severe, as it comes on 
with pain in the head and back, as if the latter would break ; and, be- 
ing a near relation to small-pox, both may be considered under the 
same head. 



656 DISEASES INVOLVING THE VARIOUS ORGANS. 

Small-Pox, of which varioloid is a modification, comes on with in- 
tense fever, spitting, pain in the head and back and lower extremi- 
ties. All the sufferings are intense. Nux vomica will remove the 
pain in the back ; Bryonia will hasten the eruption ; Pulsatilla will 
aid in carrying it off. As soon as the appetite returns, feed the pa- 
tient quite generously. In the small-pox delirium, you can give 
Stramonium ; and to prevent pitting, break the pustule's, and cover 
them with Styptic Collodion. 

Rheumatic Fevers. 

Inflammatory Rheumatism is accompanied by pain in the limbs 
inflammation of the joints, swelling of the same, and great pain and 
difficulty in moving about. Aconite reduces the fever ; Bryonia re- 
lieves the pain in moving about ; Pulsatilla, the inflammation of the 
knee-joints ; Colocynth, that of the hip-joints ; Nux vomica, the pain 
and rheumatism of the back; and Sulphur and Rhus, the stiffness 
that ensues during convalescence ; Rhus is indicated if the cause be 
check of perspiration or exposure to wet. Diet, — bread and butter, 
steak and other meats in moderation. 

Chronic Rheumatism is more confined to the muscles than the 
joints, and is often the sequel of the acute form. Sulphur is one of 
the remedies much relied upon in curing this disease. Nux vomica 
may be given after Sulphur, when there is pain in the back or sciatic 
nerve, and Rhus tox. when there is a general stiffness of the limbs. 
The medicines, in the usual doses, may be repeated every two hours. 

Lumbago is simply rheumatism of the back, in the lumbar region, 
and so stiffens one that he cannot stand erect. Sulphur, four glob- 
ules at night, and Pulsatilla, four globules in the morning, will gen- 
erally cure this trouble. Cimicifuga is a very valuable remedy, given 
hourly, in water. 

Sciatica is simply neuralgia of the sciatic nerve and may be cured 
in a short time by a galvanic battery. Rhus is often useful. Bella- 
donna, or its active principle, Atropin, is a valuable remedy to ad- 
minister internally. The diet in all forms of rheumatism, whether 
acute or chronic, may be generous. 

Toothache. 

When caused by a cold, Nux vomica; when from caries of the 
tooth, Mercurius viv. ; at the menstrual period, Pulsatilla ; neuralgic, 
Belladonna or Chamomilla ; Aconite when there is heat in the gums. 
Dose as usual, repeated every hour. 



DISEASES INVOLVING THE VARIOUS ORGANS. 657 



Diseases of the Alimentary Canal. 

Inflammation of the Tonsils is the result of a cold which affects 
this locality, and causes a swelling and sometimes a suppuration of 
these parts. When they first begin to inflame, give Aconite, and fol- 
low with Belladonna ; repeat every two hours. Mercurius viv., 
Lachesis and Mercurius iodatus are also good remedies. 

Quinsy is the same as tonsillitis, and requires the same treatment. 

Putrid Sore Throat comes on by little vesicles making their ap- 
pearance in the mouth and fauces, or throat, which soon, by reason 
of a low constitutional fever, change color, run together, and consti- 
tute the offensive sore mouth which we denominate putrid. Arseni- 
cum, Mercurius vivus, Nitric acid and Sulphur or Sulph. acid, will gen- 
erally cure. Dose and repetition as before. 



Canker of the Mouth. 

This troublesome disorder is caused by a disordered condition of 
the stomach, and requires Arsenicum when the breath is foul, the 
throat dry, and attended with much thirst ; Carlo vegetabilis, when 
the system is in a low condition, and there is much coldness on the 
surface of the body ; Dulcamara, when produced by a cold ; Hepar 
sulph., when the canker seems indolent and slow in coming to a cri- 
sis ; Natrum muriaticum, when it assumes the character of scurvy, or 
Mercurius viv. 

Dose and Administration. — ■ Dissolve from two to five drops of the 
dilution in half a tumbler of water, and give a teaspoonful every two 
hours. Diet, — avoid salt provisions ; use meat-broths, toast and tea. 

Inflammation of the Tongue. 

The first indications of this difficulty are soreness and difficulty 
in using the tongue in deglutition or eating. When caused by me- 
chanical injury, or from accidental biting with the teeth, give Arnica, 
four globules, and wash the mouth with a dilution of ten drops of 
tincture of Arnica in half a tumbler of water. If from other causes, 
give Aconite or Belladonna in the same way. When inflammation 
of the tongue takes the form of ulcers, give Arsenicum ; of blisters, 
Mercurius or Lachesis ; when the tongue inflames and cracks, give 
Nitric or Sulphuric acid. 

Pharyngeal Sore Throat. 

This is an inflammation of the pharynx or of the opening into the 
upper portion of the passage from the mouth into the stomach. It is 
sometimes quite serious, and is usually termed " quinsy sore throat." 



C>58 DISEASES INVOLVING THE VARIOUS ORGANS. 

Aconite may be given at first, and this may be followed by Belladonna, 
and this again by Mercurius viv. Should it become evident that sup- 
puration must take place, give Hepar sulph. Whichever remedy is 
given, let it be repeated every hour until amelioration or change. 
Baryta carb. is often the specific. 

Dyspepsia, Indigestion. 

Difficult digestion, whatever form it assumes, is termed dyspep- 
sia, and must be treated in accordance with the symptoms, and the 
cause that has produced them. Dyspepsia brought on by intemper- 
ance in drinking intoxicating liquors requires Nux vom. ; if from a 
cold, and the patient is chilly and feverish, Belladonna, or perhaps 
Bryonia ; if from eating fat meat or rich food, Pulsatilla ; if from 
grief, Ignatia. Dose, one drop, or four globules, repeated every three 
or six hours, according to the degree of suffering. 

Heartburn, or Waterbrash. — A burning at the pit of the stomach, 
and a constant inclination to regurgitate sour, acrid or bilious matter, 
is termed waterbrash, and is but a form of dyspepsia, and indicates 
Mercurius, Nux vomica, Pulsatilla, Arsenicum, 'Cimicifuga, etc., given 
as above. 

Cardialgia, or Gastralgia, is nearly allied to the above, only at- 
tended with pain in the stomach, as well as burning, sour or acrid 
risings. Arsenicum, Nux vomica, Bryonia, Calcarea, Chamomilla, 
Ooffea, Colocynth, and Pulsatilla are remedies indicated in this diffi- 
culty ; and each may be given and repeated every hour, in the usual 
doses, until relieved. 

Dyspeptic Headache is simply a sympathetic action of the stomach 
upon the head, causing considerable pain. Bryonia, Belladonna, Coc- 
culus, Nux vomica and Arsenicum constitute the group of remedies to 
give relief or cure. When cold water, taken into the stomach, is 
found to disagree with the stomach, either Nux vomica, Arsenicum, 
Pulsatilla or China will afford relief. When any kind of food disa- 
grees with the stomach, causing distress and headache, give either 
Ferrum, Camphor, Chamomilla, Pulsatilla or Sulphur, in the usual 
dose of one drop or four globules. If caused by beer, Colocynth ; by 
milk, Calcarea, Pulsatilla, Nux vomica. When animal food proves 
difficult of digestion, or fat meat, gravies, or drawn butter, Pulsatilla, 
Ignatia, Nux vomica, Cocculus, etc. Dyspepsia is so common a dis- 
ease, and afflicts so great a variety of temperaments and habits, we 
will be explicit in pointing to specific treatment. For hypochondria- 
cal persons, Sulphur, Nux vomica, Ignatia ; for hysterical persons, 
Sepia, Pulsatilla, Hyoscyamus and Lachesis ; for those of a sanguine 
temperament, Nux vomica ; for the sympathetic, Pulsatilla ; for the 
bilious, Mercurius viv.; and for the melancholic, Nitric and Phos- 
phoric acid, Aurum metallicum, etc. When those of a nervous tern- 



DISEASES INVOLVINCx THE VARIOUS OEGANS. 659 

perament are afflicted with dyspepsia, we find Valerian, Hyoscyamus, 
Pulsatilla, Ignatia and Moschus good remedies ; those of a scrofulous 
habit require Calcarea, Arsenicum and Sulphur; students afflicted 
with dyspepsia require Nux vomica, China and Ferrum. Dose and 
repetition as before. 

Sea=Sickness, 

There is no remedy that will prevent sea-sickness and no condi- 
tion of health capable of always resisting it. But the effects of the 
sickness, which are often distressing, can be removed by Cocculus, 
Nux vomica and Ignatia. If there remains an inclination to retch 
after the sickness has passed, give Ipecac. Petroleum is often taken 
as a preventive with success. 

Mucous Vomiting. 

This is simply sickness at the stomach, which may arise from its 
irritable condition, and result in vomiting of slime or mucus. The 
remedies that will obviate the difficulty are Ipecac, Rheum, Pulsa- 
tilla and Veratrum. Usual dose and repetition. 



Vomiting of Blood. 

This may be caused by mechanical injury of the stomach, and re- 
quires Arnica; if caused by pregnancy, Arsenicum ; if from retained 
menses, Phosph. or Pulsatilla ; if from acrid humors, Arsenicum or 
Ipecac. ; if from suppressed eruption, Sulphur. 



Gastritis, or Inflammation of the Stomach. 

This is indicated by severe pain in the stomach, continuous vom- 
iting, heat over the region of the stomach, quick and feeble pulse, 
cold feet and pain in the head. The remedies for gastritis are Acon- 
ite, Bism. subnit., Arsenicum, Belladonna, Ipecac, Tart, emetic, Vera- 
trum, Lobelia and Cocculus, and sometimes Nux vomica. Dose and 
repetition as usual. 

Gastrodynia, or Cramps in the Stomach. 

A pain in the stomach, with cramp, is very distressing and can- 
not be mistaken ; for the cramp is a sudden spasmodic action of the 
muscles of the stomach, which seems like taking the breath out of 
one. Pulsatilla, Nux vomica and Colocynth are the remedies. Any 
one of them will be likely to afford prompt relief. Bioscorea is use- 
ful. 



660 DISEASES INVOLVING THE VARIOUS ORGANS. 



Inflammation of the Bowels. 

A severe pain in the bowels, with distention, and such soreness 
to the touch that weight or pressure cannot be borne, betokens in- 
flammation. Aconite may be given in the usual dose, every half- 
hour at first. If perspiration occurs and the vomiting continues, give 
Bryonia in the same way. If there is tympanitis, or distension, so 
that percussion upon the bowels causes them to sound like a drum, 
Terebinthe, Arsenicum and Mercurius must be consulted. If the dis- 
charges from the bowels, while the inflammation lasts, are acrid, give 
Arsenicum, and follow with 'Bryonia. If there is strangury, or in- 
ability to pass urine, Cantharis. It would be better, in treating so 
formidable a disease as this, to drop ten drops of the selected remedy 
into half a tumbler of water, and give a teaspoonful every half-hour, 
or hour, until amelioration or change. Compresses on the abdomen 
are indicated. 

Chronic Inflammation of the Bowels. 

Acute inflammation of the bowels sometimes passes off, leaving 
them susceptible to entailed inflammation from trivial causes; the 
mucous coat may have been left in a semi-ulcerated condition, from 
which there will be occasional vomiting and muco-purulent diarrhoea. 
The remedies for this disease are Nitric and Sulphuric acid, Arseni- 
cum, Sulphur and Phosphorus. The doses may be as usual ; but the 
remedy may not be repeated more than twice a day, 

Inflammation of the Peritoneum. 

Peritoneal inflammation is often considered in connection with 
inflammation of the bowels, and requires nearly the same remedial 
treatment. The disease is known by the extreme sensitiveness of the 
abdomen to touch ; and the tenderness is so great as to be unable to 
bear the weight of bed-clothes. Aconite given in the usual doses 
every half-hour, until the skin becomes moist, and then Belladonna 
or Verat. viride. If there is thirst, Arsenicum ; Pulsatilla, if in fe- 
males. Nux vomica, if the bowels are constipated. If dropsy of the 
abdomen follow, give Helleborus nig. or Apis mellifica. Diet, — a 
very light gruel of corn-starch or farina. 

Diarrhoea. 

A looseness of the bowels, which may be watery, bilious, pappy, 
painless or with pain. A merely relaxed condition of the bowels 
may be cured by a single dose of four globules of Pulsatilla ; or, if 
not arrested by this, give Mercurius. A watery diarrhoea may be ar- 
rested with Chamomilla, Nux vomica or Veratrum ; a bilious diarrhoea, 



DISEASES INVOLVING THE VAEIOUS ORGANS. 661 

with Arsenicum and Mercurius ; a painless and involuntary diarrhoea, 
with Phosphoric acid. Diarrhoea with colic requires Chamomilla and 
Colocynth ; tinged with blood, Ipecac. ; with undigested food, Pulsa- 
tilla. From fruit, often China. The dose and administration must 
accord with the case. Either of the remedies may be given in water, 
a teaspoonful every hour ; five drops of the dilution, or ten globules 
in half a tumbler of water, may be the mode of preparation. The 
diet for persons suffering from diarrhoea may be mutton-broth, beef- 
tea, boiled milk, or toast and tea, as the patient may elect. 



Dysentery. 

One of the most formidable and prostrating diseases is dysentery. 
It usually begins with a diarrhoea, though occasionally with constipa- 
tion, after a season of lassitude, and increases until mucous discharges 
from the bowels follow. The disease is characterized by much strain- 
ing when trying to evacuate the bowels. This straining is involun- 
tary and painful. Just before there is an inclination for a stool, there 
is usually a sharp pain- in the lower portion of the abdomen. Dysen- 
teric discharges are mucus mixed with blood, or pure blood, or no 
blood at all. For dysentery with no blood in the stools, and yet 
much tenesmus, Gamboge ; when the tenesmus is low down, Aloes ; 
when the mucus is tinged with blood, Mercurius corrosivus, the leading 
remedy, especially if the tenesmus is painful. To arrest a dysentery 
where the discharges are pure blood, and very painful straining and 
thirst, Arsenicum. For much tenesmus, and discharge of mucus 
mixed with blood, Ipecac. Whichever remedy is administered, let 
the usual dose be given immediately after each stool, until relieved. 
The diet in this disease is somewhat important. Water cannot be al- 
lowed in great quantities, but small bits of ice may be held in the 
mouth of the patient; barley-water, flavored with lemon, may be al- 
lowed as a drink ; rice-water ; and, if the patient has any appetite, 
he may be allowed mutton-soup, beef-tea and ]amb-broth ; but chicken- 
broth must be entirely prohibited. Enemas of cold water or rice-water, 
after each discharge, are beneficial. 



Chronic Dysentery. 

Symptoms much like those of the acute, but occurs frequently as 
a weakness left after a protracted attack of the acute form. Sulphur, 
Sulph. acid, Calcarea carb., Ferrum and Carbo vegetabilis are remedies 
employed to overcome the difficulty. Sulphur may be given in daily 
doses for a while, and then Nitric acid or Sulph. acid or Calcarea, un- 
til a cure is completed. Diet in chronic dysentery should be very 
sustaining, and wine may sometimes be allowed. 



662 DISEASES INVOLVING THE VARIOUS ORGANS. 



Cholera Morbus. 

This disease begins with severe pain in the stomach and bowels^ 
and then severe vomiting and purging, until seemingly there is noth- 
ing left to be discharged from the system. Arsenicum and Verat. 
alb. are the leading remedies ; Nux vomica may be given to stop the 
vomiting; Ipecac, Tart, emetic, Podophyllum are severally good rem- 
edies, and any one of them may complete the cure ; four globules 
may be given every fifteen minutes until relief is obtained. 

Asiatic Cholera. 

More formidable than cholera morbus is asiatic cholera, as its at- 
tacks are insidious : first, by painless diarrhoea, which seems to indi- 
cate that all the contents of the alimentary canal are in a soluble 
condition. Floods of rice-water discharges pass from the bowels and 
the same matter is vomited profusely. After a time, the lower ex- 
tremities begin to cramp, and then the cramps come in the abdomen ; 
and, if the disease is not arrested, the patient soon passes into collapse, 
and then to the grave. The treatment of this disease in the early 
stage is very important. Very few cases need to prove fatal, if timely 
resort to the proper treatment is had. As soon as the patient is at- 
tacked with diarrhoea, let him go to bed, and take Veratrum alb. If he 
has great thirst, let him take Arsenicum. If without pain, Phospho- 
ric acid. If with vomiting and purging and great prostration, Iris 
versicolor. Other remedies, such as Elaterum, Secale cornutum, Cam- 
phor and Mercurius viv. may be consulted. Cuprum acet., if with 
violent cramps. The medicines may be administered every thirty 
minutes. In the collapse stage, give Muriatic acid, — ten drops in 
half a tumbler of water, a teaspoonful every twenty minutes. But 
little time can run to waste at any stage of the disease ; every mo- 
ment requires vigilance and attention. Should the disease pass over, 
and the patient is left, he must first have a stimulating diet, and then 
more and more generous, as he can bear it. 

Constipation (Costiveness). 

A confined condition of the bowels is scarcely a disease by itself, 
but a symptom that attends many maladies. In a torpid state of the 
liver, it is generally manifest, and requires a treatment tending pri- 
marily to affect this organ, and thence the bowels. When there is a 
sense of fullness in the rectum, Bryonia ; when a tedious constipa- 
tion, that indicates great torpidity of the bowels, Lycopodium ; a 
constipation following a diarrhoea requires Mercurius viv. or Sulphur ; 
a constipation resulting from a collection of hardened faeces requires 
Sulphur and Nux vomica, or Silicea. Two doses a day, of any of the 
remedies, will be sufficient. A diet for those addicted to habitual 



DISEASES INVOLVING THE VARIOUS ORGANS. 663 

constipation is important : corn-meal mush, brown-bread or bran- 
bread, prunes, apples and other kinds of fruit are recommended. 
Give the new remedies now being used, such as Alonin. 

Invermination {Worms). 

This trouble is indicated by the child picking its nose, and by vo- 
racious appetite, restlessness at night, colic and sometimes diarrhoea 
an pale expression of the face. The remedies for this difficulty are 
Santonin, Cina, Spigetia, China and Sulphur. Santonin will suit bet- 
ter for the long round worms, and Cina, Calcarea and Nux vomica 
for the pin-worms. Dose and administration as usual, three times a 
day. 

Protrusion of the Intestine. 

Falling of the bowels, as the protrusion is usually termed, is 
caused by protracted diarrhoea, and straining at stool, while the intes- 
tine is weak and relaxed. Podophyllum, Mercurius viv., Ignatia and 
Aloes are remedies that will cure the difficulty. Either may be given 
three times a day. 

Inflammation of the Liver (Hepatitis) Acute or Chronic. 

Denoted by pain in the right side, below the ribs, sometimes se- 
vere and at others dull. If there is fever, give Aconite or Verat. vir- 
ide, and follow with Nux vomica in acute hepatitis, and repeat every 
hour until relief or change. If much thirst, give Arsenicum. In the 
chronic form, a daily dose of Sulphur or Sepia, Mercurius viv., Nux 
vomica, Pulsatilla or Podophyllin, will do as much for the patient as 
any treatment in the world. 

Jaundice. 

When the gall-duct of the liver becomes obstructed, and the bile 
is prevented from passing off in the usual w&y, it seeks an escape 
through the skin, and gives it a yellow color. This is jaundice. 
Podophyllin, Chelidonium, Mercurius, Dulcamara, Leptandrin and 
Nux vomica are competent to cure the severest cases. Carlo vegeta- 
bilis, in a crude form, may be given in massive doses when an offen- 
sive odor comes from the mouth or breath. The patient, having no 
appetite, must be supplied with some farina or rice, cooked in the 
most delicate way. 

Inflammation of the Spleen. 

The spleen, being an associate purificatory organ with the liver, is 
liable to similar affections. When inflamed, it is manifest by pain in 
the left side, below the ribs. The same remedies that affect the liver 



664 DISEASES INVOLVING THE VARIOUS ORGANS. 

will also affect the spleen. For congestion of the spleen caused by 
running, immoderate laughter, etc., China, a single ordinary dose, 
will answer. 

Painter's Colic. 

The effects of lead upon the alimentary canal are sometimes disas- 
trous ; and painters who work much in mixing the various prepara- 
tions of white lead are liable to imbibe sufficient of its poisonous 
quality to give them a most distressing colic : hence its name. The 
remedies employed in antidoting the effects of the lead are Opium 
and Alumina, or Colooynth. Should the first-named remedy fail to 
afford relief, try the next, and so on, in doses of three drops of the 
dilution in a spoonful of water. Olive oil, a wineglassful every three 
hours, is good. 

Piles {Hemorrhoids). 

There occurs in the rectum a class of small tumors, caused by 
congestion of the hemorrhoidal veins; and these sometimes become 
so swollen as to protrude from the anus. Sometimes these protrud- 
ing tumors are numerous, and resemble a bunch of grapes. They are 
exceedingly painful, and destructive of comfort. To cure them is of 
the utmost importance. Constipation being often one of the proxi- 
mate causes, such remedies as overcome this condition must be called 
into use. Nux vomica, taken at night, has often proved salutary. 
Sulphur, when the tumors are painful and sting and burn so as to be 
almost unbearable. For bleeding piles, Hamamelis Virginiea is par- 
ticularly recommended. For excessively burning piles, Arsenicum ; 
and for those of a blue color, Oonium or Muriatic acid. Each of 
these remedies may be employed in the liquid form, and three drops 
of the dilution may be taken in a spoonful of water every night. 
The tincture of Podophyllum is also a valuable remedy, and may be 
administered as above ; and so also is Oollinsonia. Hamamelis sup- 
positories should be used in all cases. An injection of moderately 
cold water will often give relief and cure the most obstinate cases. 
Inject a quart, night and morning. Commence with a small amount 
at first and gradually increase ; should be used with caution until it 
is found to agree with the patient. To designate an appropriate diet 
for one afflicted with piles requires a little care. Salt provisions 
must generally be avoided. The free use of stimulating drinks is 
pernicious. Bran-bread and fruits are commendable. Meats, not 
highly seasoned, are allowable, and most kinds of vegetables. 

Itching of the Anus, which sometimes is a concomitant of piles 
and sometimes of worms, is cured in the first instance with Sulphur 
and in the latter with Cina. The usual dose should be given night 
and morning. 



DISEASES OF VARIOUS ORGANS 
AND REGIONS. 



Passage of Gall=Stones. 

The passage of gall-stones is attended by severe pain in the region 
of the stomach, obliging one to writhe in agony, and roll from side to 
side. The strongest men become subdued when suffering from the 
passage of these concretions. The pain resembles an intense colic ; 
and sometimes the agony produced by biliary calculi goes under the 
name of bilious colic. In addition to the pain occasioned by the con- 
cretions, there may be vomiting, headache, cold extremities and sal- 
low complexion. To relieve the suffering, resort has been had to 
Morphine and Opium ; but these sedatives only prolong the difficulty. 
They afford only temporary relief from pain and the use of them must 
be discouraged. Cathartics, on the whole, have failed of accomplish- 
ing the purpose, and only weaken the patient. Homoeopathic reme- 
dies have sometimes afforded prompt relief ; but, as a general thing, 
the success attending the most perfect affiliations of indicated reme- 
dies has not been great. The most modern treatment for biliary cal- 
culi is to administer to the patient from two to four ounces of pure 
Olive oil, the laxative effect of which has gently moved the bowels, 
and brought from the gall-duct large numbers of the concretions, 
sometimes a dozen or more ; after which, the blackness of the coun- 
tenance will begin to disappear, the indurations found in the region 
of the liver become lessened, and the appetite returns. When attacks 
of bilious colic occur, it is not always certain that the gall-duct is ob- 
structed with stones. Therefore, Colocynth, in the usual dose, may 
afford prompt relief ; even when gall-stones have been present, and 
the suffering and agony are indescribably great, Pulsatilla has cured. 
When there is severe pain and induration in the region of the liver, 
a dark, sallow countenance and black circles around the eyes, much 
relief has been obtained by the use of Arsenicum. When there re- 
main black spots or discolorations upon the face, Sepia. When there 
is much vomiting during an attack, Ipecac. External applications 
sometimes prove useful. Emollient poultices applied to the region 
of the pain have proved beneficial. The pain attending the passage 
of biliary concretions has sometimes been mistaken for chronic in- 
flammation of the stomach ; and, on this account the remedies have 

665 



666 DISEASES OF VARIOUS ORGANS AND REGIONS. 

failed to control the suffering. Very many persons suffering from 
chronic liver-complaint become victims to the suffering produced by 
gall-stones, and should restrict themselves to a simple but nutritious 
diet. After an attack, the olive oil should be taken for at least six 
months, a tablespoonful on retiring, each night. 

Cancer of the Liver. — Schirrus. 

In the event of a constant suffering in the right side, with apparent 
hard protuberances, while, at the same time, there are dark circles 
around the orbits of the eyes, and when there are shooting or lancin- 
ating pains darting from the indurated protuberances, a cancer may 
be suspected. If not too far advanced, it may be cured by the use 
of Arsenicum, when there is much thirst and dryness of the mouth, a 
white coating upon the tongue, and considerable prostration. Conium 
maculatum may be given three times a day when there is pain in the 
right side, as if constricted by a band, or tearing and stretching in 
the region of the liver, and colicky, abdominal spasms, 

Cancer of the Stomach. 

This formidable disease often comes on insidiously and the victim 
supposes himself to be a sufferer from an aggravated form of dyspep- 
sia. Severe anxiety and trouble are supposed to have a serious in- 
fluence in the production of the disease. A constant irritation of the 
mucous lining of the stomach may terminate in the difficulty. The 
chief symptoms denoting the presence of cancer in the stomach are 
great depression of spirits, a downcast countentance, a pinched ap- 
pearance of the nose, with the corners of the mouth drawn down, and 
also a constant inclination to retch and vomit dark matter, somewhat 
resembling coffee-grounds, and also severe cutting or shooting pains 
in the stomach, with intense thirst. Nux vomica has sometimes cured 
cancer of the stomach. The indications for its use are intensely bit- 
ter eructations, and spitting up of dark matter ; and also when the 
eructations are followed by vomiting of sanious or bloody matter. 
When the patient has suffered greatly from anxiety and dyspepsia, 
Ignatia may be given, instead of Nux vomica. When the tumor can 
be diagnosed or discovered by external manipulation, Arsenicum and 
also Conium may be given twice a day. Coceulus also may be given 
when the nausea and vomiting are similar to that produced by riding 
in a carriage, or sea-sickness. When one has suffered many years 
from dyspepsia, and then begins to emaciate and spit up this dark 
matter, Nux vomica given persistently is most likely to be of service. 
The patient should subsist upon broths, beef-tea and the most deli- 
cate farinaceous diet. 



DISEASES OF VARIOUS ORGANS AND REGIONS. 667 



Cancer of the Intestines. 

The symptoms which denote the presence of cancer of the intes- 
tines are constant pain in the bowels, and acrid discharges of black- 
ish stools, a very black or dark appearance of the countenance, down- 
cast expression, a constant inclination to relieve the pain by pressure 
of the hands and arms. This affection generally terminates fatally, 
— the result being perforation of the bowels. When autopsy, or 
post-mortem examination reveals the fact, it is then called to mind 
that the victim has worn the expression and complained for a. long 
time in a way that might have excited suspicion of the trouble. To 
note these symptoms when they first occur may suggest a treatment 
that possibly might avert a fatal termination. Arsenicum may be 
given when the patient has thirst, burning pain in the bowels, and 
hot, acrid stools ; Conium, when the pains appear to be of a neural- 
gic character, and persistent ; Belladonna, when there is painful dis- 
tention of the abdomen. The diet should be the same as that directed 
for cancer of the stomach. 

Cancer of the Skin. 

WHEN inflammation of the skin, or any persistent irritation, ter- 
minates in cancer, there is a rough, hard tumor of a bluish appear- 
ance, at first about the size of a common wart. It sometimes grows 
into the shape of a tumor, and is the seat of sharp, shooting pains. 
The remedy that has apparently cured this affection is Silicea, in 
daily doses. It is particularly indicated when there is painful sore- 
ness or sensitiveness of the skin, and an itching of the whole body ; 
and also when there is stinging in the sore. To prevent cutaneous 
ulcers of the skin from becoming cancerous, the same remedy may 
be used. To prevent horny excrescences from assuming a cancerous 
character, Conium or Causticum may be given in daily doses. Almost 
any persistent irritation may assume the character of a cancer. Icho- 
rous ulcers, fetid sores, malignant boils or ulcers, should be carefully 
treated and cured, or otherwise they may take on a settled or consti- 
tutional schirrous character. The skin should be kept clean ; a flesh- 
brush should be frequently used, and exercise in the open air is com- 
mended. Diet free from condiments, but nutritious. 

Fig=Warts, 

These are excrescences upon the skin in the shape of a fig, and 
hence their name. Nitric acid and Thuja are remedies for these ex- 
crescences. Thuja is more particularly indicated when they bleed ; 
Nitric acid, when they are flat; Nux vomica, when they are dry. 
When they suppurate, or are humid, Thuja ; when they split or 
crack, Nitric acid. Of the remedy selected, give a dose every day. 



668 DISEASES OF VARIOUS ORGANS AND REGIONS. 

For Common Warts, Thuja is also the chief remedy, and should be 
given every two or three days. 

Gangrene. 

When one has been so long sick as to acquire bed-sores, and these 
become black and fetid and deathlike, they are said to be gangrenous. 
They indicate a low condition of the system, and generally indicate 
the employment of Arsenicum in daily doses, or else Lachesis. For 
dry gangrene, give Arsenicum. For that which is humid, give China. 
For that which emits an offensive odor, give Secale cornutum. This 
last remedy may be given for gangrenous blisters. " The patient, if 
he take it, should have a generous diet. 

Zona, or Shingles. 

In some cases, there is a zone or belt of vesicles, four or six inches 
in width, that extends half way round the body, on the right side, 
over the region of the liver. These vesicles appear to be filled with 
lymph, and are prone to burn and itch to almost an unbearable ex- 
tent. It is believed to be a concomitant of chronic liver complaint, 
and indicates an exceedingly low condition of the blood. Rhus tox., 
in daily doses, will generally cure the disease. Graphites may be 
given after Rhus tox. When there is pain in the right side and a 
sallow complexion, give Mercurius. Bryonia will eliminate the 
eruption, and aid materially in the invigoration of the system. If 
there is much headache, give Belladonna. If the patient is scrofu- 
lous, give Arsenicum or Calcarea. The diet of the patient, if his ap- 
petite will permit, should be quite generous. A little wine every 
day is recommended. Beef or mutton without condiments, and the 
usual vegetables, are allowed. 

Nasal Polypus. 

This fungous growth in one or both nostrils sometimes proves a 
serious obstruction to respiration through the nose, and can be cured, 
in most instances, with well-chosen remedies. When both nostrils 
are affected, give a dose of Calcarea every twenty-four hours. When 
the polypus is in the right nostril, give Pulsatilla ; when in the left, 
give Sanguinaria. If the nostril seems plugged, give Sepia or Silicea, 

Warts on the Nose. 

Warts on the nose are sometimes quite annoying, as they not only 
are inconvenient, but often painful. It is difficult to let one of these 
excrescences alone ; and, by constant irritation, it may become can- 
cerous ; therefore, prompt treatment when they make their appear- 
ance is requisite. Causticum, given at first, will soon relieve the 
nose of this appendage. 



DISEASES OF VARIOUS ORGANS AND REGIONS. 669 



Warts on the Hands. 

When warts on the hands are prone to grow thick and large, and 
appear to be seedy, Thuja in the form of lotion may be applied exter- 
nally, while the usual dose of the same may be taken internally. Cu- 
prum ascetieum also may be taken internally, and a wash of Cuprum 
sulph., one dram to half a pint of water, may be applied externally. 

Inflammation of Glands under the Arms. 

A sore upon the back of the thumbs, and sometimes an irritable 
sore upon the backs of the fingers and hands, may cause soreness and 
inflammation of the glands in the arm-pits ; that is, the inflammation 
may be transferred to this locality from the thumb, fingers or hands. 
At first, a slight soreness is felt under the shoulder in the arm-pit, 
and the glands will swell and become sore to the touch ; more or less 
fever will manifest itself at the time ; and not infrequently pain, 
throbbing and suppuration supervenes upon the inflammation. Aco- 
nite may be given to subdue the fever and inflammation ; Hepar sul- 
phuris may be given to promote suppuration ; Belladonna or Bryonia 
to prevent it. Phytolacca, also, is a most useful specific, given every 
three hours until relieved. 

Inflammation of the Groin, Inguinal Glands. 

The inguinal glands are situated in the groin; and sometimes 
sores of an irritable character upon the toes may operate so as to 
transfer these influences to this region, causing swelling and suppur- 
ation. If taken in time, this soreness may amount to nothing more 
than an uncomfortable lameness, rendering it difficult to walk. If 
not arrested, the inflammation will pass into suppuration. Sores or 
chancres upon the integuments of the penis may also cause inflamma- 
tion, swelling, and even suppuration, of the inguinal glands. When 
caused by sores on the toes, poultices of bread and milk may be ap- 
plied to them, to draw the inflammation from the groin ; and Nux 
vomica may be given internally, to aid in curing the difficulty. When 
this inflammation occurs in scrofulous persons, Arsenicum may be 
given twice a day. When the inflammation proceeds from a chancre, 
give Merc. iod. three times a day ; when from suppressed gonorrhoea, 
give Sulphur. Mercurial ointment may be applied to the sores, when 
of syphilitic origin. If they occur from syphilis, Merc. iod. may be 
given internally three times a day. 

Milk Leg. — Phlegmasia Dolens. 

This affection frequently occurs one week after delivery. It con- 
sists in a swelled condition of the thigh and leg of either the right 



670 DISEASES OF VARIOUS OKGANS AND REGIONS. 

or left side. The skin becomes tense, sore to the touch, oedematous 
or dropsical, and very sensitive. It rarely affects both limbs at the 
same time, although in some instances such is the case. It may 
sometimes be arrested in the incipient stage by a single dose of Aco- 
nite. In a more advanced stage, Belladonna will have a curative ac- 
tion ; and, when there is great sensitiveness of the skin, Rhus tox. 
When the victims of milk leg have been afflicted with dropsy before 
confinement, Arsenicum may be given. In cases where women are 
suffering from rheumatic pains in the knees, or where there is sup- 
pressed lochia, Pulsatilla. When the bowels are constipated, Lyco- 
podium may be given, and not repeated for several days. 

Stone Bruise. 

By a stone bruise is understood an injury upon the plantar, or un- 
der surface of the foot, which becomes inflamed, painful and sup- 
purative. It mostly occurs with boys and girls who run barefooted 
thr6ugh the warm weather ; and it is believed to be the result of step- 
ping forcibly upon pebbles or other hard substances. Arnica given 
once or twice internally, and a lotion of the same applied externally, 
will often remove the pain speedily ; but, after suppuration has taken 
place, the sooner the matter is let out with a lancet the better. 

Bunions. 

These protuberances upon the joint of the great toe, or upon the 
side of the foot immediately back of the little toe, frequently grow 
so large as to interfere with the wearing of a shoe or a boot, and so 
painful as to interfere with the comfort of the patient. In order to 
derive any benefit from treatment, all mechanical interference must 
be removed, the boot or shoe must be shaped to favor the tumor, and 
then wet the tumor a number of times during the day with Arnica. 
Antimonium crud. may be given internally, or else Calcarea, Sepia or 
Sulphur. Give but a single dose of each remedy ; after which, wait 
with patience. If the bunion is very painful, give Calcarea; and af- 
ter two days, give Nitric acid. If the pains are stinging, Lycopodium, 
Silicea or Sulphur. Give a single dose of either remedy, and wait 
forty-eight hours. A weak solution of Nitric acid will often moder- 
ate the severe pain of a bunion in dry weather ; Bryonia will do the 
same in cold, damp weather. Silicea or Rhus tox. will afford great 
relief when every change of weather aggravates the pain and suffer- 
ing. In case of bunions becoming the seat of neuralgic pain, Bella- 
donna may be given ; and when they are made sore by chilblains, as 
in scrofulous persons, Arsenicum must be given. The patient must 
not walk much, but keep the feet dressed and warm until the soreness 
disappears. A poultice of bread and milk will soften and mollify the 
aching during a storm. 



DISEASES OF VARIOUS ORGANS AND REGIONS. 671 



Hectic Fever. 

The importance of this fever is so great, that, instead of elabora- 
ting upon it under the head of " fevers," it is introduced here, be- 
cause it should not be confounded with other febrile diseases. There 
is a common impression that hectic fever and consumption are one 
and the same thing ; but this impression will be corrected when we 
consider briefly the origin of this fever. It is sometimes intermit- 
tent, and sometimes remittent. Often a slight chilliness is felt some 
time during the day; and this is followed by a febrile reaction, more 
or less severe, and of a prostrating character. Extreme debility may 
cause a fever of this kind to spring into existence ; and, under such 
circumstances, it may take the form of a low nervous fever, very slow, 
and wearing upon the nutritive system. But hectic fevers show 
themselves where there are local chronic inflammations and suppura- 
tions, as in the case of abscesses, carbuncles, etc. They are some- 
times caused by grief, or emotions of any kind. They are caused by 
the loss of animal fluids ; or they may supervene upon any pros- 
trated condition brought on by acute disease. They result also from 
scrofula and syphilis, and from the poisonous influences of Quinia or 
mercurial medicines. It is probable, therefore, that hectic fever, taken 
in time, is curable, provided the organic lesions on which it depends 
are not of a fatal or incurable kind. That which usually accompanies 
pulmonary tubercles can only be overcome by curing the tuberculo- 
sis of the lungs. We will proceed to specify the treatment according 
to particular indications. Those springing from debility, and with a 
slow nervous fever, require the use of China and Arsenicum. Give 
the China every time the fever remits or intermits, — a single dose. 
Give Arsenicum in the same way when there is extreme prostration 
and thirst. Give Phosphoric acid when there is diarrhoea. When the 
fever attends local inflammation, Arsenicum may be given, when there 
is great emaciation and debility, with palpitation of the heart, hot, 
dry skin, and night-sweats; Calcarea, when there is constant heat 
and little thirst, frequent flushes of heat, especially in the evening, 
with red cheeks. Calcarea is also indicated when there is loss of ap- 
petite, great debility and emaciation, and also paroxysms of anguish. 
China is indicated when there is great paleness, sunken cheeks and 
eyes, great listlessness, dry and flaccid skin, great hunger or else loss 
of appetite, and a tendency to diarrhoea. For hectic fever brought 
on by emotions or grief, give Phosphoric acid, followed by Capsicum 
when there is painless diarrhoea, sad, oppressed mood, febrile heat in 
the evening and sweat towards morning. Give Ignatia when the pa- 
tient weeps during the fever, and has much heat in the palms of the 
hands. Give Graphites when the patient is pale and the heart is 
prone to palpitate. If the fever is produced by debilitating losses, 
give China when from hemorrhage ; give Nux vomica when from sex- 



672 DISEASES OF VARIOUS ORGANS AND REGIONS. 

ual excesses ; Phosphoric acid when from diarrhoea, and there is ac- 
celerated pulse, anguish, and sweats in the morning. When the fever 
comes on after dysentery or typhus fever or cholera, give Arsenicum, 
if there are dysenteric discharges, and if the patient is greatly ema- 
ciated, and has laborious breathing, with debility and palpitation and 
thirst, obliging him to drink frequently. Give Cocculus when hectic 
fever sets in after typhus, when there is great debility, and trembling 
after the least exertion, blue margins around the eyes, dry mouth, 
and loss of appetite, oppression of the chest, and with great sadness 
and anguish. Give Veratrum album when hectic comes on after 
cholera, if there is great weakness, or cramps, or pain in the back of 
the head during the fever. When syphilis is attended with hectic 
fever, and if the patient has taken much Mercury, give Aurum mur. 
or Stannum, when there is great emaciation, and pains in the bones, 
and loss of appetite. Nitric acid may be given when the hectic fever 
has been brought on by mercurial medicines, and when there is great 
dryness of the throat and varices of the tongue. In many cases of 
hectic fever, springing up like those named above, a careful selection 
of the remedy, and corresponding adaptation of diet and regimen, will 
bring about a large proportion of cures. Persons suffering from any 
form of hectic fever should be kept in an atmosphere of uniform tem- 
perature, — from 68° to 70° Fahrenheit, and should be supplied with 
generous food when the appetite will take it, and in some cases the 
best of grape wine. 

Night=Sweats. 

If night-sweats break out in particular diseases, they do not require 
any special consideration, unless it happens to be one of the most 
prominent symptoms ; in which case, it may constitute an important 
indication for the selection of a remedy. A profuse perspiration of 
this kind which affords no relief indicates Mercurius or China. Ex- 
hausting night-sweats in the case of persons that have become weak- 
ened by disease or other causes, point to Carbo. vegetabilis, Veratrum 
album, Sulphur. But there are individuals, who appear to be well 
enough otherwise, who perspire copiously every night, and sometimes 
so profusely as to wet the bed-clothing. It would seem that sleep 
induced some kind of labor that wrought the system up to this pitch 
of perspiration. It is said to be most common with corpulent per- 
sons. Such cases as only exhibit the one symptom of sweating for 
consideration, must be treated as follows : When one begins to sweat 
as soon as he lies down to rest at night, Arsenicum may be adminis- 
tered. When he fails to sweat so long as he keeps awake, give Hepar, 
if he is corpulent ; or Calcarea if he finds the sweats to diminish his 
strength. If exercise of mind sets him to perspiring after getting 
into bed, give Nux vomica, if there is a sanguine temperament. If 
the person is a good feeder, and eats heartily, and has these prostrat- 
ing sweats at night, let him eat less, and take Pulsatilla. Exhausting 



DISEASES OF VARIOUS ORGANS AND REGIONS. 673 

night-sweats that occur after fatigue require Arnica and China. If 
after severe mental labor, give Cocculus or Nux vomica. If from no 
cause that can be determined, Carlo, animalis. When no fever pre- 
cedes one of these exhausting sweats, and there is great debility 
after, China, Ferrum, and Graphites are appropriate remedies. For 
the exhausting night-sweats that occur after masturbation, China is 
also the remedy. If there is uncomfortable feeling about the head, — 
a dull feeling, — give Phosphoric acid. Those night-sweats that occur 
after excessive sexual indulgence require China, Arsenicum, and 
Graphites. For morbid sweats in general, Arsenicum, Arnica, Bry- 
onia, China, Ferrum, Graphites, Helleborus nig., Hyoscyamus, Ignatia, 
Mercurius, Nux vomica, and Sulphur may be consulted. 

Pulmonary Consumption. 

There is reason for a distinct monograph upon this disease. Much 
that can be done to ward off the disease by domestic treatment should 
be done; and, therefore, to point out a plain description and treat- 
ment of the incipient stage is at least desirable. The cause of con- 
sumption may be hereditary taint or overpowering influences that 
break down the strongest constitutions. When hereditary, it fre- 
quently exists as a predisponent in the system until aroused by some 
exciting cause. It is therefore of the first importance to become 
familiar with the means of protecting one thus disposed from sur- 
rounding influences that may develop the hereditary taint. When a 
child of consumptive parents appears to thrive well and grow, be- 
traying no signs of disease, it is well to keep him surrounded by such 
atmosphere, food, and clothing, as contribute to his healthy develop- 
ment, until the age of puberty. It is at this period that changes 
occur, more or less fraught with danger. With the male, there is 
danger of arousing any latent tendency to pulmonary tubercles ; with 
the female, there is danger of the menstrual function becoming so 
feebly developed, that it acts as an excitant upon any latent discrasia 
of the blood. Treatment is therefore required at this period, not 
only to obviate any derangement consequent upon its occurrence, but 
to aid a burthened system in bringing about this physiological change, 
so as to answer all the demands upon it. Separate beds should be 
insisted upon. 

For males at the age of puberty, children of scrofulous parents, 
give a dose of Cole. carb. twice a week, and restrict them to a strictly 
nutritious diet, free from fat or gravy. In case of their being chil- 
dren of parents who had tubercular disease of the lungs, give them 
Lycopodium twice a week, or perhaps Graphites, and direct for them 
a good diet of animal and vegetable food; let them avoid exposure 
to extremes of temperature ; . let them sleep in well- ventilated apart- 
ments : and any hereditary tendency to consumption can be overcome. 
Should a cough ensue upon the period of pubescence, give Lyco- 



674 DISEASES OF VARIOUS ORGANS AND REGIONS. 

podium or Calcarea ; if a short, hacking cough, give Phosphorus ; if 
a tickling cough, give Pulsatilla or Sepia. By thus watching the 
first development of cough, and by giving the appropriate remedy at 
once, the same can be cured. In females, when there is great debility 
of the chest, and sometimes a slight bleeding occasioned by a trifling 
cough, give Sauro cerasus. Thus, by noting the slightest develop- 
ment of cough at this period, and by being prompt in selecting the 
appropriate remedy, this incipient form of consumption can be cured, 
and sound health be established, and will remain until some other 
revolution occurs to unsettle the system. Any excesses on the part 
of the male must be avoided. Whatever weakens or deteriorates any 
of the functions may prove an exciting cause, so long as there is any 
predisposing influence in the system. On the part of females, there 
is danger at the period of the first pregnancy. This revolution will 
either make further improvements in the direction of sound health, 
or it will arouse unfavorable influences that depress and ruin it. Thus 
it may seem plain that consumption may be successfully treated in 
its incipient stage, whether it shows itself early or late in life. If 
there is indication of its approach after a fever, give China ; if after 
excessive fatigue, give Lycopodium or Stannum. If excessive venery 
causes a development of consumptive symptoms, give Arsenicum or 
China; if the shock of labor produces depressing effects, give Arnica, 
China, and Arsenicum; and if cough ensues, give Bryonia or Phos- 
phorus, and a well-regulated diet. It is believed, that, in a majority 
of instances, hereditary consumption can be erased from the family 
record by carefully waging a warfare upon the first approach of the 
enemy. 

But a different aspect presents itself in that form of consumption 
which comes on by reason of a good constitution having been over- 
taxed and worn out. A cold, badly treated, may leave behind a per- 
manent irritation even upon the most naturally healthy constitutions. 
A cough from a cold is not to be trifled with; therefore, attend to 
the slightest cough. Nux vomica may remove a cough brought on by 
a cold, if given at once ; a dry, hollow, or hoarse cough may be cured 
with Hepar sulph. ; a cough with heat of the chest and soreness of 
the lungs may be cured with Bryonia. Long exposure to cold that 
chills the whole system may be followed by a violent fever that fixes 
itself upon the lungs, producing violent inflammation ; and this, if 
improperly treated, may end in consumption. Almost any acute dis- 
ease, badly treated, may terminate in fatal consumption ; therefore, 
when any interruption occurs in the function of respiration, it is 
more or less dangerous. The slighter the interruption the better, 
and the more easily can it be removed. But it must not be neglected. 
An exceedingly slight capillary congestion, if neglected, may become 
chronic, and end in tuberculous consumption ; a slight bronchial dis- 
turbance, not properly treated, may terminate in bronchial consump- 
tion: in short, any of the ailments of a trivial character, which can 



DISEASES OF VARIOUS ORGANS AND REGIONS. 675 

be made worse by neglect, may demand the most careful treatment, 
or otherwise they may terminate in consumption. 

Influenza, or Grippe, comes on like a cold, with sneezing or snivel- 
ling, pain in the chest, and a general appearance of catarrh. Too 
frequently it has been neglected in the first stage, and it has run into 
the chronic form of bronchitis, and thence into consumption. Such 
being the known tendency, it is well to seek the best of treatment 
for this disease at once. Arsenicum, in the incipient stage, will re- 
lieve some of the symptoms : it will relieve the thin discharge from 
the nose and eyes, the pain in the limbs, and general aching in the 
bones. Euphrasia relieves many cases in the beginning which re- 
semble Arsenicum. Mercurius viv. is also a fine remedy for the stop- 
page of the nose, eyes, and general restlessness of the whole system. 
Influenza has been reckoned among the causes of consumption, be- 
cause, in many instances, it has been the means of calling into action 
certain latent tendencies that have been dormant until set upon 
by this exciting cause. Influenza is but an acute form of bronchitis, 
and as such it must be treated. Aconite may be given if there is a 
quick, full pulse. After Aconite has softened the pulse, and pro- 
duced moisture upon the skin, if the head continues to ache, give 
Belladonna; if there is soreness of the throat, give Merc, viv.; if 
much thirst, Arsenicum ; if pains in the back and loins, JVux vomica. 
In females, Pulsatilla may remedy many of the derangements which 
influenza produces. If a sudden check of menstruation supervenes 
upon an attack of this disease, give Aconite, and follow with Pulsa- 
tilla ; and, finally, if influenza shows itself in an epidemic form, and 
almost every man, woman and child become victims, Aconite, Bella- 
donna, Mercurius, and Nux vom., or else Arsenicum, Apis mel., Bry- 
onia, Calcarea carb., Phosphorus, and Sulphur, may constitute the 
group from which is to be selected a remedy, according to symptoms. 
It is an old saying, with regard to diet, " to starve a fever, and stuff a 
cold; " but all proverbs are not true. There is, in every cold, some 
degree of fever that must be heeded, because a too generous diet 
would be likely to do harm. A moderate diet of black tea, rice, 
barley, toast, and fruit, is best. Thus, by judicious medication and 
an appropriate diet, there need be no sequel that causes the patient 
to sink rapidly into the grave. If otherwise, it will arouse some con- 
stitutional diathesis, and this will render the joint action formidable 
in the extreme. As in tubercular consumption, or rather in that 
which is hereditary, a constant vigilance is required to put in action 
certain antagonistic influences to overpower the disease, so in bron- 
chial consumption, or that which is generated by a succession of 
ailments that implicate, in a lesser or greater degree, the mucous 
membrane that lines the bronchial tubes, an effort must be made to 
bring any and every assault upon the bronchia to a successful termi- 
nation, — whether a common cold, a trivial cough, a slight soreness 
upon the air-passages, or even pneumonia: let each be treated per- 



676 DISEASES OF VARIOUS ORGANS AND REGIONS. 

sistently, according to symptoms, until perfectly cured, so as to leave 
no entailment in the form of a sequel, to prey upon the constitution. 
Hygienic treatment must correspond with the administration of 
remedies. Well-ventilated apartments, sufficient clothing, and good, 
nourishing food, cannot fail of putting the system in a favorable con- 
dition for recovery. Regular sleep, regular meals, and a well-regu- 
lated temperature, are things indispensable. 

Weakness of the Sight. — Amblyopia. 

The term amblyopia signifies a weakness or morbid alteration of 
sight ; and there is every grade, from mere dimness of vision to com- 
plete blindness. A sense so important as that of sight is entitled to 
a distinct consideration, inasmuch as a variety of causes may operate 
to impair it. The difficulty may be attended with many morbid con- 
ditions of the organism, and a variety of remedies may be required to 
treat the affection. We will therefore point out the treatment for 
the various grades, in order. For Simple Weakness of Sight in 
plethoric persons, give Belladonna; for scrofulous individuals, Cal- 
carea ; for weak or debilitated individuals, China ; for nervous per- 
sons, Hyoscyamus. For those whose sight is impaired from biliary 
derangement, Sepia or Sulphur. For Incipient Amaurosis, Aurum, 
Sepia, Sulphur. For Complete Amaurosis, not incurable, give 
Belladonna to persons of full habit; Calcarea to persons who have a 
scrofulous tendency; Mercurius, for those suffering from hepatic de- 
rangement; Phosphorus, for those suffering from catarrhal affections ; 
and for those subject to sick headache, Sepia. For Torpid Weak- 
ness of Sight, Phosphoric acid. For weakness of sight brought on 
by fine work, give Belladonna or Buta. For that which occurs from 
old age, give Baryta carb., Opium or Secale cornutum. Where weak- 
ness of vision occurs after suppression of the menses, or hemorrhoids, 
give Pulsatilla or Lycopodium. For that occasioned by suppression 
of measles, Causticum, Stramonium or Sulphur. For that supervening 
upon rheumatism, give Belladonna, Pulsatilla or Bhus tox. For that 
attendant on gout, give Nux vom. or Colchicum. For that caused by 
the abuse of mercury, give Nitric acid. For that caused by worms, 
give Cina. For that occasioned by diarrhoea, give Merc. viv. For 
that brought on by loss of blood, China. For that produced by scrof- 
ula, give Arsenicum, Calcarea or Nitric acid. When produced by cold 
in the eyes, Dulcamara or Nux vomica. That produced by blows or 
concussions requires Arnica, Buta, Euphrasia. The remedies chosen 
must not be repeated oftener than once a day. When weakness of 
sight is attended with nervous headache, give Aurum, Belladonna, 
Bryonia, Sepia or Sulphur. If by congestion of blood to the head, 
give Belladonna, China and Phosphorus. For that attendant on 
deafness or noises, give Cicuta, Nitric acid or Pulsatilla. The reme- 
dies need not be repeated more frequently than once or twice in 



DISEASES OF VARIOUS ORGANS AND REGIONS. 677 

twenty-four hours. If weakness of vision is attended by gastric or 
abdominal ailments, give Cocculus, Nux vom., Ignatia or Pulsatilla. 
If attended by derangements of the womb, give Calcarea or Sepia. 
If by pulmonary complaints, give Phosphorus, Lycopodium, Calcarea 
and Sulphur. If by disease of the heart, Lachesis, Phosphorus, Pul- 
satilla, Sepia and Spigelia. If by epilepsy, spasm or hysteria, Hyos- 
cyamus, Opium, Stramonium or Sulphur. The remedy may be re- 
peated, if necessary, every twenty-four hours. 

The particular indications for several of the remedies may be stated 
as follows : Aurum, for black spots or scintillations, or half-sighted- 
ness, or tensive pain in the eyes, or in case of sudden attack after 
scarlet fever, or during confinement after delivery. Belladonna for 
dilated pupils or insensible pupils, spasmodic twitching of the lids, or 
mist before the eyes, aching and distensive pains in the orbits and 
forehead, and red face. Calcarea, for mistiness of sight, as if gauze 
were before the eyes, especially when reading; for dilated pupils, and 
for pressure or feeling of coldness in the eyes. Causticum, for sud- 
den and frequent loss of sight, with sensation as if something were 
stretched over the eyes, or for dim-sightedness, as if looking through 
a veil or mist. China, for weak sight : the patient only sees the out- 
lines of things near him; letters look pale, and appear to be sur- 
rounded by white borders ; dilated and not very sensitive pupils ; 
dimness of the cornea, as if the eyes were filled with smoke or black 
motes. The eyes feel better after sleeping. Cicuta is indicated 
when the sight frequently vanishes, and when there is vertigo or 
absent-mindedness, or aching pains in the orbits. Cina, for dimness 
of sight improved by wiping the eyes, and for pressure in the eyes 
when reading, as if sand had got in. Cimicifuga, when there is ach- 
ing pain in the centre of both eyeballs, and black specks before the 
eyes. Drosera, for frequent vanishing of sight, or when the eyes are 
dazzled with the glare of light or of fire. Gelsemium, when there is 
a thirst for light after apoplexy or congestion of the brain. Hyoscy- 
amus, for squinting, illusory sight and stupefying pains over the 
eyes. Mercurius, for paroxysms of momentary blindness, sensitive- 
ness of the eyes to light or the glare of fire. Nux vomica, for red 
face and sensitiveness of the eyes to light only in the morning. 
Phosphorus, for paroxysms of sensations as if things are covered 
with a gray veil. Pulsatilla, for paleness of the face, and disposition 
to vomit, and a sensation as if dimness of sight could be removed by 
wiping; for frequent and copious flow of tears, and contraction of 
the pupils. Ruta, for mistiness of sight, and boring pains in- the or- 
bits, and the filling of the eyes with water in the open air. Sepia, 
for dimness of sight when at work, stripes before the eyes and aching 
pains in the eyeballs, with sick headache. Silicea, paroxysms of sud- 
den obscuration of sight, as if a colored veil were before the eyes. 
Sulphur, for general mistiness of sight, as if looking through feather- 
dust or black gauze; great dryness of the eyes. Veratrum album, 



678 DISEASES OF VARIOUS ORGANS AND REGIONS. 

for profuse shedding of tears, or the copious filling of the eyes with 
water. Veratrum viride, when walking brings on blindness, with 
fainting vertigo and dilated pupils. When any one of the remedies 
is indicated, let the dose be repeated only once in twenty-four hours. 
In all affections of the sight, the patient should avoid hearty meals 
or excessive overloading of the stomach; he should be regular in his 
habits, and free as possible from mental anxiety ; and, above all, his 
habits should be strictly temperate, and late hours should be avoided. 
In most cases of defective sight, the eyes require rest. An attempt 
to exercise them in reading in any defective light is pernicious ; and 
so is prolonged reading in any light. 

Paralysis of the Eyelids. — Blepharoplegia. 

This affection sometimes occurs in children, but very rarely in 
adults, and requires remedial treatment. The best remedies are Bel- 
ladonna, Spigelia, Sepia and Stramonium. Belladonna, if there is red- 
ness of the face ; Spigelia, if there is any sign of spasms ; Sepia, if it 
follows severe headache and sickness of the stomach ; Stramonium, 
if there is pale face, and inclination to sleep. Causticum for chronic 
cases. 

Whooping=Cough. — Tussis Spasmodica. 

Among the diseases of children, we find this malady quite com- 
mon. The cause is only conjectured. As it is a disease much 
dreaded by parents, we shall not only be particular in describing the 
disease, but also in pointing out the remedies for the various stages 
and complications. The cough begins in the form of an ordinary 
catarrh arising from a cold. The child has coryza and coughs ; the 
mother or nurse may be aware that the disease commences in this 
way, and their fears may be that it will turn out whooping-cough. 
The catarrhal stage may last ten days or two weeks, and then a dif- 
ferent and characteristic cough sets in. This cough comes on in 
paroxysms, in which a number of rapid expirations follow each other, 
as in the act of coughing, and with much violence, and without any 
intervening inspiration, till the patient turns black in the face, and 
seems on the point of being suffocated; then one long-drawn act of 
inspiration takes place, attended with that peculiar rough, crowing 
noise, which is denominated a whoop, and gives the disease its name. 
Immediately after this long-drawn inspiration, a series of short expir- 
atory coughs, repeated till the breath is almost exhausted ; and 
then a second whoop, until a white, glary mucus is thrown up, and 
this ends the paroxysm. After a lapse of some little time, the par- 
oxysm will be repeated. During the urgency of some of these par- 
oxysms, the face becomes red and swollen, the nose bleeds, the eyes 
start from the sockets, the little sufferer stamps with impatience, and 
clings to some object near him ; and this frenzy continues till vomit- 



DISEASES OF VARIOUS ORGANS AND REGIONS. 679 

ing or expectoration ends the paroxysm. The victim pants a little 
while, and appears quite well again, and begins to have a craving for 
food. The number of paroxysms that occur every twenty-four hours 
varies in different subjects. Children are very susceptible to the dis- 
ease, and it spreads by contagion. The ordinary duration of the dis- 
ease is from six weeks to three months ; but it may run its course in 
three weeks, and sometimes not for four or five months. 

As long as this disease is uncomplicated, — unmixed with inflam- 
mation, and therefore without fever, or with that slight inflammatory 
condition proper to a mild catarrh, — it is not a dangerous disease. 
In all probability, it will run its course under the most favorable cir- 
cumstances. How much it can be abridged by appropriate remedies 
is yet a question, but the violence of the disease may be moderated, 
its sequel may be guarded against, and its complications may be tem- 
pered, by the right use of remedies. The most favorable season for 
the disease to rage is in the spring, when the weather is becoming 
warmer. The most unfavorable is late in the fall, when the weather 
is augmenting in coldness. Cold or damp weather is thought to pro- 
tract the disease, and warm weather to abridge it. We have thus 
been somewhat particular in describing this malady, in order to facil- 
itate its treatment by mothers and nurses. We will now proceed to 
direct the use of appropriate remedies. In the catarrhal stage, give 
Aconite, If there is fullness of the nose, and headache, give Bella- 
donna. In case of asthmatic breathing, give Ipecac. Aconite is the 
remedy for a dry, wheezing cough, with fever or burning pain in the 
larynx or windpipe. Belladonna is the remedy for severe paroxysms, 
with congestion of blood to the head, expectoration of blood, and 
bleeding from the nose, the eyes appear congested, involuntary stool 
and urine, and also when the paroxysm is announced with crying, 
which arises from pain in the stomach, but not accompanied by vom- 
iting. Also, in the first stage, Carlo veg. may be given when the 
cough is convulsive, especially in the evening, and when there is 
great exhaustion after each coughing-spell. Dulcamara is a good 
remedy when the cough is moist from the commencement. Ipecac. 
for the incipient stage, when the child has coughing-spells so rapid 
as not to be able to get his breath, and when the open air is requisite 
to relieve him. Pulsatilla is useful when the cough is loose from 
the beginning, and worse towards evening. In the second stage, 
after whooping sets in, with vomiting, and bleeding from the nose 
and mouth, give Caulophyllum. If without bleeding at the nose, give 
Drosera. If the children suddenly become rigid, give Chia. This 
remedy is specific when children are affected with the usual worm 
symptoms, and the paroxysm is followed by a gurgling noise from 
the abdomen. Corallia rubrum is believed to be a sure remedy for 
violent spasmodic cough ; short, barking cough all day, and towards 
evening becoming violent and spasmodic. Cuprum is indicated when 
every paroxysm is attended with cataleptic fits, so that in most every 



680 DISEASES OF VARIOUS ORGANS AND REGIONS. 

paroxysm the child appears as dead. Veratrum is very suitable after 
Cuprum. Drosera is the remedy when the paroxysms come on at 
midnight, and cease before noon, and are very severe and suffocating. 
Veratrum album is indicated, after Drosera and Cuprum have been 
employed, when the patient is very feeble, quick pulse, and with a 
sort of hectic fever, and cold sweat upon the forehead, and great 
thirst ; and also when the coughing causes an emission of urine, and 
pain in the chest and loins, and when the patient, between the par- 
oxysms, is in a comatose state, and cares not either to move or con- 
verse ; and also when there is excessive weakness of the neck, so that 
the victim is scarcely able to keep the head erect ; and also when 
there is rash over the body, or face and hands. For the most severe 
or convulsive stage of whooping-cough, give Belladonna, when there 
is pain in the head, or convulsions ; give Bryonia when the child 
coughs immediately after eating or drinking, and vomits what he has 
eaten, and returns immediately to finish his meal, and then coughs 
and vomits again ; give Chamomilla when the cough and vomiting are 
more frequent during a meal, fretful disposition, and worse at night ; 
give Causticum when the cough is better, and when it is dry and hol- 
low ; give Hyoseyamus when the patient is worse lying down, and bet- 
ter on sitting up ; give Arnica when the patient feels sore from 
coughing. After the cough subsides, and there is any sequel left 
behind, give whatever remedy is indicated, as Aconite for fever, Nux 
vom. for constipation, Phosphorus for catarrh, China for extreme weak- 
ness, etc. If there is no loss of appetite, allow a substantial diet in 
all the stages of the disease. Change of air is very beneficial, even if 
but a short journey from home, especially to the sea-shore. 

Diphtheria. 

An exudative inflammation of the throat, during the progress of 
which a dirty, grayish membrane is exuded upon the tonsils, and 
often upon the pharynx and posterior nares. The disease is com- 
monly ushered in by the following symptoms : chilliness, headache, 
pains in the back and limbs, excessive prostration, fever, some diffi- 
culty in swallowing, though not always, and offensive breath. Later 
appear acrid running from the nostrils, or bleeding, as rather an un- 
favorable indication ; swelling of the external throat ; and sometimes, 
in very severe cases, vomiting or hoarseness, and other indications 
that the disease is invading the larynx or trachea. 

This disease is now almost universally considered in some degree 
contagious, and for this reason the patient should be, so far as possi- 
ble, isolated from those who are not in charge of the case. All his 
excreta should be disinfected with a strong solution of Sulphate of 
Iron at once. The room should be well aired constantly. The throat 
should be gargled, to prevent decomposition, with glycerine and 
water mixed, one part of glycerine to seven of water, to be used 



DISEASES OF VARIOUS ORGANS AND REGIONS. 681 

every two hours, or oftener in severe cases. Small pieces of ice al- 
lowed to dissolve in the mouth have a favorable influence. The pa- 
tient's strength should be sustained by nourishing liquid food, such 
as broth of beef, lamb, mutton or fowl ; milk, or milk and raw egg ; 
oatmeal gruel; oysters, in cold weather, are allowable. Stimulants 
are not recommended, except as a gargle, as much as formerly; 
though in severe cases, with alarming sinking of vitality, brandy in 
small doses may do good, when repeated often. 

Dangerous symptoms have resulted from the patient being allowed 
to sit up too soon. The membrane should begin to disappear on or 
before the fifth day, else grave symptoms may be apprehended, such 
as delirium, epistaxis, vomiting, croup, or paralysis of the heart. The 
urine should be watched carefully, as albuminuria is generally pres- 
ent in a mild form, and sometimes complicates convalescence, induc- 
ing dropsical swellings, etc. 

In severe cases the patient should exercise care against a relapse 
for at least three months. 

Be sure that your house is properly drained. Local filth is the 
most common exciting cause of this dread and fatal disease. 

For the benefit of those who cannot secure the advice of a compe- 
tent physician in this grave disease, the following brief but trust- 
worthy indications for its treatment are given : — 

For the premonitory symptoms, such as chilliness, flushed face, 
headache, backache and fever, Gelsemium, ten drops in half a tum- 
blerful of water, a teaspoonful every half-hour until the fever sub- 
sides. Should there be no improvement in twelve hours, give Cimi- 
cifuga in the same way. This remedy has proved of great service in 
the hands of physicians of both schools. For the throat symptoms, 
the most frequently indicated remedies are the several preparations 
of Mercurius, the Mercurius biniod. taking preference, in water, and 
repeated hourly. This, or the Mercurius cyanuretum, may be alter- 
nated with Cimicifuga or Gelsemium, or, later, in obstinate continu- 
ance of the membranous exudate, with Phytolacca decandra. When 
the breath is very putrid early in the attack, and the membrane of- 
fensive, with fever, darkly flushed face, delirium, Baptisia is better 
than G-elsemium or any other remedy. Should the tonsils swell rap- 
idly, and the throat and external face have a puffy appearance, Apis 
mel. is indicated, in place of the mercurial preparations. It should 
be given in water, hourly. Should croupous symptoms begin, indi- 
cated by hoarseness, whistling breathing, dusky complexion or doughy 
pallor, croupy cough, Spongia or Iodium will be the main reliance, 
together with the inhalations of the vapor of boiling water. Lache- 
sis has saved cases of a grave type, which have resisted the before- 
mentioned remedies. When bleeding from the nose becomes trouble- 
some and alarming, the best remedy is Carlo veg., together with a 
free local use of ice. The remedies should not be changed oftener 
than once in twelve hours, as it is a disease slow to show improve- 
ment. 



682 DISEASES OF VARIOUS ORGANS AND REGIONS. 



Homoeopathic Treatment of Diphtheria. 

Two views have been taken with regard to the intimate nature 
and cause of diphtheria. Most physicians regard it as an essential 
fever, and are of the opinion that the local affections of the throat 
and air passages are secondary, and are but local manifestations of 
the special condition of the system, and that they have the same re- 
lation that the local affections of the skin and mucous membranes 
have to the eruptive fevers. They, however, admit that the general 
disorder is increased and intensified by the absorption of the septic 
matters of the local disorder, thereby producing the blood-poisoning 
of septicaemia. 

The other view is what is called the germ theory. According to 
this view, the disease is caused by a vegetable organization, which 
naturalists call sphero-bacteria or micrococci, which, finding access to 
the throat through the nostrils and the mouth, fasten upon the mu- 
cous membranes of the tonsils and fauces, and produce an inflam- 
mation which is characterized by the effusion of a fibrinous exu- 
dation called diphtherite. This is not all : under the conditions 
favorable for their life and growth they possess an enormous power 
of reproduction. From this centre of infection these germs find 
their way into the different tissues of the body, and acting as fer- 
ments, give rise to deleterious chemical products which destroy life. 
These vegetable parasites, according to this theory, are as inseparable 
from the diphtheritic process as the bacteria of decomposition are 
from putrefaction and decay. Without bacteria there can be no 
diphtheria. In grave cases, these parasites are found everywhere, in 
the smallest patches of membrane, and in immense numbers in the 
different tissues of the body. They are the cause of embolism, of 
metastatic abscess, and the intensity of the disease increases with 
their number. These are the theories of diphtheria. 

The duration of the disease depends upon its severity. The period 
of incubation occupies from two to eight days. In mild cases the 
membrane commences to be shed on the fourth day ; in severe cases 
not before the tenth or twelfth day, and it may take four or more 
days to finish it. 

The membrane is detached in the same way as any slough or ne- 
crotic tissue, by the process of suppuration. Whatever theory is 
adopted, the local treatment is of primary and equal importance ; for 
the mucous membrane of the throat, if it is the avenue through which 
germs find entrance to the body, is also the generator of those irritant 
poisons, the absorption of which contaminates the system and de- 
stroys life. The object of the treatment is, first, to put a stop to the 
spread of the disease, and to bring about a retrogression of the in- 
flammatory process, with the removal of the membrane ; secondly, by 
the most perfect disinfection and antiseptic cleansing of the mouth 






DISEASES OF VARIOUS ORGANS AND REGIONS. 683 

and throat, to prevent the absorption of injurious products of decom- 
position from the surfaces of the diseased tissues. 

In order to accomplish the above results, the local treatment by 
the application of disinfectant and antiseptic remedies is now in vogue. 

Cauterizing substances are considered hurtful and but seldom used. 
The most common remedies now resorted to are carbolic acid, sali- 
cylic acid, permanganate of potash, chloral hydrate, sulphite of soda, 
benzoate of soda and chlorate of potash. These various substances 
have been applied in solutions by means of a sponge or a brush, in 
the form of spray, and in the form of a powder, taken dry into the 
mouth combined with sugar. 

I think that the best way to treat the throat is by the frequent in- 
halation of a hot steam, applied in hourly sittings of about fifteen 
minutes' duration. These may be medicated with chloride of sodium, 
or the chlorate of potash, about twenty grains to the ounce. Such 
fluids, steadily flowing over the surfaces of the mucous membranes, 
wash away masses of mucus, remnants of food and other products of 
decomposition. They assist nature's work of promoting suppuration, 
which is the legitimate way in which these pseudo-membranes are 
shed ; and by combining this treatment with the use of strong gar- 
gles, composed of the solution of any of the above disinfecting sub- 
stances, we more completely prevent septic absorption than by any 
other treatment ever used. The steam may be generated in any or- 
dinary kettle, and conducted to the patient's mouth through any 
suitable tube. Being careful not to have it too hot, an atomizer is 
much better. The general treatment of the patient is, as in every 
other infectious disease, to be sustaining. 

Tonics, such as sulphate of quinine and the tincture of the muriate 
of iron, are also always indicated. 

It has been claimed that alcohol conjoined with quinine, given 
freely from the first, is an effective curative agent. Alimentation is 
an essential part of the treatment. The diet should be highly nutri- 
tious ; milk and animal broths are of this class. 

Patients affected with this disease should be at once isolated. 
Thorough disinfection of the dejections, and of all articles which 
have have been in contact with patients, and of the apartments which 
they have occupied, is to be recommended, and all defects of drain- 
age must be remedied. 

In case of an attack of diphtheria no time should be lost, but a 
physician should be called at once. In first stages I would advise a 
trial of the Anti-Toxine treatment. 



DROPSIES, HYDROPSIES. 



A general swelling of the whole exterior surface of the body, 
and a sensation of weakness, is termed general dropsy, because the 
water infiltrates into the cellular or subcutaneous tissue all over the 
body. Local dropsies may affect the chest, abdomen, head, womb 
and testes. 

General Dropsy, Anasarca. 

This is caused by cellulitis and infiltration of water into the areo- 
lar tissue, causing one to swell all over the body. There is generally 
some thirst and fever that ushers in general dropsy. Arsenicum in 
the usual dose may cure the disease when it seems to arise from a 
low state of the system. When it is the sequel of scarlatina or ery- 
sipelas, give Helleborus nig. three times a day. If after a bilious 
fever, give Mercurius viv. Following scarlet fever, Apis or Terebinth. 

Dropsy of the Belly. — Ascites. 

When inflammation of the peritoneum terminates in dropsy of the 
abdomen, Apis mellifica may be given, every three or four hours, for 
several days. If it fails of effecting a cure, Apocynum may be given 
in the same way, and in like manner, Bryonia, Helleborus nig. and 
Arsenicum. Tapping is sometimes necessary, when the peritoneal 
sack is filled with water, and does not yield to remedies. 

Dropsy of the Chest, or Hydrothorax. 

The cause of this affection is inflammation of the pleura, causing 
an accumulation of serum in the pleural cavity. Apis mellifica in the 
usual doses, repeated at intervals of three or four hours, will often 
effect a radical cure, and so will Apocynum. If these fail, use Sul- 
phur. 

Dropsy of the Heart. 

This is an accumulation of water around the heart, in the cavity 
of the pericardium. Spigelia or Apis mellifica will generally cure. 
Sulphur is efficient in many cases. Bryonia, if from pericarditis or 
rheumatism. 

684 



DROPSY, HYDROPS. 685 



Dropsy of the Brain. — Hydrocephalus. 

Inflammation of the brain may terminate in an effusion of serum 
in the arachnoid cavity, and is often fatal. Hyoscyamus in the usual 
dose, repeated four or five times a day, may prove beneficial. Apis 
mellifica has been employed in the same way, also Helleborus. 

Dropsy of the Womb, — Hydrometra. 

Inflammation of the womb often terminates in this affection. 
Belladonna, Apis mellifica, Arsenicum and Helleborus nig. have been 
employed against it. 

Dropsy of the Scrotum. — Hydrocele. 

This consists in the scrotum becoming filled with serum or water, 
after inflammation and swelling of the testes. It may be caused by 
gonorrhoea or it may be the sequel of scarlet fever. The same reme- 
dies employed in other local dropsies may be employed; or, these 
failing, the water may be drawn off, and a weak solution of iodine 
may be injected into the sack by a surgeon. 

Ovarian Dropsy. 

Inflammation of the ovaries is the cause of this difficulty. Ar- 
senicum will generally have a good effect, and so will Conium and 
also Apis mellifica and Pulsatilla ; either remedy in the usual dose 
may be administered every three hours, with the prospect of relief. 



INSIDIOUS DISEASES. 



Malignant Pustule. 

There is sometimes a low and vitiated state of the blood, and so 
powerfully predisposed to take a malignant, if not a fatal tendency, 
that a very slight exciting cause will arouse a disturbance not easily 
quelled. Such is believed to be the origin of what is usually termed 
"the Malignant Pustule, a small pimple upon the face, regarded of 
little account by the person, who, unconscious of the vitiated condi- 
tion of his blood, pinches it and irritates it. It begins to inflame ; a 
determination of all the subtle impurities of the fluid takes place at 
this spot ; and a malignant and disorganizing fever pervades the en- 
tire economy, and, if not arrested, it runs a rapid course, and termi- 
nates fatally often in a single day, or before any remedial agent can 
be brought to bear to arrest the process. Pimples upon the face 
should never be pinched or squeezed, for fear of inviting inflamma- 
tion to the spot, that might react in calling up or setting fire to a 
discrasia of a malignant quality. Individuals apparently well in the 
morning have gone to business, and, ere another morning came round, 
have found themselves fatally prostrated by this disorder. As soon 
as suspected give Arsenicum every hour for three or four hours, and 
then follow with Nitric acid ; and, if there is any indication of change 
for the better, well ; if not, give Muriatic acid, or Lachesis. . Just as 
soon as any pustule upon the face begins to inflame like a boil, and 
there are chilly rigors running down the back, retire to bed, take 
Arsenicum, and a change in the febrile condition may take place for 
the better, and the life of the patient may be saved. When the face 
begins to swell and there is delirium, give Belladonna every half- 
hour to hold in check, if possible, the tendency to the brain. After 
Belladonna, give Rhus tox. Very many cases of " Malignant 
Pustule " have been cured by a timely resort to proper remedies. 
But celerity of action is required ; one moment's unnecessary delay 
may be too hazardous for the patient. It is believed that the brain 
and nervous centres elsewhere are most liable to speedy implication. 
A resort to such remedies as will guard against these will undoubt- 
edly furnish the best protection. Consult Arsenicum, Apis mel, 
Bell., Graphites, Merc, Conium, and Sulphur, 

686 



INSIDIOUS DISEASES. 687 



Spotted Fever. — Febris Petechialis. 

This fever usually begins with great lassitude ; the patient feels 
fatigued, and unable to be about ; and then a headache ensues, without 
much fever ; the pulse is not much accelerated, the tongue is coated 
with a dark or brown coating, nutrition becomes interrupted, and 
rapid emaciation takes place. After a while, the patient begins to 
suffer from intense pain in the back and limbs ; a cold chill comes 
over him, and a febrile reaction, that is characterized usually by great 
thirst, entire loss of appetite, and inclination to vomit. During the 
febrile excitement, the skin becomes discolored, and red or purple 
spots appear in great numbers upon the surface of the body. This 
is believed to be the crisis, and affords an indication of the malignant 
character of the disease. For the most part, the patient lies in stu- 
por, or perhaps at times evinces a low, muttering delirium, and 
inclination to pick the bed-clothes. The cause of this fever is sup- 
posed to be some malarious poison acting upon the blood. The prog- 
nosis, or prospect of the result, is by no means favorable ; yet many 
such cases recover under proper treatment. In the first stage, when 
the patient is complaining of great weariness and lassitude, give Arnica 
every three hours. When the head begins to ache, give Belladonna, 
and especially if there is any* twitching of the muscles, or redness of 
the eyes. If there is any derangement of the kidneys, following 
checked perspiration, give Rhus tox. For the intense pain in the 
back, give Belladonna, and follow with Verat. viride. When the cold 
chill ensues, and the countenance looks pallid and sunken, give Carlo 
vegetabilis. When the fever appears, and there is thirst, and incli- 
nation to vomit, give Arsenicum, or perhaps Veratrum album, and 
repeat the remedy every three hours. When the low, muttering de- 
lirium shows itself, give Stramonium. Let the surface of the body 
be rubbed gently with a crash or Turkish towel, and wet with tepid 
water. If the patient becomes quiet, and the spots gradually begin 
to disappear, and the coating upon the tongue begins to break up, 
and a normal secretion upon the tongue begins to show itself, — 
these are signs of convalescence ; and then it is well to give China, 
and supply the patient with beef-tea or broth in moderate quantities, 
and then with something more substantial, as he can bear it. 

Cold Fever. 

In some parts of the country, there has prevailed endemically a 
kind of fever which at first makes its appearance with general pros- 
tration and coldness of the surface of the entire body. The face ap- 
pears as cold as marble, the nose pinched, the eyes sunken in their 
sockets, the tongue covered with a thick white coating, no appetite, 
but intense thirst. This cold stage lasts for a longer or shorter 
period; and then it is followed by a febrile reaction, and the entire 



688 INSIDIOUS DISEASES. 

body becomes intensely heated, the pulse becomes quick and feeble, 
the head and back become the seat of pain for a while; and then all 
these symptoms disappear, and another cold, sunken condition of the 
system ensues, and sometimes the body is covered with a cold perspira- 
tion, which lasts for an indefinite period, and then a more fierce febrile 
reaction comes on again, and elevates the pulse and temperature of 
the skin, giving a flushed appearance of the countenance, redness of 
the eyes, and heat of the head ; when a warm perspiration terminates 
the febrile heat, and then there gradually appears the coldness of the 
surface again. These alternations of the extremes of temperature 
upon the surface go on until a crisis occurs that terminates the life 
of the patient, or the disease begins to wane. But, to mitigate the sev- 
erity of the disease by treatment, in the cold stage, give Carlo, veg. 
every four hours until the reaction commences, and then give Bryonia 
or Rhus ; and these remedies may moderate the reaction. If, in the cold 
stage, the patient is stupid, give Belladonna ; after Carlo veg., and 
and for the cold perspiration, give Carlo animalis. At the recurrence 
of the fever upon the surface, give Arsenicum and Bryonia. If the 
patient has much heat in the head, and is delirious, give Belladonna ; 
and, until the coating upon the tongue begins to disappear, do not 
thrust any food other than light gruel upon the patient, but as soon 
as the natural secretion of saliva appears upon the tongue, give beef- 
tea or good mutton soup, a little wine, and other nutritious stimu- 
lants ; and as the appetite returns, increase the strength of the diet. 
The same process of rubbing must be employed as in the Spotted 
Fever. If the urine is turbid, give Nux vom. If the feet swell dur- 
ing the convalescence, give Arsenicum, Apis mel,, or Hellebore* 

Putrid Fever. 

This fever, as its name implies, emits an unpleasant or fetid odor. 
It comes on much like those just described, only the breath appears 
to be tainted with something of a putrid character, and very often 
there are putrid discharges from the bowels. The urine has a putrid 
odor ; and when there is any perspiration upon the surface, it has the 
same smell. The disease comes on unobserved, and is attended with 
lassitude and inappetency. There is seldom any noticeable cold 
stage, and yet there is very little if any heat upon the surface. 
The tongue becomes coated with a dark brown coating, and sordes 
collects upon the teeth in large quantities. The pulse is feeble and 
quick ; the skin, for the most part, is dry and of low vitality. There 
is often more or less pain in the bowels, and a distension of the ab- 
domen. The urine is thick and high colored, and of an offensive 
odor. The patient rejects all kinds of food and drink, except water ; 
and this uniformly has to him a disagreeable taste. His nose is dry 
and sore, and his lips become dry and cracked ; and sometimes a black 
or dark-colored saliva runs out of the corners of his mouth, which dis- 



INSIDIOUS DISEASES. 689 

colors them, and gives to his pale and sunken countenance a distress- 
ing appearance. The progress of this fever is slow and low, and 
often terminates in ulceration of the bowels. There is from the first 
a labored respiration and a putrid breath. For the commencing 
stage give Arnica ; if this fails to relieve the symptoms in twenty-four 
hours, give Baptisia ; when the mouth becomes dry and the lips 
cracked, and the sordes collects upon the teeth, give Nitric acid, and 
follow with Arsenicum ; when the patient complains of pain in the 
bowels, and there are putrescent discharges from them, give Phos- 
phorus ; if there is involuntary and painless diarrhoea, give Phos- 
phoric acid ; in case of great prostration, give Arsenicum, followed in 
twelve hours, if no relief, by Muriatic acid. Putrid fevers are often 
fatal, and especially where a putrid diarrhoea is kept up by the fever. 
For the distension of the abdomen, give Nux ; for the thick and of- 
fensive urine, Sulphur, Carbo veg., or Arsenicum ; should the putrid 
stage pass off, leaving the patient prostrate, give China, wine, egg- 
nog, and even a little brandy to keep up the vitality of the system. 
The sooner any one recovering from this fever can take light, solid 
aliments, the better. 



MISCELLANEOUS DISEASES. 



Relapsing Fever. 

A fever has lately made its appearance in some of our large 
cities, having all the characteristics of a common typhoid, that appar- 
ently passes through all its stages, and then reproduces itself, 
and the same round occurs again. Each siege lasts about seven 
days. Several of these in succession make the condition of the pa- 
tient precarious, and the prognosis unfavorable. The treatment is 
with stimulants, and the usual remedies for low fevers, such as Ars., 
Carbo vegetabilis, Bryonia, and Rhus tox. Doses as usual, and repe- 
tition of the remedy selected, every three hours. A stimulating diet 
always required. 

Black Tongue. 

In warm climates and in a low country, there are biliary derange- 
ments, accompanied with low fever, and a black coating upon the 
tongue. This is what is termed the Black Tongue. Carlo veg. has 
been given freely, even the crude powder, a teaspoonful at a dose. 

Black Vomit. 

This is another bilious disease, that results from superabundance 
of carbon in the blood, and a wretched derangement of the liver and 
stomach, which causes copious vomitings of black bile. Arsenicum, 
given every hour, has remedied this difficulty. After the vomiting is 
arrested by the use of Arsenicum, give Carbo veg., China, Rhus, or 
Bryonia. Whichever remedy is selected by the indications should 
be repeated every hour or two hours, until complete recovery takes 
place. As soon as the patient can take nourishment, give beef-tea 
and other nourishing soups, and then more solid aliments. 

Nightmare. — Incubus. 

The characteristic symptoms of this distressing condition are semi- 
consciousness, and a sense of inability to extricate one's self from 
some imaginary weight or seizure. It may be caused by some defect 

600 



MISCELLANEOUS DISEASES. 691 

in the circulation or indigestion. The sufferer is generally supposed 
to be asleep ; but in some cases, he knows when persons are about 
him, and yet, unless he is spoken to or moved, or by effort himself 
can voluntarily move his foot or hand, he is liable to remain spell- 
bound, under a sense of weight or oppression. To relieve one when 
thus affected, turn or shake him. The remedies that may be em- 
ployed to prevent nightmare are Aconite, when there is a feverish 
condition of the system ; Nux vomica, when there is indigestion ; and 
also Pulsatilla and Sulphur, 

Hysteria. 

This is a name applied to a great variety of nervous derangements, 
that for the most part are dependent upon nervous debility. It may 
manifest itself in an irresistible inclination to weep or laugh ; some- 
times in fainting and spasms, shortness of breath, screeching and a 
sensation of choking. Aconite will sometimes quiet the nerves ; Ig- 
natia, if there is an inclination to weep ; Hyoscyamus, if inclined to 
laugh ; Pulsatilla, if connected with the menstrual period. For hys- 
teric mania, Hyoscyamus, Stramonium or Belladonna. Either of the 
remedies may be given in the usual dose, and repeated every two or 
three hours until relief is obtained ; and it is also recommended that 
such persons ride out in the open air and seek change of scene. 

Hydrophobia. — Rabies, 

The bite of rabid dogs is productive of this disease. The poison 
communicated by the bite may remain in the system for an indefinite 
period ; and then all at once, the sight of water or some polished 
metal will throw the victim into indescribable distress and madness, 
which are apt to increase and terminate in death. A dread of water 
is an unmistakable sign of the disease. When one is bitten by a rab- 
id animal, the effect may be extinguished by an immediate resort 
to cauterization. A heated poker brought as near to the wound as 
possible without contact is believed to be effectual in destroying the 
poison ; or the application of Nitrate of Silver immediately may also 
have the same effect. Hydrophobia has been cured by the persistent 
use of Belladonna in the usual dose, repeated every hour or two 
hours for several days ; Hyoscyamus may also be employed in the 
same way ; Oantharis has been recommended as an antidote to rabies. 
Lachesis, and even copious draughts of whiskey, have been found 
useful. Nothing, however, has been found more salutary as an im- 
mediate resort than dry or radiating heat, unless the patient is put 
immediately under the Pasteur treatment, which operates on the 
theory that rabies is a germ-disease, and has proved very successful. 
There is a special hospital for the Pasteur treatment in New York 
City 



AFFECTIONS OF THE MIND. 



It is well known to physiologists, that soundness of mind, as well 
as entire soundness of body, indicates a condition of perfect health. 
The two are so intimately blended, that one can hardly exist without 
the other, and vice versa. An unsound condition of the physical sys- 
tem is often attended with manifest unsoundness of mind. It is not 
intended to include the mental phenomena frequently attendant on 
acute fevers, as in nervous, scarlet and other fevers, but such only as 
appear to exist as the chief symptom of disturbance in the entire sys- 
tem ; and we will begin with simple 

Mental Derangement. 

What is understood by mental derangement is a disordered mind, 
which may have been occasioned by one or more of a variet} 7 of causes. 
It is indicated by irrational expressions of illusory notions, incoherent 
ideas, strange fancies, and not infrequently by vicious inclinations. 
There is, nevertheless, some specific cause for every case of mental 
alienation that occurs ; and the treatment has to be adapted with 
reference to the cause, when there is a chain of circumstances that 
indicates it. Nevertheless, the cause is not always apparent, and 
therefore particular symptoms must be our guide in affiliating reme- 
dies. When insanity takes the form of rage, and the patient appears 
to be governed by angry and revengeful feelings, and is inclined to 
utter imprecations and threats towards his best friends, give Aconite 
in daily doses. If his face appears flushed, and his eyes suffused, and 
exhibit a fiery red appearance, give Belladonna. If in a scrofulous 
subject, give Qalcarea. If strange fancies seem to beset the patient, 
or complaints are made of illusory sights, give Hyoscyamus. If the 
patient is inclined to run away from home, or hide in some secret 
place, give a dose of Sulphur, and follow with a few doses of Stra- 
monium every three or four hours. If the patient seems depressed, 
and sighs frequently, give Lachesis. If much distress is evinced, 
and there is defective nutrition, give Nux vomica. For violent rage, 
followed by soporific sleep, give Opium. If the patient laughs and 
talks continually, give Hyoscyamus ; or if given to crying, sobbing or 
constant weeping, give lgnatia. If the patient is subject to cold 

692 



AFFECTIONS OF THE MIND. 693 

sweats, give Veratrum. If thirsty, give Arsenicum. If there is great 
weakness and prostration, give China. If, during paroxysms of rage, 
there is intense perspiration, give Mercurius. Disposition to suicide, 
Aurum. None of the medicines need be repeated oftener than twice 
a day. Great care should be taken to keep the stomach of the pa- 
tient at ease, by furnishing for it light but nutritious food. 

Mania Produced by Depression of Spirits. 

Protracted Grief. — Extreme mortification or chagrin, or intense 
anger, may end in mental derangement. When grief wears out the 
mind, and strange fancies begin to show themselves, give Ignatia. 
When great mortification on account of some exposure to censure or 
on account of some humbling of family pride, give Phos. acid. When 
disappointment unsettles the mind, and chagrin gives rise to insane 
imaginings, give Pulsatilla ; or, if there is a manifest inclination to 
hide away from friends, give Sulphur, and follow, in four or six 
hours, with a dose of Hyoscyamus. If the face is red, and the temples 
beat and throb, give Belladonna. When excessive anger and general 
moroseness of spirit ensue, with general antipathy towards every one, 
give Sulphur, and, in six hours, follow with a few doses of Nux vomica. 

Mania from Excited Emotions. . 

The mind is often beset with emotions of one kind or another, that 
often tend to unsettle and derange it. Anguish or foreboding often 
has this disastrous effect, and one of the principal remedies is Aconite. 
If there is an attending inclination to weep, give Ignatia. If there is 
dullness or stupor, give Opium, or if in females, give Pulsatilla. If 
mania is produced by fright, give Aconite, Coffea or Nux vom. When 
fear unsettles the mind, give Lachesis, Hyoscyamus, Gelsemium, Opium 
or Pulsatilla. When excessive joy produces derangement of the men- 
tal faculties, and gives rise to strange fancies, give Coffea, Opium or 
Pulsatilla. When homesickness unsettles the mind, give Phos. 
acid. When fancied neglect of friends distracts the imagination, 
give Causticum or Capsicum. For unhappy love, and the derange- 
ment of mind consequent thereon, give Hyoscyamus, Ignatia or Phos- 
phoric acid, or, perhaps, Coffea or Nux vom. 

If disappointed affection or any cause produces the mania of sui- 
cide, give Aurum. If excessive jealousy ends in mania, give Hyos- 
cyamus. If rage ensues upon insults, give Veratrum alb., Belladonna 
or Chamomilla ; if upon contradiction, give Aconite, and afterwards 
Ignatia or Nux vom. For the concomitant symptoms of insanity 
from excited emotions, give Aconite when there is headache, feverish 
heat or tendency of the blood to the head. Give Belladonna when 
there is loss of consciousness, or constant anxiety, with fear, weeping, 
howling and malice (in children), and also when Aconite and Opium 



694 AFFECTIONS OF THE MIND. 

had proved insufficient for the consequences of flight. Give Bryonia 
when there is chilliness and shuddering over the whole body, great 
tendency to vehement anger, loss of appetite, nausea, vomiting and 
bilious state in consequence of anger. Give Capsicum for sleepless- 
ness caused by homesickness, with heat and redness of the cheeks. 
Give Chamomilla when anger produces bitter taste of the mouth, 
nausea, disposition to start, and vomiting of bilious matter. Give 
Coffea when there is much nervous excitement after great joy. Give 
Colocynth when chagrin or mortification produces spasmodic colic or 
cramps. Should this condition persist, give Causticum. Give Hyos- 
cyamus when fear produces stupefaction or convulsions, involuntary 
laughter during sleep, or a desire to run away. Give Ignatia for 
grief, disappointment, or unhappy love, when there is deep, gnawing, 
irresistible grief, vomiting, headache, vertigo, pale face, convulsions 
or epilepsy, and in children when they occur from the shock of fright 
or fear. When homesickness, fright or mortification is attended with 
great anguish, restlessness and trembling, or sudden starting from 
sleep, or accelerated circulation on the least exertion, sleeplessness 
and inability to bear the warmth of the bed, great nervousness, a 
disposition to be quarrelsome, and to complain of everybody as being 
hateful, and the patient takes a dislike to his own family, and wishes 
to leave them, and also when there is shivering and night-sweats, 
give Mercurius. Give Nux vomica, when, after an angry fit, there is 
chilliness "without heat. Give Opium when diarrhoea follows exces- 
sive joy or fear, or when a sudden start or fright produces sudden 
and involuntary diarrhoea, with heaviness of the abdomen. For 
chronic diarrhoea from fright, Gelsemium. Give Phosphoric acid in 
all cases after deep grief, homesickness, or unhappy love, when the 
patient is taciturn, dull or listless, and has a constant desire to sleep, 
and has night-sweats towards morning, after hectic fever in the even- 
ing. Give Pulsatilla when fear produces cold hands and feet. Give 
Veratrum album when any emotional excitement produces diarrhoea 
or involuntary evacuations from the bowels, with coldness of the 
whole abdomen. 

Morbid Emotions. 

A celebrated writer on insanity considers all morbid emotions 
under this head, and for this reason : that all morbid states of the 
mind may become so augmented as to result in complete mania or 
monomania. It is, therefore, well to understand the best method of 
bringing remedial action to bear upon the first departure from sound 
health of any faculty or emotion of mind. For anguish or anxiety, 
no remedy seems better adapted than Arsenicum, to be given morn- 
ing and evening, or perhaps, Pulsatilla for females at the menstrual 
period, or Veratrum album for very weak and exhausted persons. 
For apprehension or fear, give Aconite morning and evening, espe- 
cially if the sufferer is a plethoric, full-blooded person. Give Bella- 



AFFECTIONS OF THE MIND. 695 

donna to one who suffers much from headache, or rush of blood to 
the head ; or Bryonia if there is anxiety, with heat of the chest and 
difficult respiration ; or Hyoscyamus for anxiety about one's safety, or 
religious anxiety ; or Opium for a kind of anguish and depression of 
spirits that confuses one's ideas, and is attended by a stupidity and 
headache. When one is constantly vexed and irritable, it may be in- 
ferred that a corresponding physical condition requires Arsenicum 
once or twice a day, or perhaps Nux vomica. Ignatia is suitable when 
there is a tendency to be vexed, and to weep on account of trifles. 
For one always in haste to get angry without reason, give Aurum or 
Sulphur. When one is morbidly suspicious and distrustful, and, in 
fact, is a hater of his fellow-men, and wishes to avoid every one, and 
to spend his time in seclusion, give Arsenicum, Hyoscyamus, Pulsa- 
tilla or Rhus tox. For nervous excitement, which may lead to men- 
tal derangement, give Aconite or Pulsatilla ; and especially if there 
is great tendency to start. For a morbidly malicious disposition, 
give Belladonna, Hyoscyamus and Lachesis. For a disposition to kill 
somebody, or to commit acts of violence, give Stramonium, Bella- 
donna or Veratrum album, morning and evening until a change. For 
a morbid disposition to be audacious or impertinent, give Ignatia, 
Opium or Sulphur. For headstrong obstinacy and disposition to be 
quarrelsome, give Belladonna, Nux vomica, Ignatia, Lachesis and 
Veratrum. For an artful disposition or an involuntary disposition 
to practise deception with no definable motive, give Lachesis and 
Nux vomica. When the mind is either beset with fancies or fixed 
ideas, give Belladonna, Cocculus, Stramonium or Sulphur. For sad 
and melancholic fancies and forebodings, give Calcarea, China or 
Pulsatilla, and Petroleum. For a morbidly serious, silent and un- 
talkative disposition, give Belladonna, Hyoscyamus and Pulsatilla. 
For morbid indifference and apathy, give Arsenicum morning and 
evening, or else Phosphoric acid, Sepia and Sulphur, in daily doses. 
Moaning and lamenting without any special cause indicates a degree 
of insanity that demands prompt attention ; and Hyoscyamus may be 
given three times a day, or else Chamomilla, Coffea or Ignatia. De- 
spondency, despair and being tired of life, as well as an inclination 
to suicide, are severally affections of the mind that are subject to 
medical treatment. Arsenicum may be given morning and evening 
for despair. Lachesis for despondency, especially where there is sigh- 
ing, as if something awful was weighing upon the mind. For incli- 
nation to commit suicide, give Aurum and Arsenicum, especially if 
there is great anguish, melancholy and morbid disgust of life. For 
one simply tired of life, and anxious to get out of this world by natu- 
ral death, give China, Lachesis or Nitric acid. For illusions and illu- 
sory notions, showing mental difficulties, give Lachesis, China or Pul- 
satilla. Many of these mental difficulties are the result of selfishness 
or mortified self-love, and can be overcome by strong determination 
of the will and moral training, which, of course, involves more or 
less of self-denial. 



696 AFFECTIONS OF THE MIND. 



Religious Mania. 

This mental affection is simply a morbid excitation of religious 
sentiment and feelings, producing strange and fanciful ideas of God, 
heaven and the importance of certain missions to which the victims 
believe themselves specially called. Religious mania is characterized 
by morbid inclination to be always singing, praying, preaching and 
performing religious rites, out of time and place, and in a discon- 
nected and incoherent manner. The cause of this mental affection 
may be excitement upon religious topics, or during what is ordinarily 
termed religious revivals. The effect of anything of the kind is to 
unsettle the healthy condition of the nerves and that of the nutritive 
system. For religious mania in general, give Hyoscyamus or Stra- 
monium ; for that which is attended with indigestion, give Nux vom- 
ica ; for that which is accompanied by torpidity of the liver and mel- 
ancholic temper, give Arsenicum, Mercurius, Podophyllin and Ignatia. 
Let the patient avoid all surroundings calculated to unsettle the mind 
or emotions. 

Hypochondria. — Hypochondriasis. 

Pinel classes hypochondria among the various forms of insanity, 
as it is characterized by morbid imaginings concerning one's health. 
Sometimes the victim imagines himself void of strength, or sadly dis- 
eased at the heart ; he fancies he sees death staring him in the face, 
and believes himself often in a dying condition, when, in fact, there 
is not the slightest reason for such apprehension. In the future, all 
is darkness : the next hour, the next day, week or year, is believed by 
him to be pregnant with something awful. He never enjoys a laugh, 
for everything is "clothed in gloom. If the subject is of a bilious 
temperament, and has black hair and eyes, give Mercurius ; if of a 
lymphatic temperament, and inclined to obesity, give Pulsatilla ; if 
of a sanguine temperament, and has red hair and blue eyes, give Nux 
vom. ; if addicted to the use of intoxicating liquors, give Arsenicum 
or Nux vom. ; if of a downcast countenance, and subject to indiges- 
tion, give Nux vomica, Lycopodium or Petroleum. If caused by sex- 
ual abuse, give China or Sulphur ; when caused by sedentary habits, 
Nux vomica and Sulphur, or if by derangement of the abdominal func- 
tions and constipation, give Calcarea, Lachesis or Lycopodium ; for 
one suffering from languor, mental dullness, or mental distress and 
discouragement, give China. If the victim has the fixed idea that 
he is unhappy and has no friends, and imagines himself surrounded 
by enemies, China is also the remedy. For a hypochondriac troubled 
with weak digestion and distension of the abdomen, ill-humor and 
indolence after eating, give China ; when he laments on account of 
the future, and desires to be alone, give Natrum muriaticum ; when 
he is beset with ill-humor, despondency and aversion to life, give Nux 



AFFECTIONS OF THE MIND. 697 

vomica ; when with painful anxiety of mind and lowness of spirits, 
Sulphur ; when he has great dread of death, and is in restless, whin- 
ing mood, give Aurwn ; if indifferent about his business or his own 
family, give Sepia. Any of the remedies named may be given three 
times a day. 

Weak Memory, 

There are many conditions of the physical system that may oper- 
ate to impair the memory ; the most prominent of which are those 
that produce debility, — such as loss of blood and other animal fluids, 
and intense application of the mind. When occasioned by the former, 
give China, Nux vom. and Sulphur, in daily doses ; when by the lat- 
ter, Nux vom., Pulsatilla or Sulphur ; if caused by external injuries, 
Arnica or Rhus ; if by inebriation, Arsenicum, Opium or Nux vom. ; 
if caused by violent emotions, as fright, grief or anger, give 
Aconite, Opium, Phos. acid ; if caused by dampness, give Carbo veg., 
Rhus, Veratrum album; if by rush of blood to the head, give Bella- 
donna. In nearly all instances of weakness of the memory, it is con- 
nected with some form of debility. That following epileptiform dis- 
ease requires Sulphur; that following childbirth requires China; and 
also weakness of memory following an acute fever, or any other 
prostrating disease, requires China, Ignatia, Nux vom. and Arsenicum. 
Give the remedy selected twice a day. 

Hysteric Derangement. 

The ordinary forms of hysteria sometimes degenerate into insan- 
ity. The nervous system becomes shattered, and such patients be- 
come tormented with all kinds of fancies, — sometimes sexual, frivo- 
lous and even foolish. For hysteric insanity in general, give Ignatia, 
Phosphorus or Platina ; or, if attended with uterine derangement, 
give Aurum, Crocus or Sepia; for those tormented with excessive 
sexual fancies, give Phosphorus, Pulsatilla or Platina ; if the patient 
acts foolishly, with much frivolity and levity, give Apis mel.; if fitful, 
laughing at one time and crying at another, give Crocus or Stramo- 
nium ; if there are marked heavings of the chest, give Phosphorus ; 
and if the bowels are constipated, persistent and tedious, give Lyco- 
podium; if in any way connected with the menstrual function, give 
Pulsatilla ; if the patients are prone to lie and deceive, give Vera- 
trum album; when they evince an insane passion for work, give 
Lachesis and Hyoscyamus ; when full of suspicion and distrust, give 
Hyoscyamus, Mercurius and Pulsatilla ; if excited excessively in body 
and mind, give Aconite and then Nux vomica, after which give Phos- 
phorus or Lachesis ; if disposed to be imperious, and exhibit a passion 
to order their friends about, give Lycopodium or Cuprum; if the}^ 
betray a tricky and malicious disposition, give Nux vom. ; if there is 
great obstinacy, give Belladonna, Ignatia ; if disposed to hide or be 



698 AFFECTIONS OF THE MIND. 

alone, give Calcarea ; if on the contrary there is a mania for company, 
and a dread of being alone, give Arsenicum, Lycopodium, Phosphorus 
and Belladonna ; for great loquacity, give Stramonium ; if excessive 
mirthf ulness, give Hyoseyamus ; if there is a disposition to obscenity, 
and a great want of modesty, give Hyoseyamus, Phosphorus or Vera- 
trum; if there is a great disposition to sing, warble or whistle, give 
Belladonna or Stramonium ; if there is a disposition to make faces 
and cut antics, give Cuprum or Stramonium ; if there is a disposition 
to scold or swear, give Lyeopodium ; if given to self-importance and 
pride, give Cuprum to men and Platina to women. Let whatever 
remedy is selected be administered twice a day. Diet should be 
moderate, and easy of digestion. 

Imbecility. 

Loss of mind, as well as the derangement of its faculties, comes 
under the head of mental difficulties. There are several causes that 
may operate to destroy the intellect. Epileptic fits will in time ren- 
der the brain an unfit organ for the mind, and consequently there can 
be but little power or force in the mental manifestation. A soften- 
ing of the brain that may supervene upon inflammation is also at- 
tended with imbecility. Self-pollution is also a fruitful source of 
mental weakness. Congenital idiocy results from causes not possible 
to describe ; but many a bright child has become the victim of idiocy 
by the mal-treatment it has had in the nursery. To quiet crying 
children resort has been had to a variet}^ of sedatives, instead of ex- 
ercising patience, to initiate them into sleep and quietness. How of- 
ten do nurses give poppy or lettuce-tea, to put a crying infant to 
sleep, little dreaming that they inflict a permanent injury upon the 
mind of the child. The effect of paregoric, soothing-sirup and poppy- 
cordial is often disastrous, and the source of spasms, fits or convul- 
sions that impair the tender textures of the brain so much, that, even 
if the children live, they are apt to be the victims of imbecility. 
Fear and fright also are causes of imbecility. If epilepsy is the cause, 
give Cuprum or Sulphur in daily doses, or else Belladonna, Helleborus, 
Laehesis, Hyoseyamus or Opium. If caused by a softening of the 
brain, there is not much hope of the patient deriving much benefit 
from remedies. There is only a bare possibility that the difficulty 
may be arrested. Hyoseyamus, Sulphur and Apis mel. may do some- 
thing to ward off total and hopeless idiocy. When imbecility is 
caused by onanism, give Arsenicum or China twice, a day ; when by 
sexual excesses, give Nux vomica every evening, and Sulphur every 
morning ; when from the effects of opium, a persistent course of re- 
storative treatment must be decided upon. Give Coffea, in usual 
doses, every three hours ; give also Sulphur, in the full strength of 
the tincture, in drop doses ; also, give Ammonia curb., and when from 
the use of other narcotics, give Nux vomica or Ignatia* 



AFFECTIONS OF THE MIND. 699 



Monomania. 

This term signifies insanity upon a single matter, when in every 
other respect the mind is sound. ^Vhen a single idea seizes the mind, 
and morbidly dwells there, however erroneous, it is difficult to dis- 
lodge it. Sometimes a most singular and absurd idea will be cher- 
ished ; as that one is dead. Dr. William Rush once had a patient in 
Pennsylvania hospital, who claimed to be dead ; and, after exhaust- 
ing his ingenuity to convince him of the contrary, he told him ab- 
ruptly that he was dead, and should be buried ; for he would not 
have his stinking remains there to pollute the room any longer. This 
had the tendency to fire up the anger of the pretended dead man ; 
and, on cooling down, this singular illusion left him. The treatment 
of monomania is for the most part moral. It is never prudent to con- 
tradict the patient, or to show disfavor to any absurd idea that may 
be besetting him, but rather to indulge him in it. A celebrated 
French writer on this malady says of a case at the Maison des Inva- 
lides, that he fancied that if he urinated, it would cause a flood; 
and, after finding that the patient must die unless there was an evac- 
uation of the bladder, the attendant hit upon the idea of crying 
" Fire ! " and exclaiming at the top of his voice that the city was on 
fire, and wanting in water to extinguish it, said to the patient, " to 
let the flood come " ; it was wanted to save the city from ruins ; and 
this appeal had the desired effect. For a mania to kill some one per- 
son, under the idea that it must be done, Arsenicum has apparently 
proved to be a remedy. In a case quite similar, Lachesis proved of 
great service. For some of the fixed ideas in monomania, remedies 
may have a good effect. When one has the idea of being great above 
all created beings, give Aconite or Conium. When one has an idea 
that he is hated, and his mind appears sound in other respects, give 
Aurum or Ignatia. When he is tormented with the idea that his 
family or friends are all conniving against him, and appears sane on 
other subjects, give Sulphur and then Nux vom. If he seems right 
on all questions, except that his mind is cogitating theft, so that he 
has an irresistible inclination to steal when occasion offers, give Sul- 
phur, Pulsatilla. 



SURGICAL DISEASES. 



Concussion of the Brain. 

This is the result of a fall or blow, and may be relieved by Arnica, 
usual dose, and repeated if necessary. Should stupor and inability 
to retain food persist, try Glonoin. 

Concussion of the Chest. 

This may be produced by some sudden mechanical injury. If there 
is fever, give Aconite every three hours. If from having been com- 
pressed mechanically, Arsenicum may prove serviceable ; and so may 
Arnica, Pulsatilla, and Nux vomica, Bryonia, and China. Any of the 
remedies selected may be given in the usual dose every three hours. 
In all cases let the diet be simple, and use friction externally ; and 
when there has been a blow upon the head causing the concussion, 
pour a stream of cold water from a small pitcher or coffee-pot for 
thirty or forty seconds. 

Sprains. 

A sprain may be more or less severe. Sometimes it may impli- 
cate only the muscles, and at others the ligaments, involving the ap- 
paratus of the joints. A sprain of the wrist requires Arnica, inter- 
nally and externally at first, and then a compress of tepid water, 
covered with a dry bandage. A sprain of the hip-joint or shoulder- 
joint requires Ledum, with a lotion of the same of twenty drops to 
half a tumbler of water, applied by means of wetting with it a com- 
press, covered with a dry bandage. A sprain of the knee-joint should 
be treated with Arnica, externally and internally, as above, and also 
with Pulsatilla after. Sprains of the ankles are soonest cured by 
applying compresses of cold water, and dry bandages over them, and 
by the administration of Ledum internally. Should this fail, use 
Bryonia. 

Injury of a Nerve. 

The place which Arnica has in surgery in the treatment of ordinary 
bruises and sprains is of no greater importance than that of Hyperi- 

700 



SURGICAL DISEASES. 701 

cum perforatum applied directly to injuries involving the nerves. 
Shocks upon the nervous system, injuries to the spine, or from ex- 
tracting teeth, all require Hypericum internally and externally, in the 
usual dose, and lotion. 

Wounds. 

Wounds are of various kinds ; such as incised, lacerated, punc- 
tured, gun-shot wounds, etc. A simple incised wound needs only the 
sides pressed together, and compressed with a strip of adhesive 
plaster. The application of Calendula externally will facilitate the 
healing. Lacerated wounds require careful adjustment and dressing, 
and then let the dressing be wet frequently with a dilute tincture of 
Calendula ; and where it is supposed the trunks of nerves are impli- 
cated, use Hypericum. Any of these remedies may be used internally, 
in the usual dose, three times a day. Contused wounds require com- 
presses of cold water and Arnica ; while Arnica, Buta, and Hyperi- 
cum may be administered in the usual form internally. 

Hemorrhage from Wounds. 

To remedy protracted hemorrhage from wounds, give Arnica or 
Calendula internally, and, with a lotion of forty drops of either in 
half a tumbler of water, wet compresses, and apply externally. 

Hernia, or Rupture. 

There are two kinds of rupture met with among persons. One is 
termed the femoral, and is near the groin ; and another is termed 
umbilical, and is near the navel. There is a third kind, where the 
sack descends into the scrotum ; and it is termed scrotal or inguinal 
hernia. When either has been of long standing, well-adjusted trusses 
must be worn, or else for scrotal hernia, a suspensory bandage. For 
recent inclination to rupture, Aconite will subdue any inflammatory 
symptoms. Arnica, if caused by a strain ; Nux vomica, in case of 
constipation of the bowels. The remedies as indicated may be given 
in the usual dose three or four times a day. For strangulated hernia, 
Nux vom. every half -hour ; and if this affords no relief, Opium the 
same. Lycopodium and Sulphur follow these well, given three times 
daily. The patient should be in a recumbent posture uporf the back. 

Luxations, or Dislocations. 

These consist in the removal of the head of the bone from its cor- 
responding cavity, where it forms the joint. After dislocation is re- 
duced, the joint may be bathed with a lotion of forty drops of the 
tincture of Aconite in half a tumbler of water, while. four globules 
may be used internally to allay any febrile excitement. Arnica lotion 



702 SURGICAL DISEASES. 

prepared and used in the same way will relieve the soreness. The 
usual dose of this remedy may be administered internally, and re- 
peated two or three times a day. To remove the pain and suffering 
of luxations in general, Arnica, Aconite, and Rhus tox. may be given 
as required. 

Fractures. 

When there is a separation of bony fibres, either simple or com- 
plicated, and the fracture has been properly reduced and bandaged, 
and splints have been called into requisition to aid the system in re- 
covery from the shock, give two or three doses a day of Arnica in- 
ternally, and wet the bandages with a lotion of the same. If there is 
fever, give Aconite or Bryonia. 

• 

Burns and Scalds. 

By a burn is understood a sore or blister caused by dry heat. By 
scald is understood that produced by some heated fluid, as water, 
spirits or oil. The former is soonest relieved by the application of 
cotton, provided the skin is not broken. The latter by cotton dipped 
in lime-water. If the skin is broken, it will be necessary to use, in 
each instance, a salve made of lard and finely prepared carbonate of 
lime. In all cases of burns or scalds, internal remedies are required; 
Aconite, in case of much fever; Arsenicum, or Cantharis, if there is 
much burning, smarting, and thirst; Apis mel., if there is swelling, 
and inflammation following as a sequel. 

Snake Bites. 

These are to be treated somewhat after the manner of the bites 
of rabid animals : that is by dry or radiating heat at first, and then 
by cauterization ; internally, Lachesis, Apis mellijica and Hyoscyamus. 
Either may be given every two hours ; at the same time, there is 
good authority for drinking copiously of whiskey or other alcoholic 
spirits. Several drops of tincture of Iodine, repeated every fifteen 
minutes, have saved some cases. 

Stings of Insects. 

Aconite, Belladonna, Merc, viv., are remedies for internal adminis- 
tration, either of which may be given three times a day ; Arnica lo- 
tion, weak solution of Nitric acid, or Lemon juice, may be applied 
externally. Dilute Aqua ammonia is a good antidote as a lotion. 

The Removal of Tumors. 

Nearly all tumors require removal with the knife. It is not our 
purpose to specify the nature of the operation, but rather to point out 



SURGICAL DISEASES. 703 

a treatment to be pursued after their removal. "When cancerous 
tumors are removed, Arsenicum should be persistently given, every 
three or four hours, with the view of preventing the cancerous dia- 
thesis, or condition from reproducing the same. Where fibrous tu- 
mors are cut out, give Calendula three or four times a day, and apply 
it to the wound. Adipose tumors require, after their removal, Pul- 
satilla, three or four times a day. Fungous tumors require, after re- 
moval, Oalcarea. The fungoid or medullary tumors are mainly 
subject to medical treatment, and various remedies may aid in curing 
them. Conium, Arsenicum, Sulphur, Cuprum met., and Calcarea may 
be consulted. Encysted tumors are embedded in the skin, and re- 
quire dermic treatment. Nitrum, Natrum muriaticum, and Natrum 
carb. may be employed, internally and externally. Scrofulous tu- 
mors require Arsenicum, Graphites, Juglans regia, and Calendula. 
The two last named may be used internally and externally. Scrof- 
ulous tumors require Arsenicum, Graphites, and Calendula. The 
two last named may be used internally and externally, several times 
a day. 

Lumbar Abscess. 

A very malignant sore, that discharges a cheesy matter, and from 
which very few recover. Calendula, Hepar sulph. and Mercurius 
may be given internally, and Calendula, Baptisia, and Arnica may 
be used in the form of lotions, to apply externally. 

Ulceration of the Bone. 

For bone ulcers, Aurum met., Silicea, and Calcarea may be given in 
daily doses, — one remedy only at a time: Aurum met., for bone 
ulcers caused by syphilis ; Silicea, if from injury ; Calcarea, if from 
scrofula. For ulceration of the hip-joint, Arsenicum, three times a 
day ; of the knee-joint, Sulphur, or perhaps Pulsatilla, twice a day. 

Rickets. — Rachitis. 

Disorder of the nutritive functions may end in distortion of various 
parts of the system, and give rise to various deformities of the head, 
trunk, and extremities. Remedies directed to the digestive system 
must first be employed, in order that a healthy nutrition may be es- 
tablished. Nux vomica, Pulsatilla, Ferrum and China, either of which 
may be given in the usual dose three times a day ; after which, Cal- 
carea carb. may be given in daily doses persistently, followed by 
Silicea. Good animal food may be allowed as a diet. Frequent 
bathing with salt water, and friction, are also to be commended. 

White Swelling. 

This is a form of scrofula, and requires the same remedies used in 
other scrofulous complaints. Arsenicum, Jodium, Calcarea and Sul- 



704 SURGICAL DISEASES. 

phur may be employed ; and whichever remedy is selected may be 
given twice in twenty-four hours. Pulsatilla, Bryonia and Nux vom., 
in like manner, may be given, one at a time, and repeated every four 
hours, when there is any pain in the affected joints. 

Dropsy of the Joints. 

Friction externally, and some kind of soap liniment, and then the 
application of compresses. Apis mellifica may be given internally, 
every four hours, or else Pulsatilla, Arsenicum, Bryonia or Conium. 

Stiff Joints. — Anchylosis. 

This difficulty involves the tendons, ligaments, and bones, which 
in some instances become united at their extremities. These joints 
may be showered with cold water, rubbed with a stiff brush, bathed 
with soap liniment ; while Sulphur, in daily doses, may be given in- 
ternally, or else Aurum mur., Nitric acid, or Jodium. 

Aneurism. 

Aneurisms are pulsating tumors formed of arterial blood. Aconite 
is a good remedy to administer, three or four times a day ; Digitalis, 
also, in the same way ; Valerian, in the usual dose, when the tumor 
appears to be in the abdomen. For Varicose Aneurism, bandaging 
is required, while Hamamelis virg. may be administered internally. 

Varicose Veins . 

When the entire lower extremities are involved, bandaging with 
a roller, or lace stocking, must be employed, while Hamamelis Virg. 
is administered several times a day, internally. Pulsatilla, for preg- 
nant women thus affected, and follow with Lycopodium, after three 
weeks. 

Goitre. — Bronchocele. 

This is an enlargement of the thyroid gland, and causes a swelling 
of the neck. Jodium, externally and internally, is said to be a sure 
remedy. Kali hydriodicum, the usual dose three or four times a day, 
may also be used. Spongia is also a valuable remedy, and so also are 
Merc, iod., Merc, biniod. The remedies must be used persistently 
until the goitre disappears. 

Wry Neck. — Torticollis. 

This is owing to the contraction of some of the cervical muscles. 
Stimulating liniments may be employed externally, while Nux vom. y 
Rhus. Sulphur, Bryonia, or Pulsatilla may be administered inter- 
nally. 



SURGICAL DISEASES. 705 



Fistula in Ano. 

This difficulty requires Silicea, Calcarea, or Sulphur, in daily 
doses. If an operation has been performed, and the Sphincter ani 
has been divided, Arnica may be given three or four times a day, or 
perhaps Calendula ; after which, consult Pulsatilla and Nux vom. 



DISEASES OP INFANTS. 



Crying. 

When a young infant is inclined to cry continually, and sleeps 
but little, give it one or two globules of Coffea or Chamomilla and 
repeat every four hours. 

Colic. 

For infantile colic, which may be caused by flatulence, give Cham- 
omilla ; put one or two globules upon its tongue. If this does not 
relieve, give a globule of Nux ; if restless, and throws up its food, 
after the Nux, give a globule of Coffea. Verat. album is an excellent 
remedy for infantile colic, and Dioscorea has a great reputation. 

Infantile Diarrhoea. 

There will generally be a diarrhoea after an infant has nursed the 
first-fruits of the breast. If excessive, give one or two globules of 
Pulsatilla ; if attended with colic, give the same of Chamomilla ; if 
the diarrhoea is acrid or scalding, give Arsenicum, one or two glo- 
bules ; if with excessive vomiting, give Ipecac. 

Infantile Dysentery. 

When young infants are observed to strain, and have frequent 
stools, and sometimes pass mucus and blood, give Ipecac, one globule, 
or else Mercurius. If they cry out after each stool, and the intestine 
protrudes, give one or two globules of Ignatia. If they refuse the 
breast, give Aconite. In case of heat in the head, give Belladonna. 

Inability to take the Breast. 

Some infants are congenitally opposed to nursing the breast ; and 
all the coaxing and trying which a patient perseverance can supply 
avails but little. Such infants require to be fed ; and to devise for 
them a good and wholesome nourishment is sometimes difficult. 
The nursing-bottle must take the place of the breast, and the child 

706 



DISEASES OF INFANTS. 707 

must be nourished by it. One of the best preparations of food for 
young infants is a thin gruel made of a table-spoonful of unbolted 
flour to a quart of water, to be boiled half an hour, and then strained 
through a fine strainer, sweetened, and put into a nursing-bottle suf- 
ficiently thin to flow through the tube. This food may be enriched 
with a little good milk, as the child requires it. Nothing has so uni- 
formly answered as a substitute for the breast, though many of 
the so-called Infants' Foods are good, such as Mellin's or Nestle°s. It 
is often necessary to try several before one is found that will per- 
fectly agree with the infant. 

Infantile Jaundice. 

Young infants sometimes become yellow, and their skin affords 
evident signs of jaundice. One or two globules of Mereurius viv., 
followed by one or two of Pulsatilla, will change this condition. If 
frequent discharges from the bowels occur after these remedies, give 
one or two globules of Arsenicum. 

Snuffles. 

In cold weather, young infants are prone to take cold easily, from 
the slightest change ; and they will show it by sneezing and snuff- 
ling : occasionally there will be indications of fever, and heat in the 
head. One or two globules of Aconite may be given first, and then 
one or two of Nux vomica. If there is thin discharge from the nose, 
give a globule or two of Arsenicum. Sambucus, twice daily, is a good 
remedy. 

Sore Mouth, — Aphthse. 

Considerable uneasiness is manifest in young children from a per- 
ceptible inflammation of the mucous membrane of the mouth. It 
will look red and inflamed, and there will be perceptible some little 
points or pimples of a whitish character. Give one or two globules 
of Mereurius or Bryonia, and wash the mouth with warm tea, or 
milk and water. Some have introduced into their mouths a little 
powdered Borax. This difficulty is generally of brief duration, and 
is but a trifling malady. 

Thrush. 

This is also a sore mouth to which infants are subject, and a little 
more serious in its character. The child first has fever, and then 
refuses to take its food. On examining the mouth, it is found to 
contain a number of white blisters that have a sore and inflamed 
appearance. One or two globules of Phosphorus will often cure the 
trouble. Bryonia has also been used. Mereurius viv. may also be 
used. A decoction of black tea may constitute a wash ; also a weak 



708 DISEASES OF INFANTS. 

solution of Borax. Good nursing, and care to prevent taking cold, 
are essential. If with this kind of sore mouth there is diarrhoea, give 
one or two globules of Arsenicum. If the child cries much from 
colic, one or two globules of Colocynth may afford relief. 

Red Gum. 

When an infant is one or two days, or a week old, there occurs 
an eruption all over the body of a bright red appearance, that prob- 
ably itches, and causes the child some suffering. A couple of glob- 
ules of Pulsatilla night and morning will suffice to cure the difficulty. 

Retention of Urine in Young Infants. 

This difficulty occasionally is observed, and is attended with much 
restlessness and inquietude. An infant should urinate eight or ten 
times in twenty-four hours ; and, when there is a failure in this re- 
spect, give one or two globules of Hyoscyamus, and repeat every three 
or four hours until the derangement is obviated. When Hyoscyamus 
fails, give a globule or two of Pulsatilla or Aconite. 

Teething, Dentition. 

When an infant has attained the age of four or six months, the 
period of teething commences. The child begins to drool, and is rest- 
less and uneasy, and frequently cries out with pain. At times the 
cheeks will be red, and the head will be hot ; or else there will be 
diarrhoea, and the food will pass the bowels undigested. The child 
is generally fretful and uneasy. The most effectual remedy for the 
restlessness and irritative fever is Chamomilla. Two or three glob- 
ules may be given three times a day. When the head is hot, and 
the child thrusts its fingers into its mouth, give it two globules of 
Belladonna ; when the food passes undigested, give two globules of 
Pulsatilla. When there is a general heat of the body, and deranged 
condition of the stomach, give two globules of Aconite ; if this fails 
to relieve in twenty-four hours, give Cimicifuga every hour. 

Summer Complaint, Cholera Infantum. 

During the heat of the summer, teething children are prone to be 
affected with a prostrating diarrhoea, sometimes watery, at others 
dysenteric, when the stools are tinged with blood. In the first stage, 
when there is considerable fever and watery discharges from the 
bowels, two or three globules of Aconite may arrest the difficulty, fol- 
lowed by Tartar emetic ; if the discharges are profuse and frequent, 
Veratrum album ; if there is much thirst, Arsenicum. For discharge 
of mucus, give Mercurius ; when tinged with blood, give Ipecac, 
The dose of either is two globules. When there is coldness of the face 



DISEASES OF INFANTS. 709 

and extremities, give Carlo veg. If, in spite of these remedial meas- 
ures, the disease continues, let the child be taken into the open air, or 
into the country, or better, to the sea-shore. A trip upon salt water in 
a steamboat has frequently resulted in a favorable change in the con- 
dition of the child. The diet, aside from nursing, should be mutton- 
broth and beef*tea, or perhaps arrowroot or farina gruel. 

Marasmus, Extreme Emaciation. 

From the combined effects of teething and interrupted nutrition, and 
also from diarrhoea, the child will lose its flesh in a remarkable degree, 
and nearly all the adipose or fatty tissues will soon disappear. The 
bones of the face will become prominent ; the eyes will sink into their 
sockets ; the skin will be shrivelled and loose over the entire body, and 
very marked upon the upper and lower extremities. The most 
prominent feature of the disease is interrupted nutrition ; and often 
the child's stomach rejects the simplest kind of food. When there 
is continual retching, give Ipecac, to allay the irritable condition of 
the stomach ; and then give Calcarea ; or if, at first, there is no nau- 
sea, but thirst, give Arsenicum. Sulphur is a valuable remedy, and 
also Ferrum. When either beef-tea, or barley-gruel, or any other 
kind of light soup or gruel, fails of being retained upon the stomach, 
a gruel made of the flour of the yelk of a hard-boiled egg has supplied 
the want of nourishment, and promoted the recovery of marasmus 
patients. When the child is old enough to feed himself, the yelk, 
boiled hard, may be broken in a saucer, and seasoned with a little 
salt ; and the child will pick it up a little at a time and eat it. But 
if otherwise, to a pint of boiling water add a half-pint of fresh milk 
and the flour of one yelk, seasoned with salt, and sweetened. This 
makes a gruel that will flow through a nursing tube. 

Hiccough. — Singultus. 

This annoying difficulty results from the irritation of the dia- 
phragm and the oesophagus, or passage from the mouth to the stomach. 
Nux vomica, Ipecac, Pulsatilla, and Sambucus, have been employed 
as remedies. A single dose of two globules of either may be admin- 
istered when infants are so affected. 



Convulsions, Fits. 

There may be various causes of these convulsions in infants. A 
fever, an irritable stomach, teething, or cold, may produce them ; 
when from fever, give two globules of Aconite, and in two hours fol- 
low with a dose of two globules of Belladonna. When from an ill- 
conditioned stomach, give Ohamomilla, Ipecac, or Ignatia ; when from 



710 DISEASES OF INFANTS. 

cold, Nux vomica, or Sulphur. When the convulsion comes on with 
vomiting, Ipecac. ; when from colic, Pulsatilla or Colocj/nth ; when 
with inclination to sleep, Opium, or perhaps Stramonium ; when from 
the sudden disappearance of any rash or eruption, Cuprum. 

Excoriations. 

The tender and delicate skin of infants is liable to become excori- 
ated from the slightest causes. To relieve the pain and suffering 
attendant upon it, give two globules of Chamomilla, Mercurius viv., 
or Pulsatilla internally, and wash them with a weak solution of Arn- 
ica or Hamamelis externally. Should this condition persist, give 
Sulph. daily. 

Soreness behind the Ears. 

When a child is teething, and there is considerable of the fever of 
dentition, an eruption is liable to show itself behind the ears ; and, 
although this eruption is believed to be effectual in preventing more 
serious disease of the head, it is, nevertheless, an unnecessary disease. 
Graphites may be given to remedy the difficulty, a single dose in 
twenty-four hours; and, in like manner, Arsenicum, Calcarea, and 
Baryta Carb., may be employed. 

Prickly Heat. 

During intensely hot weather, children are liable to break out 
with prickly heat. The stomach at first seems slightly deranged, 
and the eruption upon the surface appears to be an elimination of 
some internal disorder. There is sometimes much fever and head- 
ache ; for this, give two globules of Aconite. If the child is teething, 
give Chamomilla. If the surface becomes red and inflamed give Rhus 
tox. If burning and smarting, give Arsenicum. In case of severe itch- 
ing, give Sulphur. When children are taken out by their nurses on a 
hot day, they must not be exposed to the heat of the sun : shade 
should be sought for them, where, if any air is stirring, they can get 
the benefit of it. 

Milk=Crust. — Porrigo. 

This is a scabious eruption upon the scalp of nursing infants, which 
at first appears to be a humid scurf. It collects as a slight humor, 
and begins to enlarge, involving more and more of the surface, until 
that of the scalp is entirely covered. It is a source of annoyance to 
mothers and nurses. There appears to be great difficulty in keeping 
the affected surface clean, and consequently a hasty resort to some 
drying wash has wrought disastrous effects. When milk-crust is 
suppressed, the irritation is apt to fall upon internal organs, and 
produce worse affections. The tar and sulphur ointments, which 



DISEASES OF INFANTS. 711 

have been too frequent a resort, have had the effect, in some measure, 
to dissipate the eruption ; but the usual sequel to this are convul- 
sions, or fatal brain diseases. It is, therefore, recommended as the 
most prudent course, to depend upon the internal administration of 
remedies such as eliminate the humor, and keep it upon the surface. 
The purer the blood can be kept, the sooner will the disease disap- 
pear. If no attention is paid to the use of external agents, the en- 
tire difficulty will be eliminated and dissipated in the course of a few 
months. Two globules of Aconite may be given when there is fever, 
and this may be followed for a while with daily doses of Rhux tox. 
and Bryonia. In scrofulous children, give Calcarea, Arsenicum, or 
Sulphur. In debilitated constitutions, give Graphites, Ferrum, Hepar 
sulph. and China. Lycopodium, three times daily, has cured most 
obstinate cases. All oily food should be withheld. Butter is not 
allowable. After children have been weaned, and still the milk-crust 
remains, a farinaceous food is best. 

Scurf of the Head. 

This is an accumulation upon the scalp, of an oily and dirty 
appearance, which, in many cases, is the result of not being particu- 
lar in washing and wiping the head dry. Soap should never be used 
upon the scalp, and strong alkaline solutions are injurious. Water 
softened with corn or rye meal will answer all the purposes for cleanli- 
ness. As the difficulty does not penetrate below the external skin, 
Rhus tox., Pulsatilla, Calcarea, and Silicea are remedies, either of 
which, in daily doses, will be all that is required. 

Scrofulous Swelling of the Salivary Glands. 

This is a disease somewhat common to children of scrofulous par- 
ents ; and it is of the utmost importance to understand well its charac- 
ter and treatment. When these children take cold, the glands are 
apt to become excited, and there is a perpetual flow of saliva from 
the mouth ; at the same time there will be soreness of the throat, stiff- 
ness of the neck, and swelling of the glands externally. Sometimes 
children will carry their heads to the right or left shoulder, when 
laboring under the difficulty ; and, in spite of the best efforts to re- 
lieve them of suffering, they will continue indisposed a long time. 
Two or three globules of Aconite will subdue the initial fever. Mer~ 
curius viv. may then be given two or three times a day. If this fail 
to arrest the salivation, give Nitric acid for a day, at intervals of six 
hours. Belladonna also may be given to remove any congestion of 
the throat. Silicea may be given afterwards to aid in softening the 
glands. Also, JVux vomica and Sulphur may prove to be useful rem- 
edies. The children should be kept in a room of moderate tempera- 
ture, and not be allowed at any time to be exposed to extremes of 
heat and cold until they have fully recovered. 



712 DISEASES OF INFANTS. 



Sleeplessness of Infants. 

Infants are sometimes smitten with inability to sleep, as well as 
adults. The cause is not always known. It is believed, however, 
to be the result of some disorder acting upon their delicate nerves ; 
such as indigestion, excoriation, or overloading their stomachs. If 
from an irritable stomach, give them Chamomilla or Ooffea every 
night. If from any excoriated surface, that burns and smarts, give 
two globules of Arsenicum, and then apply to the excoriated surface 
a little rye-flour, or Lycopodium powder, aud soothe them to sleep in 
a quiet and noiseless room. If the sleeplessness is produced by re- 
tention of urine, give Hyoscyamus ; if by worms, Cina. If the head 
is hot, give Belladonna. If the sleeplessness is from feeding the 
child too much, give two globules of Pulsatilla. If from constipa- 
tion of the bowels, give Nux vomica or Lycopodium at night. If 
these remedies fail, a tepid bath will often consummate the desired 
result. 



DISEASES OP WOMEN. 



Derangement of the Function of Menstruation. 

From the age of puberty until the change of life, the health of 
the female system depends upon regular menstruation, varying in 
intervals from twenty-six to twenty-nine days. With this standard 
in view, the irregularities as to time are easily noted. By the period 
of puberty is understood the age capable of bearing children, which 
is denoted by menstruation taking place. 

Ailments at the Age of Puberty. 

Immediately preceding the first menstrual period the breasts 
increase in size, the voice is changed, the system becomes rapidly 
developed and the mind matured. There may be headache, dullness 
of the eyes, pains in the lower abdomen, lassitude, capricious appe- 
tite, and, not unfrequently, a premonitory leucorrhcea. To relieve 
these ailments, Aconite ; four globules may be given first ; Pulsa- 
tilla may be given after Aconite, to remove the pains in the abdomen, 
and to promote menstruation. If there is much pain and the func- 
tion is tardy in making its appearance, give Calcarea or Sulphur, and 
then follow with Pulsatilla every four or six hours until the period 
commences. In case of considerable leucorrhcea, give Sepia, or per- 
haps Graphites. When the periods become established they should 
last from three to five days. If scanty at first, give Ferrum, and 
follow with Pulsatilla ; if there is intense headache give Belladonna ; 
if there is hysteria and much agitation and suffering, give Hyoscya- 
mus ; and during the interim let the young lady take strengthening 
food until signs of the recurrence of another period. If it comes on 
normally, it is well ; but if tardy or painful, resort again to Pulsa- 
tilla, Hyoscyamus, Belladonna and Graphites, as they may be indi- 
cated ; and continue this treatment from time to time until regularity 
is established. If tardy, with pains in the back, Kali carb. 

Interrupted Menstruation. 

This may be caused by cold, fright, fevers, diarrhoea and dysen- 
tery, and by pregnancy. When by cold or getting the feet wet, 

713 



714 DISEASES OF .WOMEN. 

Aconite, at first, to remove any febrile excitement or neadache, and 
then Pulsatilla. If this fail to remove the obstruction, give Calcarea, 
and follow with Nux moschata ; should this fail, try Sulphur. 
When menstruation is interrupted by fright, and there is intense 
headache, give Aconite, and follow with Belladonna or Ignatia, and 
finally with Pulsatilla. When fevers weaken and depress the system, 
so as to interrupt the function, first reduce the fever, and then, by 
properly nourishing the patient, the period may return. The same 
rule may be observed in treating the .interruption caused by diar- 
rhoea or dysenteiy. These diseases should be treated and cured by 
appropriate remedies, and the period will be likely to return sponta- 
neously. If otherwise, resort may be had to Pulsatilla, Belladonna, 
Sepia, Calcarea, and other remedies, according to indications. 

Excessive Menstruation. 

When the flow is excessive or weakening, Ipecac, and China may 
be employed, — the first to regulate, the last to strengthen the sys- 
tem ; and this treatment will be found necessary at each period, until 
duly regulated. Calcarea should be given once daily between the 
periods. 

Menorrhagia, or Profuse Bleeding from the Womb. 

This indicates a want of tone in the uterus, if not a state of dis- 
ease, and is usually attended with fainting, pain in the back, nausea, 
and hysteria. When from a want of tone, or debility, China or 
Ferrum may arrest the difficulty; if from disease or inflammation. 
Belladonna or Arsenicum ; when there is fainting and nausea, Ipecac; 
pain in the back, Nux vomica, Nux moschata, or Ignatia, especially if 
the flow is dark or almost black, with fainting and drowsiness ; for 
hysteria give Hyoscyamus. The patient should lie in bed until 
relieved, and should begin sitting up with great caution. A generous 
diet, easy of digestion, should be supplied patients of this description. 
When the strength will permit, this class of patients should seek 
fresh air, and should avoid warm baths. Bathing with tepid water 
is far better. 

Painful Menstruation. — Dysmenorrhea. 

Some ladies suffer intensely at every menstrual period. They 
have chills, headache, fever, colic, and most excruciating pains in the 
womb. Aconite must be given for the fever, Belladonna for the 
chills and headache, Colocynth for the colic, and for the pains in the 
uterus, Hyoscyamus, Pulsatilla, Cimicifuga, or Rhus. 

Ailments attending Change of Life. 

This occurs about the forty-fifth year of life, and is denoted by 
irregularities, — profuse menstrual periods, great irregularities, pain 



DISEASES OF WOMEN. 715 

in the head, melancholy, mania, loss of memory, and great nervous 
depression. For profuse menstruation at this period, give Arnica or 
Lachesis; for headache, Belladonna or Sepia; for intense pains in the 
womb, Arsenicum and Conium ; for Melancholy, Lachesis, or per- 
haps Petroleum; for mania, Stramonium; for loss of memory, 
Sulphur, China, or Qalcarea, 

Ailments during Pregnancy. 

Some ladies are troubled much with morning sickness in the early 
stage of pregnancy, and this is often cured with Cocculus or Nux 
vomica ; if with heartburn, Cimicifuga or Mercurious viv. ; if with 
water-brash of a hot or acrid nature, Arsenicum. Sometimes these 
derangements are so stubborn that no remedies seem to relieve. 
pimple syrup, by the wineglassful, has been taken by some, cham- 
pagne wine by others, hard cider by others. The simple resort will 
sometimes relieve ; and at others nothing seems to afford relief. 
Discharge of blood from the uterus may be cured with China. 
Leucorrhgea, very profuse and debilitating, requires Sepia twice a 
day; corroding discharges, Calcarea twice a day; for rheumatic 
pains, Caulophyllum ; for painful breasts, bathe with Phytolacca; 
for threatened miscarriage, Ipecac, Sabina, China, Arsenicum, and 
Belladonna ; for sleeplessness, Nux vomica or Ars., and a light diet 
at night ; for nose-bleed, Carlo veg., Aconite, Belladonna, Lachesis, 
and Mercurius, a dose of any one of them twice a day. 



LABOR, PARTURITION. 



False Pains, 



There is a kind of pain that afflicts parturient women, thai? 
simply aggravates and unsettles the nerves. Cimicifuga or Caulo- 
phyllum will usually control this. When true labor pains commence, 
they may be regarded as normal if they come at regular intervals, 
and increase in force and frequency as the labor progresses. No 
medicine is needed ; and waiting, with patient labor, will accomplish 
the object. After the child is born, a dose of Pulsatilla will aid in 
expelling the placenta. If there is hemorrhage, elevate the hips and 
depress the head, and give a dose of Secale cornutum ; if anything 
more complicated occurs, call on an experienced midwife. 

Milk Fever. 

About the third day after labor, there is a struggle in the system 
to fill the breasts with milk, attended with fever. Give Bryonia or 
Pulsatilla ; if the milk is tardy in coming, give Oaloarea. 

Difficult Urination. 

After labor, there may be a difficulty in passing urine, which 
Arsenicum or Hyoscyamus will usually relieve, if aided with cloths 
wrung out of warm water applied to the region of the bladder ; or 
else Aconite may be used instead of Hyoscyamus, and sometimes 
Pulsatilla, or Qantharis, 

Soreness after Delivery. 

A painful soreness of the muscles after delivery may be relieved 
by the internal administration of drop doses of Arnica in a spoonful 
of water, while at the same time a towel wet with Arnica tincture 
may be applied to the abdomen. If there is soreness of the vagina, 
forty drops of the tincture of Calendula, in half a pint of tepid water, 
may be used as an injection. 

716 



LABOR, PARTURITION 717 



Constipation of the Bowels. 

This condition after labor may be removed by one or two doses of 
Nux vomica, or perhaps by the use of Lycopodium ; if they fail, the 
bowels should be moved by an enema of warm salt water. 

Excoriated Nipples. 

Soon after the breasts fill with milk, and the child begins to nurse, 
the nipples are apt to become sensitive, and sometimes exceedingly 
sore. For a little sensitiveness, or slight irritation, bathing the 
breasts with a solution of Arnica will help them ; or perhaps a solu- 
tion of powdered Borax will do as well. If the soreness amounts 
to a decided inflammation, and the exterior of the nipples crack and 
bleed, a more careful and efficient treatment is needed. When put- 
ting the child to the breast excites great pain in the gland, and 
severe after-pains at the same time, the internal administration of 
Belladonna is necessary, — two or three doses during twenty-four 
hours , and, at the same time, wet a compress with Arnica tincture, 
and apply to the nipple. Arnica also may be given internally. 
When Belladonna fails, Bryonia, when the pains are worse in damp, 
cold weather. As an external application, a decoction of Oak-hark 
has been found useful, and also the same of the Apple-tree root. A 
solution of Alum, Tannin, or Sulphate of zinc, has been employed ; 
but if the skin is cracked, and blood oozes out every time the child 
nurses, it is of little service. A weak solution of Nitric acid is 
better, two drops to an ounce of water. The best external applica- 
tion for healing the cracks is the Giycerole of aloes, which is made 
by dissolving one ounce Aloes in four ounces of Glycerine. This is 
the best preparation known to heal an inflamed and cracked surface 
on any part of the body. At the same time, Sulphur, Hepar sul- 
phuris, Oalcarea, and Nitric acid may be administered internally. It 
is hardly necessary to add, that whatever lotion is used externally 
must be carefully washed off with warm milk before the child is al- 
lowed to nurse. 

Suppression of the Milk. 

After the breasts have once filled with milk, and it disappears, a 
return may be promoted by the internal use of . Oalcarea carbonica, 
followed with Pulsatilla, or Phytolacca, while the patient is required 
to drink chocolate, or table-beers. 

Induration of the Breasts. 

When the breasts cake, or portions of them seem hard, like a po- 
tato, rub them well with lard, and give internally Oarbo animalis. 



718 LABOR, PARTURITION. 

In a majority of instances, these hard cakes will disappear if care- 
fully attended to. When lard fails to soften, try dry rubbing with 
the hand. If the breasts ache, give Belladonna; if there is fever, 
Aconite, or Phytolacca. If inflammation sets in, and cannot be scat- 
tered, give Hepar sulph. to hasten it to a crisis. Poultices of flax- 
seed meal may also be applied to hasten suppuration. If it is found 
necessary to lance the abscess, let it be done with an opening in the 
direction of the milk-ducts, and not across them; for, when once 
severed, the parts never unite perfectly again. After the matter 
has discharged, some emollient salve spread on chamois skin may be 
applied, for the double purpose of protecting the breasts and healing 
the sore. 

Suppression of the Lochia. 

The flowing after delivery is termed " lochia," and should con- 
tinue for ten days or two weeks. If, through any unfavorable influ- 
ences, the flow is suppressed, the whole system will be more or less 
disturbed. If simply arrested, Pulsatilla may be given every two 
hours, for at least a day ; and, if there is no return, give Secale cor- 
nutum. If still the suppression seems stubborn, and the head begins 
to feel light, and the nerves become unstrung, give Hyoscyamus, and 
repeat every three hours until better, or there is indication of a 
change. Sulphur will sometimes remove the difficulty. If the light- 
headedness be very marked and maniacal, and there is no inclination 
to sleep, a decided advantage may be found in the use of Belladonna. 
If the lochia should finally return, and be of offensive odor, give 
Rhus tox.; if much thirst and dryness of the throat, Arsenicum ; in 
case of diarrhoea, Arsenicum and Mercurius viv., repeated every two 
hours. The application of tepid cloths to the abdomen is recom- 
mended, until the lochia returns. Should the lochia continue too 
long, — that is, beyond the seventeenth day, — Rhus. 

Child=bed Fever. 

A low form of fever frequently sets in about the fourth or fifth 
day after confinement, sometimes severe enough to prostrate the pa- 
tient for weeks. Every day she will suffer from pain in the head 
and copious perspiration ; the hair falls out. This fever sometimes 
continues until a diarrhoea sets in, and the patient sinks into a typhus 
and expires. Therefore, at the first manifestation of this fever, 
Bryonia should be given every three hours ; and this may be fol- 
lowed with Rhus tox., in the same manner. In case of diarrhoea and 
prostration, give Arsenicum or Veratrum album. If there is sallow- 
ness of the complexion, give Mercurius viv. A very light mutton- 
broth may be given for nourishment. Should there be a general 
pain, and aching of the whole body, give Phosphorus two or three 
times, and especially if the diarrhoea should be dark and watery. If 



LABOR, PARTURITION. 719 

the fever should be subdued and convalescence established, allow the 
patient a little wine and water, beef-tea, and a gradual approach to 
more substantial aliments. Should the above remedies fail, and ty- 
phoid symptoms present themselves, Baptisia, hourly. 

Leucorrhoea after Confinement. 

A flux of this kind may result from general debility, and requires 
for its removal a good nourishing diet. China may be given three 
or four times a day at first, and afterwards Sepia or Calcarea. 

Falling of the Womb. 

In some cases, after child-birth, there will be falling of the womb. 
This may be the result of a weakened condition of the muscles that 
retain the womb in its place. When this trouble is of an aggravated 
form, and is attended with copious leucorrhoea, Nux vomica may be 
given every evening. The patient should allow herself to be as little 
upon the feet as possible, — rest being one of the essential conditions 
for gaining strength and for obviating the difficulty. 

Hemorrhoids, or Piles. 

For the piles consequent upon a tedious labor, Arnica may be 
given every morning and evening, or perhaps Hamamelis, if they are 
inclined to bleed; also Nux vomica and Sulphur, when there is severe 
constipation and hemorrhage at every stool. Sulphur in the morn- 
ing, and Nux vomica in the evening. In all cases use Hamamelis 
suppositories. Stewed prunes, Graham toast, and chicken soup, may 
enter into the diet. 



SPECIFIC INDICATIONS FOR REMEDIES 

IN FEVERS. 



In giving specific indications for the selection of remedies in 
fevers, a large ground is covered, inasmuch as nearly all the dis- 
eases to which flesh is heir are attended by some specifically charac- 
terized fever, which calls for the proper remedy. It is therefore 
deemed important to state, in connection with the names of the im- 
portant remedies, the particular characteristic symptoms that they 
represent. 

Aconite is indicated for violent heat and chill, heat about the head 
and face ; and red cheeks, palpitation of the heart, pleuritic stitches, 
anguish, sadness or ill-humor, despondency, and dread of death, bodily 
restlessness. 

Antlmonium is indicated when there is little thirst, yellow coat- 
ing upon the tongue, bitter taste in the mouth, eructations, nausea, 
loathing, vomiting, and other gastric derangements ; constipation or 
diarrhoea. 

Arnica is indicated when there is thirst before the chill, and when 
the chill comes on in the evening after considerable aching of the 
bones ; and also when there is constant desire to change one's posi- 
tion during the fever ; for apathy, and pains in the stomach ; for 
want of appetite, and aversion to meat when the fever has gone off. 
It is particularly indicated when there is weariness, listlessness, yel- 
low color of the skin, and bitter taste, and following a blow or con- 
cussion. 

Arsenicum album is called for when the chill and heat set in 
simultaneously, or when they rapidly alternate with each other, or 
when there is internal chilliness and external heat, and vice versa; 
also for burning heat, as if boiling water was flowing through the 
veins ; no sweat until the commencement of sleep, oppression of the 
chest, anguish and uneasiness, pressure in the head, vertigo, pains in 
the liver and spleen, great debility, burning pain in the stomach, and 
disposition to vomit, great uneasiness and anguish in the region of 
the heart, violent pains and lameness of the extremities, and tendency 
to dropsy. 

720 



SPECIFIC INDICATIONS FOR REMEDIES IN FEVERS." 721 

Belladonna, when the fever comes on with violent headache with 
stupefaction, marked chilliness and slight heat or the opposite ; red- 
ness of the face, with heat and throbbing of the temporal arteries and 
carotids ; entire absence of thirst, or the reverse ; and also when the 
patient is irritable and in a whining mood. 

Bryonia, for coldness, chill with red cheeks, heat about the head, 
and yawning ; or when the heat prevails with subsequent chilliness, 
heat of the chest with slight pains indicating pleurisy ; or when there 
is a coated tongue, or headache and vertigo during the heat, nausea 
and faintness on sitting up. 

Calcarea carbon ica, for heat in the face, then chills; or with cold 
hands, heaviness of the head and limbs, pains in the small of the back, 
and restlessness ; cold, sour-smelling sweat on the head. 

Capsicum, when there is thirst during the chill and fever, and 
much mucus in the mouth, throat and stomach ; also when there is 
diarrhoea with slimy and burning evacuations ; and when the patient 
is irritable, anxious and oppressed during the chill, and when the 
chill begins in the back. 

Carbo veg., when the chill occurs in the evening or at night; thirst 
during the chill only, which is followed with fever and copious sweat 
and chilliness ; afterwards rheumatic pains in the teeth and limbs 
before or during the fever ; and when there is vertigo, nausea and 
red face during the heat. 

Chamomilla, when there is pressure in the pit of the stomach, hot 
sweat on the forehead, despair, tossing about or bilious vomiting, 
diarrhoea and colic, — the thirst, heat, and sweat prevailing, frequent 
urination. 

China is indicated when there is nausea, canine hunger, headache, an- 
guish, palpitation of the heart, or other ailment previous to the parox- 
ysm ; when there is thirst generally before or after the chill and heat, 
or during the sweat; when there is no thirst, but tendency of blood to 
the head, headache, red face, uneasy sleep and yellow complexion. 
China is also indicated when there is drowsiness, pains in the liver and 
spleen, bilious or dropsical symptoms, or enlargement of the liver 
and spleen. 

Cina, for vomiting and canine hunger, both before and after the 
paroxysm of fever ; the face is pale during the fever, and a tendenc}' 
to emaciation exists, and dilated pupils. 

Ferrum is indicated when the fever comes on with chill and 
thirst, headache and tendency to congestion of various organs ; swell- 
ing of the external veins, swelling of the face, especially around the 
eyes ; great debility, vomiting of the food when partially digested, 
and laborious breathing. 



722 SPECIFIC INDICATIONS FOR REMEDIES IN FEVERS. 

Ignatia, when there is thirst only during the chill, and when this 
is moderated by external heat, or when there is external heat with 
partial internal shuddering ; nausea and vomiting, pale color of the 
skin, and pains in the back during the chill ; and also when there is 
no thirst, with headache, vertigo and delirium, and particularly when 
there is paleness of the face, or else alternately pale and red, or only 
one cheek red during the heat ; great languor, deep sleep, with snor- 
ing ; after or during the fever, eruption on the lips and in the corners 
of the mouth. This remedy is also indicated for the fever attending 
nettle rash and other eruptions of the skin. 

Ipecacuanha is indicated for a fever of much chilliness and little 
heat, or vice versa, and when the chill is increased by external heat, 
or when there is little or no thirst during the chill, and great thirst 
during the heat ; and also when there is nausea and vomiting, and 
other gastric symptoms, previous to, or during and between, the 
paroxysms of fever; and when there is a coated tongue and an 
oppression of the chest. 

Lachesis is particularly indicated when chills occur after a meal 
in the latter part of the day, with violent pains in the limbs, and 
pleuritic stitches, oppression of the chest, and convulsive motions ; 
and when there is violent headache during the heat, delirium, burn- 
ing thirst, red face, restlessness, internal shudderings during the 
heat, livid complexion, debility, prostration between the paroxysms, 
heat especially at night, sweat after the heat, and when the fever is 
easily excited by eating lemons or other sour things. 

Jlercurius is indicated when heat and sweat appear together, and 
when there is violent thirst, pains in the right side, acid stomach, and 
regurgitation of sour or bilious matter from the stomach , and when 
there are pains in the bones, and an aching of the limbs. 

Nux Vomica is suitable for a fever that comes on with great debil- 
ity, then chill and heat ; constant desire to be covered, even during 
the heat and sweat; and when, during the chill, the skin, hands, 
feet and face are blue ; and when there are pains in the chest and 
abdomen, back, and particularly in the small of the back, or drawing 
in the limbs , and when there is headache, buzzing in the ears, dis- 
tress in the chest, heat about the face, red cheeks and thirst during 
the chill and heat ; and also when there are gastric or bilious symp- 
toms, vertigo, anguish, and constipation. 

Opium is called for when there is sleep during the heat, and even 
during the chill, with snoring respiration with the mouth open ; con- 
vulsive twitchings, warm sweat, suppression of the secretions. This 
remedy is suitable for old people and children. 

Pulsatilla is wanted when there is no thirst during the fever, or 
thirst only during the heat, and when there is an aggravation in the 
afternoon or evening, with headache, anguish, and oppression during 



SPECIFIC INDICATIONS FOR REMEDIES IN FEVERS. 723 

the entire period of the fever ; and when there is a red and bloated 
face, sweat in the face, and shuddering as soon as the patient recov- 
ers himself; and also when there are gastric or bilious symptoms, 
bitter taste in the mouth, bilious, slimy, or sour vomitings, or 
diarrhoea, alternating with constipation, oppression of the chest, moist 
cough, or headache. Pulsatilla is frequently suitable after Lachesis, 
or when the fever comes on again after overloading the stomach in 
any way. Often beneficial after the abuse of Quinine. 

Rhus tox. is suitable for an evening or night fever, when the 
chilliness and heat both make their appearance simultaneously, and 
a copious sweat comes on after midnight or towards morning; and 
when, during the chill, there are pains in the limbs, headache, vertigo, 
or toothache ; or when, between the paroxysms, there are convulsive 
twitchings of the limbs, nettle-rash, colic, diarrhoea, and gastric de- 
rangement ; or when there is jaundice, sleeplessness, and tossing 
about, thirst at night, palpitation of the heart, with anguish and 
pressure in the pit of the stomach. 

Veratrum, when there are external chill and cold sweat, or inter- 
nal heat, with dark-red urine, delirium, and flushed face ; or when 
there is chill, with nausea, vertigo, pains in the small of the back and 
back ; or when there is chill alternating with heat, constipation, or 
vomiting with diarrhoea ; and when there is thirst during the chill 
and heat. 

With the above remedies, or any of them, the following remedies 
maybe employed: as Cantharis, when the urinary passages are in- 
volved ; or Cocculus, when the patient is nervous and threatened 
with spasms, cardialgia,and constipation. When the fever for which 
any of the remedies are indicated is in sensitive persons, made rest- 
less by great nervousness, give Coffea ; and especially when there is 
sweat with thirst, soft stools, or diarrhoea. Give Drosera, when there 
is violent chilliness with cold face, icy cold hands and feet, nausea 
and bilious vomiting, headache and spasmodic cough during the heat, 
and gastric symptoms between the paroxysms. Give Hepar, when 
the patient has coryza, cough, or distress m the chest, or chill and 
thirst, preceded by bitter taste, followed by heat and sleep. Give 
Hyoscyamus, when the fever is attended by cough at night, or even 
epileptic attacks. Mercurius, sour and fetid sweat, with palpitation 
of the heart. Sulphur, when the fever is from suppressed Itch, with 
chills every evening, heat and sweat towards morning, fever with 
palpitation of the heart, and violent thirst even before the chill. 

In case of any fever occurring with symptoms described as being 
particular indications for the employment of any one remedy, always 
select that remedy ; and, in all probability, but few doses will be re- 
quired to effect a cure, provided the patient is placed in the most 
favorable condition for recovery ; for this is as essential as the em- 
ployment of remedies. 



724 SPECIFIC INDICATIONS FOR REMEDIES IN FEVERS. 

In many instances, only a single symptom may present itself, while 
in other respects the patient may be well. A brief consideration of 
some of these may be useful ; as, — 

Aversion to Food. — Anorexia. 

When this exists as a mere symptom, or dislike for food, give 
Tart, emetic. If after gastric affections, give China. For aversion 
to food, accompanied with hunger, give Bryonia or Rhus tox., or else 
Ignatia or Nux vomica. For complete loathing of food, give Ipecac. 
or Pulsatilla. 

. Loss of Smell. — Anosmia. 

This symptom may show itself independently, and consists in a 
mere insusceptibility of the olfactory nerves, which may be quickened 
by one or two doses of Belladonna, Calcarea, or Sanguinaria. If 
from paralysis of the olfactory nerves, give Nux vomica or Sepia, If 
from catarrh, give Calcarea, Hepar, Silicea, or Sulphur. 

Loss of Taste. — Agustia. 

Foe, the absense of this sense, independently of other affections, 
give Natrum mur. and Silicea. For loss of taste from purely nervous 
causes, such as paralysis of the gustatory nerves, give Hyoscyamus, 
Nux vom., or Sepia. For the same attended with catarrh, coryza, 
and other effects of cold, give Pulsatilla or Sulphur, or else Hepar or 
Sepia. Give the usual dose, and repeat twice a day as long as is 
necessary. 

For alterations of taste, viewed as mere symptoms, the following 
remedies may be employed : Aconite, Arsenicum, Belladonna, Bry- 
onia, Mercurius, Rhus, Pulsatilla, etc. For bitter taste, give Aconite, 
Bryonia, Mercurius, or Nux vomica. For the taste of blood, give 
Ipecac, or Sulphur. For the taste of pus, Pulsatilla. For clayey 
taste, China, Hepar, Pulsatilla. For flat, watery taste, or insipid, 
give Bryonia or China. For the taste of bad eggs, cheese, etc., give 
Arnica, Rhus, or Sulphur. For greasy taste, Causticum. For metal- 
lic taste, give Calc, Lachesis, Nux vomica, or Rhus. For clammy or 
slimy taste, Arnica or Belladonna. For rancid taste, give Bryonia 
or Ipecac. For salt taste, Arsenicum, Carlo veg., or Sulphur. For 
sour taste, give Calc, China, Nux vomica, or Sulphur. For other 
forms of illusory or bad taste in general, give Nux, Pulsatilla, or 
Sepia. For sweetish taste, give Belladonna, Bryonia, China, Merc, 
or Pulsatilla. When food tastes bitter, give Colocynth. For bitter 
taste after eating and drinking, Bryonia, China, Pulsatilla. When 
food has a salty taste, give Carbo veg. When it tastes sour, give 
Calc or China. When there is a sour taste after eating, Nux vom. or 
Pulsatilla. Sour taste after drinking, Sulphur. If after drinking 



SPECIFIC INDICATIONS FOR REMEDIES IN FEVERS. 725 

milk, Ntix vomica. When bread tastes sweet, give Mercurius. When 
those who use tobacco imagine that it has an acid taste, Staphysagria. 
When there is an illusory taste of sweetness of beer, Pulsatilla. 
For nauseous taste, Ipecac. A single dose of the remedy indicated 
for illusions of taste will generally correct the disorder. Nearly all 
these departures from the normal condition of the sense may be indic- 
ative of some peculiar derangement of the animal or organic func- 
tions, that the chosen remedy may avert or correct. The value of 
these isolated symptoms in pointing to remedies that may be used 
as timely preventives of more serious derangements can hardly be 
appreciated. As, for instance, a bitter taste may forebode a serious 
biliary derangement, that Aconite may prevent. And so with all the 
other varieties of illusory taste : what might follow, if neglected, no 
one can tell. It is better to prevent than to cure a malady : and 
when the sentinels of taste and smell stand ready to guard against 
the approach of diseases, it is always best to give heed to their 
admonitions. 



POISONS AND THEIR ANTIDOTES. 



SUBSTANCES which derange the vital functions, and produce death 
by an action not mechanical, are denominated poisons ; and distin- 
guished writers have noted three classes of these substances, which 
may be noted as follows : — 

1st. Irritant Poisons, or those which produce irritation or inflam- 
mation, as mineral acids, Arsenic, Copper, etc. 

2d. Narcotic Poisons, or those which produce stupor or delirium, 
and other affections of the brain and nervous system, as Opium, 
Prussic acid, etc. 

3d. Narcotic-acrid Poisons, or those which sometimes produce irri- 
tation, and sometimes narcotism ; sometimes both together. These 
are all derived from the vegetable kingdom ; as Strychnia, Nux vom- 
ica, etc. 

As almost everybody is obliged to be so situated, that, through mis- 
take or accident, poison of one or another of these classes may be 
taken into the system, it seems desirable to be well instructed in the 
use of antidotes, and the treatment of the supervening irritation or 
inflammation. 

If, through mistake or accident, either sulphuric, nitric, or hydro- 
chloric acid is taken into the stomach in poisonous doses, give Chalk 
or Magnesia ; or, if this is not at hand, beat down the plaster from the 
wall, and make into a thin paste with water, and give this. Soap-suds is 
another antidote. Drink freely of any mild fluid, or milk, both before 
and after the antidote is administered. For the supervening inflam- 
mation, such remedies may be employed as in Gastritis from any 
other cause: Aconite, in case of much fever; Bryonia, if glairy 
vomitings ; Nux vomica, if there is sense of weight, etc. 

In case of Oxalic acid being taken into the stomach by mistake, 
as this may occur from its resemblance to Epsom salts, it will be nec- 
essary to excite vomiting at once by tickling the throat with a 
feather, or by an emetic ; and, after, to administer Chalk or Magnesia 
in large doses suspended in water. These not being at hand, break 
off the plaster, and make a paste as before. Alkalies will not answer, 
as they would only form neutral salts. For the after-symptoms, 
give Aconite dissolved in water, — a tablespoonf ul after every par- 
oxysm of vomiting, until they cease; and give the victim at the 

726 



POISONS, AND THEIR ANTIDOTES. 727 

same time, freely, mucilaginous drinks, and also Coffea and Opium 
as antidotes. 

For poisoning with Arsenic, the first thing necessary is to thor- 
oughly evacuate the stomach; and, for this purpose, give an emetic, 
and then follow with iron-rust, or the Sesqui-oxid of Iron, largely dif- 
fused in water; and let the patient drink freely of mucilaginous, 
farinaceous, or albuminous drinks, and milk. The subsequent in- 
flammation must be treated with Aconite, — a dose every two hours 
until the nausea entirely disappears ; Nux vomica, also, for the inflam- 
mation and soreness of the gastric region ; Bryonia, if the slightest 
motion produces pain ; and Pulsatilla or Nux vom., if the most deli- 
cate kinds of food aggravate the suffering. 

For Poisoning with Mercury, and Corrosive Sublimate. — This is 
the usual form of Mercury employed for committing suicide ; and, as 
it is used for bed-bug poison, it is liable to be taken through careless- 
ness or mistake. It is therefore requisite to point out some antidote 
the nearest at hand. Give whites of eggs in abundance, or Gluten if 
eggs cannot be had ; or else milk. The most usual form of the sup- 
ervening irritation is salivation or mercurial fever. For these, give 
Nitric acid, Hepar sulph., and obtain for the patient fresh air and 
a nourishing diet as soon as possible. 

For Poisoning with Copper. — The blue vitriol, or Sulphate of 
Copper, and Verdigris, are the forms in which this poison is most 
common ; and, when taken into the system, the most ready antidote 
is the white of eggs. Great care should be taken to exclude vinegar, 
for this acid would add virulence to the poison. To allay or cure 
the remaining irritation, give Sulphur twice a day. 

Poisoning with Antimony or Tart, emetic, is liable to occur, as this 
substance is sometimes used in medicine as an emetic. When given 
to excess, it produces vomiting, attended with burning pain at the 
pit of the stomach, followed by purging and colic, stricture of the 
throat, and cramps. As an antidote, give large draughts of warm 
water, and tickle the throat with a feather to induce vomiting ; also 
the decoction of any bark containing tannin, as oak, hemlock, or 
cherry-tree bark. For the subsequent ailments, give Sulphur, China, 
Nux vomica, or Opium. 

For Poisoning with Zinc, or white vitriol, which is denominated by 
violent vomiting, sunken eyes, and pale face, cold extremities, and 
fluttering pulse, give the infusion of any of the substances contain- 
ing tannin, and feed the patient with cream, butter, and chalk quite 
freely. 

For Poisoning with Lead. — Red lead and white lead, as well as 
sugar of lead, are liable to be taken by mistake ; and their poisonous 
effects are denoted by obstinate colic, spasms of the muscles, and 
sometimes apoplexy. As an antidote, give water of ammonia, or 
hartshorn, or pearlash-water, or any of the earthy sulphates, as lime, 
etc. For lead paralysis, give Sulphur, and afterwards Nux vomica. 
For colic, Opium. 



728 POISONS, AND THEIR ANTIDOTES. 

For Poisoning with Cantharides, which is denoted by intense burn- 
ing in the pit of the stomach, and pain in the lower abdomen, feeble 
voice, laborious breathing, strangury, and tenesmus of the bladder, 
headache, and delirium. To remove the Cantharis from the stomach, 
excite vomiting in the quickest and most speedy way, — by tickling 
the throat with a feather, or drinking a strong mustard-tea, or by 
taking snuff upon the tongue. Give Aconite to allay the fever ; give 
Nux vomica and Pulsatilla to allay the irritability of the stomach, and 
Arnica to relieve the tenesmus, or straining ; or else spirits of Camphor. 
This is believed to be the best antidote. 

For Poisoning with Morphine, which is denoted by giddiness and 
stupor, the person becomes motionless, and insensible to external im- 
pressions, breathes slowly, and -lies quite still, with the eyes shut and 
the pupils contracted, the whole expression of the countenance being 
that of perfect repose. As the poison advances, the features become 
ghastly, the pulse feeble and imperceptible, the muscles excessively 
relaxed ; and, unless assistance is speedily called, death soon ensues. 
The first thing necessary is to remove the poison from the stomach, 
which is by inducing vomiting. If soon after taking the morphine, 
give mustard-water freely, or inject in the stomach some Sulphate of 
Zinc, if the patient is too insensible to take it otherwise. After 
vomiting is induced, arouse the victim, make him walk up and down 
the room for hours, until the inclination to sleep is superseded by 
nausea, headache, and vomiting, and then give him strong coffee ; and 
afterwards to remove the entailed symptoms, give Nux vomica. 

For Poisoning with Prussic Acid, when not fatal, resort to cold 
shoiver-bath, and inhalation of diluted water-of -ammonia vapor ; give, 
also, solution of Carbonate of potash. 

For Poisoning ivith Charcoal Gas, as from the fumes of burning 
charcoal in a close room, resort to cold affusion, and give Aconite, in 
drop doses, in a spoonful of water. The same treatment may be 
resorted to in case of poisoning with any of the poisonous gases, as 
sulphureted hydrogen and carbonic acid. 

Poisoning by Strychnia, or Nux vomica, is denoted by convulsions, 
with much anxiety and agitation during the fits. The whole body 
is stiffened or straightened ; the legs pushed out and forced wide 
apart; no pulse or breathing can be perceived; the face and hands 
livid, and the muscles violently convulsed. Nux vomica, or Strychnia, 
in poisonous doses, generally proves fatal, in spite of treatment. If 
emetics are given, and the stomach is made to disgorge its contents 
sufficiently early, and the patient is not attacked with convulsions in 
two hours, he will generally be safe. 

In treating any case of poisoning, two things are required : 1st, re- 
moval of the exciting cause ; 2d, treatment of the effects that remain. 
The removal of the poison should be done, if possible, with little vio- 
lence, and by the simplest and most innocent method, either with the 
finger, or in case the poison has been a long time swallowed, excite 



POISONS, AND THEIR ANTIDOTES. 729 

vomiting or stool by the simplest means. Copious administration of 
tepid water, irritating the fauces by means of a feather, or something 
similar, or by salt, mustard, and snuff, or injections of tobacco-smoke; 
and neutralize the poisons by means of albumen, vinegar, lemon-juice, 
coffee, camphor, milk, oil, soap, mucilaginous drinks, tea, wine, sugar, 
or, as it has been seen, with ammoniacal gas, iron-rust, charcoal, 
kitchen salt, Epsom salt, potash, and starch. 

It is well to be familiar with these antidotes of poisons, and to 
bear in mind the particular indications, or poisonous substances that 
call for them, as follows : — 

Albumen, or whites of eggs, antidotes such metallic substances as 
quicksilver, corrosive sublimate, verdigris, tin, lead, and Sulphuric 
acid, when the victim complains of violent pains in the stomach, with 
tenesmus, or diarrhoea, and pains at the anus. 

Vinegar antidotes alkaline poisons, and obviates the ill effects of 
aconite, opium, poisonous mushrooms, belladonna, etc. 

Coffee. — Strong black coffee, made of the berry lightly roasted, 
and drunk hot, is an antidote to opium, nux vomica, belladonna, nar- 
cotics, mushrooms, poisonous sumac, bitter almonds, and all those 
substances containing prussic acid. It must be borne in mind, how- 
ever, that the cause must be removed, if possible, first. 

Camphor antidotes the ill effects of poisonous insects, and especially 
cantharis, whether administered internally or externally. Camphor 
also antidotes the toxical effects of phosphorus, spigelia, and santonin. 
It is also useful for the after-effects of acids, salts, metals, etc., after 
the poisonous substance itself has been removed from the stomach by 
means of vomiting, etc. 

Milk is frequently alluded to as an antidote for poisons ; but it has 
no real merit. Mucilaginous substances are better, and much to be 
preferred. 

Olive Oil ranks with milk, and is much less useful than is believed. 
It is useless in metallic poisons, and even hurtful in poisoning with 
arsenic. It is of some service, however, in case of poisoning either 
with Nitric, Sulphuric, or Phosphoric acid. Olive oil and vinegar, 
administered in alternation, has proved serviceable in cases of poison- 
ing with alkalies. 

Soap. — Castile soap, dissolved in four times its bulk of hot water, 
and drunk, will antidote many cases of poisoning with Corrosive sub- 
limate and also with arsenic, or with any of the numerous forms of 
lead. Soapsuds is likewise a valuable antidote for poisoning with 
Sulphuric and Nitric acid. Soap is hurtful in cases of poisoning with 
alkalies. 

Sugar, or sugar-water, is quite as good as any of the antidotes, and 
much to be preferred in cases of poisoning with paint, verdigris, cop- 
per, sulphate of copper, alum, etc. In cases of corrosive sublimate, 
in solution, being taken into the stomach by mistake, as it has been, 
sugar-water may be given before the white of an egg. Sugar is also 



730 i'OISONS, AND THEIR ANTIDOTES. 

an excellent antidote in cases of poisoning with Arsenic. The other 
antidotes are, — 

Ammoniacal gas, or the volatile odor of spirits of hartshorn, for 
poisoning with alcohol, bitter almonds, or prussic acid. 

Iron-rust, or the sesqui-oxide of iron, for poisoning with arsenic, 
freshly-prepared. 

Epsom salt, for the various alkaline poisons. 

Charcoal, for poisoning with putrid fish, meat, mushrooms, or 
mussels. 

Kitchen salt, for poisoning with nitrate of silver, and poisonous 
wounds. 

Magnesia, for poisoning with any of the mineral acids. 

Potash and Sweet Almond oil are also good antidotes for acids. 

Starch, in solution, is the best antidote for poisoning with iodine. 

Strong tea is a good antidote for poisoning with honey ; and so is 

Wine, for noxious vapors and poisonous mushrooms. 

And here it may be repeated, that the first thing we have to do, 
in treating cases of poisoning, is to remove the poison by vomiting, 
and then to administer the suitable antidotes. In case we should 
not be able to ascertain what kind of poison has been swallowed, we 
should first administer the white of egg ; and in case there should be 
stupor, give coffee, quite strong, made of the lightly-roasted kernel. 
But if we should know the poison to be mineral or metallic, the first 
resort may be to white of egg, sugar-water, soap-water, or soap-suds, 
and for the remaining effects give Sulphur, which has been ascer- 
tained to be a real antidote to the effects of metallic poisons. If it 
should be known that acids or corrosive substances have been taken, 
give castile soap mixed with four times its bulk in warm water, or 
magnesia dissolved in water, or powdered chalk stirred up in water, 
or a solution of saleratus, pearlash, or super-carbonate of soda, in 
spoonful doses, after each paroxysm of vomiting, as long as it con- 
tinues ; and afterwards give mucilaginous drinks, and, alternately, 
coffee and opium, in the form of homoeopathic remedies ; and for the 
remaining ailments, give Pulsatilla. After the antidotes have been 
administered, give Pulsatilla for sulphuric acid, Bryonia for muriatic 
acid, and Aconite for other acids, and especially for crab-apple vin- 
egar. In case it should be known that alkaline substances have been 
swallowed in poisonous quantities, vinegar and water may be given 
in large quantities, and also lemon-juice or cranberry-sauce, without 
sugar, or sour milk ; and for the secondary effects of poisoning with 
potash, give Ooffea or Carbo veg. If the poisoning is known to be 
the effects of spirits of hartshorn, give Hepar sulph. ; if it should be 
known the patient had been inhaling noxious vapors, bathe the 
patient freely with vinegar and water, and let him inhale the vapor 
of a solution of hydrochloric acid; and, after a return to full con- 
sciousness, give a strong decoction of partially-charred coffee, or a few 
doses of Opium or Belladonna. 



POISONS, AND THEIR ANTIDOTES. 731 

The vapors of coal, when having a poisonous effect, may be anti- 
doted by copious draughts of vinegar and water ; and for poisoning 
by any substance not mentioned, first follow the rule of removing the 
poison from the stomach by vomiting, and, for the irritation or in- 
flammation left behind, affiliate any homoeopathic remedy that may 
meet the case. If there is much fever or arterial excitement, give 
Aconite, every hour; if severe burning at the stomach, and thirst, 
give Arsenicum or Mercurius; if there is great soreness of the mus- 
cles, give Arnica, and let the patient be bathed with a lotion of the 
same; if it is known that any of the animal poisons have been taken 
into the stomach, give a teaspoonful of powdered charcoal in half a 
tumbler of water at a dose, and repeat after each vomiting until the 
stomach becomes quiet ; and if a poison of this kind has come in 
contact with the eyes, give Aconite ; and, finally, to guard against the 
infection of poisonous wounds, when touched with the fingers or 
hand, let them be held in strong heat, as strong as it can be borne, 
for ten or fifteen minutes, and afterwards wash them with soap. 



PROCESSES OF THE HYDROPATHIC 
TREATMENT. 



Fob the description of the hydropathic appliances contained in the 
following pages, I am indebted, in substance, to the " Hydropathic 
Family Physician," by Joel Shew, M. D., author of several popular 
works upon the principles and practice of hydropathy. I have not 
uniformly adopted his exact language, which is not always the best 
he might have chosen to express his thoughts. 

Priessnitz is admitted to have been the originator of the hydro- 
pathic modes of treating diseases. He was an unlearned man, though 
he had original powers of mind ; and, imperfect as the treatment is, 
he benefited his race by conferring it upon the world. 

At first, and for some time, baths were made too cold, and were 
continued too long ; the result was much injury to the patient in 
many cases. Time and experience have brought a better adaptation 
of the temperature and continuance of the water appliances to the 
symptoms, constitution, and temperament of each patient. Formerly, 
weak, exhausted, and nervous persons, not less than the full-blooded 
and strong, were put into the wet-sheet pack, and reduced near to 
death's door; and there is reason to believe that in some cases where 
the practice is in ignorant hands, this barbarity is not wholly discon- 
tinued. The practice, however, is now mainly in better hands ; and 
although I by no means admit its sufficiency as a system of remedial 
agencies, I am persuaded it is doing some good. Used in connection 
with the ancient system of regular medicine, which is the joint prod- 
uct of time, science, and experience, the water treatment, moulded 
and modified to the circumstances and strength of the patient, is an 
auxiliary of no mean power. As such, I accept it. As such, it is re- 
ceived by hundreds and thousands of regular practitioners through- 
out the world. Further than this, it never can or will be generally 
received. By pushing it beyond this, its rightful and honored sphere, 
its friends only limit its progress and injure its influence. 

Division of Baths. 

On no one subject connected with hydropathy has there been more 
"confusion of tongues," than concerning the temperature of baths. 

732 



PROCESSES OF THE HYDROPATHIC TREATMENT. 733 

Both in books and in popular language, among physicians as well as 
laymen, have, words been used, sometimes confusedly, and at other 
times without any meaning whatever. Orthodox medical works, as 
well as the unorthodox, come under the same category of error. A 
few simple explanations on this head, properly made, will be sufficient 
for all practical as well as scientific purposes. 

The simplest and most natural division of baths is into cold, tepid, 
warm, and hot. These are all terms of e very-day life, and are fully 
sufficient to guide us in the selection of any and all the multiform 
uses of water which hydropathy teaches. I admit, however, that 
when we wish to be especially explicit, the actual thermometrical 
temperature should be mentioned. Hot baths, I maintain, have no 
proper place in hydropathic practice. He who resorts to them either 
does not at all understand the true principles of the Water-Cure, or 
is guided merely by the whims or caprices of those who employ him. 

But whatever words we use to designate the different baths, there 
is one objection, which is, that all such terms are necessarily arbitrary 
in a greater or less degree. What appears to one person cold, may 
to another appear tepid, or warm, or even hot. Thus it is said that 
on a road over the Andes, at about half way between the foot and 
the summit, there is a cottage in which the ascending and descending 
travellers meet. The former, who have just quitted the sultry val- 
leys at the base, are so relaxed, that the sudden diminution of tem- 
perature produces in them a feeling of intense cold ; while the latter, 
who left the frozen summit of the mountain are overcome by dis- 
tressing sensations of extreme heat. If on a cold winter's morning 
we go from a warm bed to a bath of sixty to seventy degrees Fahr., 
the water appears cold. If we then plunge immediately into water 
which is at about the freezing point, and then return again to the 
water at sixty to seventy degrees Fahr., it appears warm. When the 
temperature of the atmosphere is at fifty-five degrees Fahr., in No- 
vember or October, in this latitude, and the body of a comfortable 
degree-of warmth, and we take three basins of water at sixty, seventy, 
and eighty degrees Fahr., placing one hand in the water at sixty de- 
grees, the other in that at eighty degrees, letting them remain thirty 
seconds in each, and then immerse them both in the water at seventy 
degrees, it appears to one cold, to the other warm. 

But we can arrive at rules which approximate so nearly to the ac- 
tual truth, that they will serve us, as before remarked, for guides in 
all practical and scientific purposes. 

The Cold-Bath. — With a majority of persons, and at most seasons 
of the year, water at from seventy to eighty degrees Fahr. downward, 
gives, when immersed in it, a sensation of coldness. The spring- 
water of all countries furnishes what may therefore be called a cold- 
bath, although there will be a range of many degrees variation in 
what we term cold. 



734 PROCESSES OF HIE HYDROPATHIC TREATMENT. 

The Tepid Bath. — The word tepid is from the Latin tepeo, to be 
warm. The true English meaning of the term, however, is, according 
to Mr. Webster, moderately warm, or lukewarm; in other words, 
water which, when a person is immersed in it, gives a kind of inde- 
finable sensation, one which, coming properly under the term neither 
cold nor warm, is said to be tepid. This temperature will be found 
to range at from eighty to ninety-two degrees Fahr. 

The Warm Bath. — The term warm is generally well understood. 
It means that temperature of water which is peculiarly agreeable to 
the sensations. Fresh-drawn milk or blood we say are warm. The 
temperature of water which will cause this sensation varies from 
ninety-two to ninety-eight degrees Fahr. 

The Vapor Bath. — The temperature of the vapor of simple water 
varies from about ninety degrees Fahr. upward, according to the heat 
of the water, and the space through which the vapor passes. 

The Hot Bath. — The term hot is also expressive of its proper 
meaning. If the body is immersed in water above blood-heat, it 
causes an uncomfortable sensation, which we designate as hot. Hot 
water is a disturber of the vital functions, particularly if the whole 
body is immersed in it. Hot baths, therefore, should be used, if ever, 
only in a most urgent necessity. Hot water, in no form whatever, 
entered into any part of Priessnitz's treatment. 

Having thus explained the temperatures of the different divisions 

of the bath, it is proper to state them in a tabular form, the better to 

aid the memory. They are as follows : — 

Cold-bath, from freezing point, . . 32 to 85° F. 

Tepid " 80 to 92° 

Warm " 92 to 98° 

Vapor " 90° and upward. 

Hot " above 98°. 

I now propose to explain somewhat minutely, and at the same time 
with a due regard to the needs of the non-professional reader, the 
physiological effects of each of the several kinds of bath, and I here 
respectfully premise that any one who attempts to practise the water 
treatment without having in his mind clear notions upon this subject 
is, to say the least, as much a "groper in the dark " as he who attempts 
the practice of drugs of which he knows nothing, upon the living 
body of which he knows less. How can a man be trusted in water 
treatment if he cannot tell beforehand what effect a bath is to have ; 
and this he cannot, if he does not fully understand the meaning of 
the terms which I have here explained. 

Effects of the Cold Bath. — The effects of the cold bath are properly 
spoken of under two heads, the primary and the secondary. The 
terms are sufficiently expressive of their meaning. The first are 
those which take place at the time of the immersion ; the second, 
those that occur later, constituting what we understand by the term 
reaction. 



PROCESSES OF THE HYDROPATHIC TREATMENT. 735 

Immediately on immersion in cold water, the bather experiences 
some acceleration of respiration and the heart's action, .although the 
pulse becomes at the same time smaller and weaker. Very soon, 
however, the panting, if I may so call it, passes off ; the temperature 
of the body is found diminished, the surface paler than natural, the 
skin taking on that form of appearance known as "goose-flesh." 

The first effect of cold water applied to the body, generally, is to 
abstract a certain amount of heat from the surface, to constringe the 
capillary vessels, and to force the blood inward. Now, as the living 
body possesses the remarkable property of maintaining its tempera- 
ture at very nearly the same point, whether it is in a colder or hotter 
medium than itself, the vitals at once set to work in restoring the 
caloric abstracted by the contact of the water; and as the functions 
of circulation and calorification go necessarily together, the vital 
power, acting through the heart and blood-vessels, attempts a return 
of the blood that had been forced inward by the coldness of the 
water. 

This is what we call reaction. If the individual is sufficiently 
strong and well stocked with vitality, the blood is quickly returned 
to the surface and to the extremities (which are always most liable 
to become cold, being farthest from the heart), constituting what is 
termed good, or vigorous reaction. But if the surface and extremities 
continue to remain unwarmed by this return of the blood to them, 
as happens in the case of feeble persons, there is said to be poor, or 
insufficient reaction. It would then be necessary to give some warm- 
ing medicine to start the blood circulating. 

Effects of the Tepid Bath. — The tepid bath, which we have seen 
ranges from eighty to ninety-two degrees Fahr., produces effects 
analogous to those of the cold bath, only not so lasting and perma- 
nent. It is especially useful in the treatment of infants and children, 
and in all cases where the reactive energy is feeble. If in any case 
we are in doubt as to whether the cold bath is admissible, the tepid 
form will be a milder measure, and at the same time serve as a test 
in venturing upon the cold. The tepid bath may be continued longer 
at a time, which in some cases will be found an advantage. 

Effects of the Warm Bath. — There is among hydropathic physi- 
cians, if I am not mistaken, too great a fear of warm applications on 
the part of some, while others go to the opposite extreme. Mark, I 
speak of warm applications. Hot, as before remarked, have no proper 
place in hydropathy, — a rule to which the exceptions are few. 

The warm bath, as before remarked, ranges from ninety-two to 
ninety-eight degrees Fahr. It is not the most useful of the hydro- 
pathic resources, but one of the most useful, as I shall endeavor here- 
after to show. 

Among the ancient Romans the warm bath was not considered as 
a means of luxurious indulgence that tended to weaken the vital 



736 PROCESSES OF THE HYDROPATHIC TREATMENT. 

powers, but a means of refreshment for the wearied traveller, and of 
preparing him for the repast and the enjoyment of other rites of 
hospitality. The effect of the warm bath is not one of debility, as 
many suppose, but, on the contrary, it is a sedative, lowering the 
heart's action and the circulation, and tending to repose rather than 
excitement. 

Effects of the Hot Bath. — The hot bath, before remarked, is one 
which is above the temperature of the blood, ninety-eight degrees 
Fahr. It was laid down as a precept by Hippocrates, that a bath en- 
feebles when the heat exceeds that of the body immersed in it. The 
truth of this precept has often been verified in practice. 

I do not wish to be understood as affirming that hot applications 
can never be made with benefit to the body ; on the contrary, heat 
applied to a part locally may be of service, although I am inclined to 
believe that even in those cases where heat acts in a beneficial way, 
some other form of hydropathic appliance can be used more bene- 
ficially. I make, it will be remembered, a broad distinction between 
the terms hot and warm, 

Sea=Bathing. 

As regards temperature, sea-bathing comes under the general head 
of cold baths. Sea-water, however, at those seasons of the year when 
sea-bathing is resorted to, is of a moderate degree of coldness, vary- 
ing in this latitude not much from seventy degrees Fahr. 

In order to appreciate fully the effects of sea-bathing upon the sys- 
tem, a number of things are to be considered. 

Sea-water differs in its effects from common water by its possessing 
greater density. This circumstance, however, is not of so great im- 
portance as that of the stimulating nature of the minerals it contains. 
The saline ingredient is a powerful stimulant and even irritant of the 
skin. On account of this property, it is found that an exposure to the 
action of salt water is not so liable to cause ill effects as that to fresh. 
The salt causing a degree of heat upon the surface somewhat higher 
than that of the natural state, the system is for the time shielded 
from the action of cold. It does not follow from this, however, that 
a person could live longer immersed in sea than in common water, 
any more than it follows that because alcohol for a time increases the 
animal temperature, life can, under circumstP^oes of great exposure 
to cold, be the longer preserved. This it is now well known is not 
the case. 

An advantage of sea-bathing in the hot season is, that the air at 
the sea-shore is cooler than on land. That our climate in summer is 
too hot for the most favorable development of health is proved by 
t lie great increase of mortality, not only in our cities, but in other 
parts, during the hot season. The European cities, with all their 
numbers of inhabitants, dampness, narrow streets, intemperance, 



PROCESSES OF THE HYDROPATHIC TREATMENT. 737 

pauperism, etc., would naturally be expected to show a higher range 
of mortality than our American cities, but such is not the fact. Even 
New York, with all its natural advantages, is as sickly, probably, as 
any of the British or European cities. This, it is agreed on all 
hands, must be owing in great part to the intense heat of our summer 
months. 

The manner of taking the salt-water bath has some peculiarities 
which are favorable to health. It is, in the first place, in the open 
air, which, if the weather is favorable, that is, neither too hot nor too 
cold, is always a great advantage. Other things being equal, a bath 
in the open air is always attended with a better reaction and a greater 
degree of invigoration than one within doors. 

In the second place, sea-bathing is usually and almost necessarily 
connected with exercise both before and after the bath, circumstances 
which are always highly favorable to the action of cold water. So 
beneficial, indeed, is exercise taken in this way, that it would be dif- 
ficult to determine which of the two — the exercise or the bathing — . 
is the more beneficial. In connection, the two act reciprocally upon 
each other, each rendering the other doubly beneficial. 

Injections. 

The term injection implies the act of throwing a fluid into some 
cavity of the body. 

In Water-Cure we inject water more frequently into the bowels 
than any other cavity. This kind of injection is also called enema, 
or clyster. 

Most people have so little confidence in simple water, that if a 
clyster is administered to them, thay have no idea that it can operate 
in so effectual a way as it usually does. Years ago, when the water 
treatment was much less known than at the present time, I have 
been suspected of having secretly put some cathartic substance in the 
Avater, " for," said the patients, " how is it possible for water to act in 
this way ? " 

A great variety of injection-instruments have been invented. Some 
of these are very convenient and useful ; others are got up on mere 
speculation, and are but little worth. Every family, at least, ought 
to have a good injection-instrument. A lady's toilet is never com- 
plete without it. A good article is either manufactured or sold by 
most surgical-instrument makers and druggists. 

Modus Operandi of Water. 

It is often objected to hydropathy, that water, being but one agent, 
cannot be made useful in all diseases. I propose here to make some 
remarks on the modus operandi of water, in which I shall endeavor to 
explain, not only to the scientific scholar, but to the ordinary reader, 



738 PROCESSES OF THE HYDROPATHIC TREATMENT. 

that water is capable of being made available as a remedy, — and 
that powerfully too, — in a great variety of ways. It then acts : — 

1. By its Presence. — Water, as we have seen elsewhere, com- 
poses the larger part of the living body, and that without its presence 
in a large proportion in the living system, the vital processes cannot 
for a moment go on. 

2. By its Coldness. — Cold, within proper limits, preserves and 
augments life, while heat tends to debility and decay. In proportion 
as the animal heat is diminished in the different classes of animals, 
the less is the want of air felt. If in a puppy the eighth pair of 
nerves be divided, producing a closure of the glottis so that no air 
can enter its lungs, the animal dies in half an hour, if kept at an or- 
dinary temperature. But if the animal is benumbed with cold it 
survives the operation for a whole day. Frogs, in the summer, when 
the temperature of water is elevated, are obliged to come often to the 
surface for air. But in winter, when the water is colder, they live 
almost entirely under its surface. A cholera patient in collapse, a 
person who has been stifled by foul gases, one in the sinking stage of 
a fever, or fainting from loss of blood, or in any way asphyxiated, 
desires always coldness rather than heat. It may not be possible in 
the present state of science to explain these phenomena; but unde- 
niably we have the facts. 

3. By Endosmosis and Exosmosis. — Animal membranes have the 
power of absorbing liquids, — called endosmosis, or imbibition, and of 
throwing them out, exosmosis, or transudation. 

If we take a portion of the intestine of a chicken, tie one end, 
nearly fill it with milk, then tie the other end, and lastly immerse it 
in a tumbler or other vessel of pure water, we find that in a short 
time the milk passes out of the intestine into the water, and the 
water inwardly mingling with the milk. This process goes on till 
the fluid within and without the intestine becomes one and the same. 
This is a familiar illustration of the principle in question. 

4. By Dilution. — Water is the greatest diluent in nature. There 
is no substance which is at all comparable to it for penetrating the 
myriads upon myriads of capillaries that exist in all parts of the 
living structure. When the fluids become thick, viscid, and filled 
with impure matters, as is usually the case to a greater or less ex- 
tent, in disease, it is an important object to dilute these matters. 
For this purpose water is the only available remedy. 

5. By its Tonic Effect. — Water is the greatest of all tonics, and 
possesses the valuable property, not of wearing out, but of increasing 
in its good effects. 

6. By its Excitant or Electrical Power. — A man feels dull and 
stupid from excessive bodily or mental labor, from excessive alimen- 



PROCESSES OF THE HYDROPATHIC TREATMENT. 739 

tation, or spirit, or tea and coffee drinking, with the blood all crowd- 
ing up into his head. We apply the well- wrung rubbing wet sheet 
one, two, or three times, to his surface, according as he may need, 
and he at once perceives a most wonderful change for the better. Or 
a man feels of a morning dull and stupid, with his muscles sore ; he 
has the rubbing wet sheet, the plunge, shower, or douche, and in- 
stantly his troubles vanish. Or he may have a lumbar abscess, which 
has run him down so low that when he wakes in the morning he finds 
he cannot walk. Two or three gallons of cold water are poured over 
him, upon which he walks readily. Now these effects of water, re- 
markable as they are, arise simply from its excitant or electrical 
power. 

7. By its Temperature. — In acute disease, in all fevers and in- 
flammations, of whatever name or grade, the great power of water to 
regulate the temperature of the body is one of the most striking of 
all the phenomena cognizable by man. By the use of cold water we 
can always vary the heat of the body and the velocity of the heart's 
action to any desirable extent. 

8. By Purifying the Blood. — Water accomplishes one thing which 
no drug, no other substance in nature can. It purifies the blood. It 
does this because it penetrates every lane and alley of the system, 
however minute. No capillary is so delicate that it does not pene- 
trate its smallest possible part. It purifies the blood, because as long 
as the vital principle lasts, the tendency of nature is to preserve the 
vital fluid in a healthy state; and penetrating every tissue of the 
body as water does, it assists nature in the purifying process as no 
other substance can. 

9. By Augmenting the Vital Force. — No fact in science is better 
established than that water possesses the power of actually increas- 
ing the amount of vitality in the system. This is, in fact, the prime 
effect of water. It aids the system in throwing off disease in the 
same way that increasing a merchant's capital aids him in throwing 
off debt. 

The foregoing propositions are submitted as elucidating some of 
the leading principles concerned in the action of water upon the liv- 
ing body. I do not claim, however, that the whole of the philosophy 
of the effects of water is yet understood by any one. Doubtless 
those who know most about it have yet much to learn. 

Rules for Using Water. 

The Time of Day. — In general, the more powerful applications 
should be made in the early part of the day. At this time the calor- 
ific powers and the circulation are more vigorous, and, consequently, 
the body more able to resist powerful applications of whatever kind. 

The Meals. — Ordinarily, no powerful bath should be taken within 



740 PROCESSES OF THE HYDROPATHIC TREATMENT. 

three to four hours after a meal. A full stomach and cold water do 
not at all agree. But in certain diseased conditions, as feverishness, 
inflammation, colic, cramp in the stomach, cholera morbus, and other 
sudden attacks, water appliances are to be commenced without refer- 
ence to hours or meals. The symptoms then are our only guide. 

The Lighter Baths. — If there is doubt as to which application to 
make, the well-wrung rubbing wet sheet, the tepid shallow bath, or a 
warm bath should first be taken. 

Reaction. — Within a reasonable time after a bath, the body in all 
its parts should become naturally warm. If the feet and hands re- 
main cold, and the nails and lips blue, the bath has, to say the least, 
done no good. In some cases of fevers and other inflammatory dis- 
eases, it is better to keep the body chilly than to allow it to become 
too warm. 

Ulceration. — If any part of the body, as the extremities, lungs, 
bowels, etc., is undergoing any considerable ulceration, very cold 
baths are inadmissible. 

Nervousness. — With some persons who are highly nervous, and 
particularly with nervous females, much cold bathing, although it 
appears to agree well, and to be the best for a time, is in the end 
harmful, rendering the nervousness and general debility worse. 

Exercise. — For the douche, plunge, cold sitz, and foot baths, and 
all others that abstract a large amount of caloric from the system, 
the body should be fully warm, and the circulation somewhat acceler- 
ated by exercise. Exercise should also be taken after the bath, 
until the heat and circulation are fully restored. But if exercise is 
impracticable either before or after the bath, friction should be made 
to take its place. 

Increased Heat. — Elevation of temperature constitutes no objec- 
tion to bathing, provided the body is not excessively fatigued. The 
reason why overheated persons sometimes lose their lives by plunging 
into or drinking largely of cold water, is, that the vital force has 
been too much exhausted. Mere heat is an advantage. 

Perspiration. — Neither does this constitute an objection to bath- 
ing or water-drinking, if the foregoing rules are observed. 

The Air. — Bathing in the open air is always preferable to in-doors, 
provided the extremes of heat and cold are avoided. 

The Head. — It is well always to wet the head with cold water, 
both before and after a bath. Douches and the shower should never 
be taken on this part. Simple pouring or affusion is the only mechan- 
ical force of water that should be allowed on the head. 

Pregnancy. — This, as abundant experience proves, forms no ob- 
jection to bathing, or any form of properly regulated water treat- 



PROCESSES OF THE HYDROPATHIC TREATMENT. 741 

ment. Cold bathing and water-drinking are of the greatest service 
during this period. 

The Season. — If the lungs are not extensively diseased, and if 
there is no considerable ulceration going on in any part of the sys- 
tem, the cool and cold seasons are preferable for a course of bathing. 
With right management, a patient gains two or three times as much 
in a given time during the cold months as he does in the hot. 

Days of Rest. — One day in seven water-treatment should be dis- 
continued, with the exception of a simple ablution in the morning. 
Six days' treatment in the week is worth more than seven, because it 
is a law of nature that, if a remedy is continued steadily and without 
change, it loses much of its good effect. This is as true of water as 
of any other agent. Those who do wisely will omit the treatment 
on Sunday, whatever their religious convictions may be. 

Internal Use of Water. — The same general rules apply here as in 
the external applications. Thirst should for the most part be grati- 
fied whenever it is experienced. As a rule, the less water drank at 
meals the better. For the tonic effect, it is to be taken while the 
stomach is empty, and it is better that exercise should accompany it. 
From six to twelve tumblers per diem is a fair allowance for average 
patients. 

Quality of Water. — For all remedial as well as hygienic purposes 
water should be as pure and soft as can be obtained. With proper 
care and ingenuity in the construction of cisterns, filters, etc., this 
desirable end can be everywhere accomplished. Lead, and lead 
pipes, should be avoided, except where the water runs freely and 
constantly. 

The Sweating Process. — Formerly it was much in vogue to sweat 
patients in the blanket pack, but latterly the practice has quite gone 
into disrepute. For several years of the latter part of Priessnitz's 
career he was very averse to using the process. It was a remark of 
his, that the cures by sweating were not permanent. 

Wet Bandages, Compresses, etc. 

These, as we have already seen under the head of wounds and in- 
juries, are of great value in water treatment. They are used of any 
desirable size, upon any part of the body, and produce different effects 
accordingly as they are used. Cooling wet compresses are such as 
are changed or rewet frequently, and for the most are left uncovered. 
The warming or stimulating are covered and left upon the part until 
it becomes as warm or warmer than natural. Warm, fomentations are 
useful in certain cases, but the hot should, as a rule, be discarded. 

The wet girdle is one of the most useful of all medical appliances. 
Two and a half or three yards of good toweling, with tapes arranged 
at one end, the corners of which have been turned over and sewed so 



742 PROCESSES OF THE HYDROPATHIC TREATMENT. 

as to form a point, forms a good girdle. It should pass usually three 
times about the body, one-half having been wet. This brings two 
thicknesses of wet on the abdomen and one upon the back. At 
Graefenberg, this application was worn by every patient, and, as a 
rule, all of the time. It is useful in a great variety of ailments, both 
acute and chronic. The same form of application is also useful for 
the arms, legs, etc., the tapes being used in preference to pins. 

The wet jacket, or chest wrapper, is also a valuable resort in dis- 
eases of the chest. Oiled silk and other similar articles, as I have 
elsewhere observed, are not to be used upon these local applications. 

The following is the substance of Dr. Shew's description of hydro- 
pathic appliances. 

The Wet=Sheet Pack. 

In this process a coarse linen or, cotton sheet is used, long enough 
to reach from the patient's head to the soles of his feet, and about 
two yards in width. The bed is stripped of all its covering, one or 
two pillows only being left for the head. One or two comforters are 
then spread upon it, and over these the same number of woollen 
blankets, which are less injured by wet than cotton comfortables. 
The sheet having been pretty well wrung out of cold water, — always 
pure and soft, if such can be had, — is then spread out smoothly upon 
the blanket. The patient being undressed, lays himself upon the 
sheet, and, his arms being held up, an assistant laps one side of it 
over the body and lower limbs ; when, the arms being dropped at the 
side, the other part of the sheet is, in like manner, lapped over. The 
blankets are then, one by one, brought over the person in the same 
way, and tucked under from head to foot. Comfortables may be added, 
if necessary. ■ 

It is always best to place a wet towel, covered with a dry one, on 
the patient's head while he is packed. If too much chill is not pro- 
duced, the dry one may be left off. 

This is the ordinary way of taking a pack in chronic disease. 

The wet sheet is one of the most soothing and agreeable of all the 
water appliances. Hence it is that it is so often misused. It is so 
delightful, and tends so much to produce slumber, that the patient 
never feels ready to get out of it But this slumber, — so profound 
and sweet as it often is, — he should remember, may be only an apo- 
plectic stupor, which leaves him with a swimming head, attended with 
faintness, perhaps, and ending in a severe headache ; giving him, in 
short, a congestion of the brain. All this happens in consequence of 
robbing the skin too long of the air it should breathe. 

There has been a notion at some of the establishments that the 
wet sheet is to be used for sweating ; and to this end, the patient has 
been literally stewed hour after hour, in some cases, even four, five, 
and six hours in succession, with the view of sweating him. All 
such practice is hurtful. If the patient gets better under it, it is in 



PROCESSES OF THE HYDROPATHIC TREATMENT. 743 

consequence of the good effects of water used in other ways, coupled 
with the ever-important adjuncts, air, exercise and diet. In later 
times, Priessnitz never sweat patients at all, much less in wet sheets. 
If a man must sweat, leave off the wet sheet assuredly, as that only 
hinders the operation. Use the blanket pack or the vapor bath. 

How Long shall the Pack Continue? — Here, too, there has been, 
and still is, much error in hydropathic practice. "Stay in the pack 
till you get warm," has been the old doctrine. But some get warm 
at first, and afterward get cold ; — so at least they feel. What is to 
be done? 

One of Priessnitz's improvements was to give short packs. " Re- 
main enveloped for fifteen or twenty minutes only," he said. " If you 
are not able to bear the pack in that way, take the rubbing wet sheet 
and the lighter processes until you are." In some cases he gave two 
or three of these short packs in succession, the patient rising between 
each to take an airing, a rubbing wet sheet, or other bath, and then 
returning to the pack. 

Thus far the wet sheet has been spoken of as used in chronic dis- 
eases. In acute attacks it is managed differently, according to the 
case. If the object be to abstract caloric from the body, we cover the 
sheet but little, — with a single dry sheet, or a blanket or two, or, per- 
haps, with none of these. 

We know that if we keep a wet towel about a keg of water on a hot 
day, the water will be made cooler by evaporation. In the same way, 
when a patient is hot and feverish, we keep one, or, still better, two 
wet sheets around him, without other covering, and thus bring down 
the heat and circulation to any desirable degree. We sprinkle water 
upon the sheets, or rewet them as often as is necessary, — in some 
extreme cases of fever continuing them a whole week or more. Ex- 
perience teaches that the continuous application of the wet linen is, 
in such cases, a most serviceable application, and one that tends most 
powerfully to induce in the dermoid structure its natural and health- 
ful state. 

The Wet Sheet Acts by Absorption. — It draws morbific matter 
out of the body, as any one may see who applies the sheet for a short 
time, and then washes it. Observe, too, what an odor comes from 
the sheet when a diseased patient has been packed. At the same 
time, it absorbs the pure water into its finest tissues on a large scale, 
thus supplying that fluid which of all substances the system, under 
such circumstances, most needs. This moist warmth of the sheet also 
acts as a most soothing poultice. 

The Wet Dress. 

A modification of the wet sheet, and in some respects an improve- 
ment, is the "wet dress," so called. 

A coarse linen or cotton dress is made with large arms, so that one 



744 PROCESSES OF THE HYDROPATHIC TREATMENT. 

may take the application without help. The dress being wet and ap- 
plied, the patient lays himself upon blankets, in which he wraps him- 
self just sufficiently to become comfortable. Or, he may have dry 
flannel dresses to put on over the wet one, and then lie in a common 
bed. In this application, the air is not excluded from the surface to 
anything like the same extent as in the common tight pack. Hence, 
a patient may remain in it a half, or the whole of the night, if he 
chooses, — being careful to become neither too warm nor too cold. 
Rewetting once or twice in the night will be of service. Often in a 
single night a bad cold may be thrown off in this simple way. 



The Half Pack. 

Many patients have so little reactive energy, that while they can 
bear a half pack, so called, the entire sheet would abstract so much 
caloric from the body as to injure them. In such cases, the sheet is 
to be applied so as to extend only from the arm-pit, or at most, from 
the neck to the hips, leaving the lower extremities, as it were, in the 
dry pack. Sometimes the sheet is allowed to extend to the ankles, 
not including the feet. Packing the trunk of the body in wet towels 
acts upon the same principle as the partial or half pack, and is, in 
many cases, a valuable preliminary measure. It is well to take these 
preparatory steps when a patient who has suffered long from chronic 
disease is beginning with the envelopment. 



The Folded Wet Sheet. 

In domestic practice, a modification of the wet sheet may be had 
by folding four-double a common coarse sheet, for enclosing the trunk 
from the armpits down. Two thicknesses of this are wet in cold 
water to come next the body. 

This is a valuable application in a host of ailments, as pleurisy, 
inflammation of the lungs, inflammation of the bowels, colic, cholera, 
cholera morbus, rheumatism, painful menstruation, after-pains, etc. 
This remedy, which can be applied in five minutes, will often soothe 
a patient quietly to sleep, whose lot, without it, would be a night of 
agony. One advantage of this application is, that if a patient is too 
weak to rise, the sheet may be opened in front, so that fresh water 
may, when needed, be sprinkled upon it, and wet towels may be 
added under it upon the abdomen, if necessary. 

In all the methods of applying the wet sheet, there can be no pos- 
sible objection to using warm bricks, bottles, etc., for the feet when 
cold. 

Bath after the Pack. — It is the practice generally to take some 
form of the bath after the pack. If the patient is too feeble to rise, 



PROCESSES OF THE HYDROPATHIC TREATMENT. 



745 



an ablution is performed while he is in bed. In other cases, a wet- 
sheet rubbing, shallow, plunge, towel, or other bath, is resored to, 
but not strictly of necessity. It is better however, as a rule, to make 
the process a compound one, that is to take some form of bath after 
the pack. This should also be followed by exercise in the open air, 
if it can possibly be taken. A pack, followed by a faithful turn at 
work, or by exercise in the open air, is always worth much more 
than when followed by rest within doors. 



The Rubbing Wet Sheet. 

The rubbing wet sheet, too little appreciated, and too seldom used, 
is one of the most valuable of all the hydropathic resources. There 
is probably no other single application of water, in all the multiform 
modes of hydropathic medication, that can be made, on the whole, as 
useful as this. It is a tonic, a stimulant, a sedative, an antispasmodic, 
a derivative, or a febrifuge, according to the circumstances under 
which it is applied. 

We take a coarse linen sheet, — although cotton answers a very 
good purpose, — large enough to throw around the body like an In- 
dian's blanket. It is wrung more or less, according to the demands 
of the case. Thereupon, it is thrown 
quickly around the patient's body, who, 
if strong enough, is in the standing pos- 
ture ; and then both patient and assistant 
set vigorously to work, rubbing over the 
sheet, not with it, as some do, three, four, 
or more minutes, until the surface becomes 
thoroughly warm (Fig. 188). 

If there is fever, less friction is required. 
After the wet sheet, comes a dry one, to be 
used in the same manner. Those who have 
sufficient reactive energy, — and most have, 
— may dry the body simply by fanning it 
with the dry sheet, the windows at the 
same time being open. This sort of air-bath exerts a highly pleasurable 
effect upon the skin. Instead of giving one a cold, it helps greatly 
to ward it off. This method of drying the body was one of Priess- 
nitz's later improvements. 

The rubbing wet sheet, it should be remembered, is not a single 
application, capable of producing only one effect. It is used in three 
different gradations, and to produce very different results. It is well 
wrung, or only moderately wrung, or left quite wet and dripping. 
If a person is fatigued, or has a low degree of reactive energy, the 
first form is the one to adopt; if there is not much fatigue, and good 
reactive energy, the second ; and if the patient is feverish, and the 




Fig. 188. 



7-ifi PROCESSES OF THE HYDROPATHIC TREATMENT. 

object is to abstract heat simply, we use the sheet quite wet and drip- 
ping: and we repeat it as many times in succession as the case may 
need. One great advantage is, that we give it before or after a wet 
pack, when no bath is at hand; we also give it in connection with 
any other bath we may choose. 

See how admirable a remedy the rubbing wet sheet is, when prop- 
erly understood! A patient, — a child, perhaps, — is so feeble in the 
reactive power, that almost any form of bath we can give it sends 
the blood from the surface, making the lips and nails pale or blue, and 
the extremities cold, showing congestion of the internal organs. 
When a bath produces such effects, it is very apt, to say the least, to 
do more harm than good. But we can apply the rubbing wet sheet 
in such a way as to cause none of these ill effects ; besides, it may be 
repeated many times in the day, so as to give the patient the advan- 
tage of a strong treatment ; for a light treatment, which can be easily 
borne, is made a strong one hj the frequency of its repetition. 

A wet sheet, well wrung, holds perhaps a pint of water ; or, at 
most, a quart. Now, it must appear plain, that a pint or quart of 
cold water, spread over so large a surface as the whole skin, must 
become very easily warmed by the body's heat. Besides, if there is 
great delicacy of constitution, we may wring the sheet out of water 
at seventy, eighty, or even ninety degrees, gradually lowering it as 
the patient can bear it. 

The domestic availability of tins application is also to be spoken 
of. In every dwelling, however humble, there is the coarse sheet, 
and the bucket of water. How useful, therefore, as a resort, in 
home practice! 

The rubbing wet sheet appears a trifling application, — one which 
is not capable of producing any great result. But when we remem- 
ber the myriads of nerves of animal life, spread over the skin, and 
derived from the brain and spinal cord, it need not surprise us that 
its application should so invigorate the body, take off bodily and 
mental depression, remove languor and fatigue, expel flatus from the 
bowels, remove thirst, give appetite, and cause a feeling of calmness 
and relief which can be appreciated only by those who experience it. 
A minister, for example, preaches three times on a Sunday, and gets 
his brain so excited that he cannot sleep. A cold bath would be too 
powerful, and opiates would only act as stimulants, making the mat- 
ter worse. Two or three successful applications of the rubbing wet 
sheet, with powerful friction, bring the blood so much to the surface, 
that his brain becomes relieved, and he very soon falls into a sound 
and refreshing sleep. So, too, when a man has been long wet and 
drenched on a rainy day, and comes home, with the surface and ex- 
tremities cold, and the blood pressing hard upon the brain and other 
internal organs, — the well-wrung rubbing sheet is applied, with plen- 
tiful friction, and at once the oppressed organs are set free. 

In using the rubbing wet sheet, as in all other forms of general 



PROCESSES OF THE HYDROPATHIC TREATMENT. 747 

bath, it is well to wash the hands and face in cold water, both before 
and after it. There is no need of throwing it over the head, as some 
have thought it necessary to do. A patient needs to breathe freely 
when he takes a bath. 

This application is not always the most pleasant one. It does, in 
fact, require a good degree of moral courage to enable one to endure 
the first shock. The sensations produced by it are worse, if possible, 
than those from a plunge into cold water ; I mean the first touch of 
the sheet to the body. Nervous ladies sometimes tell us they cannot 
take the rubbing wet sheet, when, at the same time, they take the 
cold plunge, which is far more powerful, and perhaps too powerful 
for their case. This unpleasant feeling does no harm, for it vanishes 
in a moment or two after the sheet touches the body. 

The Douche Bath. 

This is the most powerful, but not the most useful of all the 
hydropathic appliances. A common douche consists of a stream of 
water from one to two inches in diameter, with a fall of five to ten 
feet. But douches may be arranged of any desirable size and height. 
(Fig. 189.) 

This remedy is useful in paralysis, stiff joints, gout, rheumatism, 
tumors, and old swellings of various kinds. Those who have weak 
lungs, stomach, or other abdominal organs, should not resort to the 
douche without the best of medical advice. 



The Shower Bath. 

This is also one of the more powerful of the hydropathic appli- 
ances, and needs judgment in its use. It consists in fact, of a vast 
number of small streams or douches, and hence is a powerful refrig- 
erant, as well as excitant, to the system. It is useful to commence 
this bath, for a time at first, only upon the limbs. It is used by all 
gymnasts. 

The Cataract Bath. 

This also is one of the more powerful of the hydropathic processes, 
and is to be classed with the two preceding baths. Like them it may 
be said to be stimulant, tonic, and alterative, while it is also highly 
sedative as far as animal heat is concerned. 



The Hose Bath. 

Through the modern improvements in India-rubber, gutta-percha, 
leather, etc., it is easy, whenever there is a small fall or head of 
water, to arrange what is called a hose-bath. It is in principle a 



748 



PKOCESSES OF THE HYDROPATHIC TREATMENT. 



douche, with the additional advantage that it can be made to act 
upon any part of the body," and from whatever direction we choose. 
Rightly applied, the hose bath is a valuable remedy. (Fig. 190.) 





Fig. 189. 



Fig. 190. 



The Pail Douche. 

The process which passes under this name is taken thus: The 
patient seats himself in an empty, shallow, or other bathing-tub, and 
crosses his hands over his chest. As many pails of water as are 
ordered are then dashed over him suddenly, one after another, before 
and behind alternately, — not poured, but thrown with some force, 
by first a backward and then a forward motion of the pail. 

A better method of using it is, for the patient to stand in an 
empty bathing-tub, while an assistant takes two pails of water, one 
ten degrees warmer than the other, and empties the warmer half upon 
the chest and half upon the back, and then bestows the colder pailful 
in the same manner ; and then dries with friction. 

The Wave or Sluice Bath. 

This is taken at the sluice-way of an undershot mill-wheel, or in 
any similar place. The patient takes hold of a rope, or something by 
which he can maintain his position, and then, lying down, subjects 
his body to the action of the water. This is, on the whole, a pleasant 
and agreeable bath, and in its effects somewhat resembles the douche, 
being, however, milder and safer. 



The Half Bath 



This bath may be used as one of the 
processes, or as one of the most powerful, 
is a very good apparatus for the purpose, 
will answer very well, if there is nothing 
should generally be quite shallow in this 



mildest of the water-cure 

An ordinary bathing-tub 

A good-sized washing-tub 

else at hand. The water 

bath, — from three to six 



PROCESSES OF THE HYDROPATHIC TREATMENT. 749 

inches. Priessnitz's half-baths were made of wood, four or five feet 
long, about two and a half feet wide, and twenty inches deep. This 
simple contrivance is one of his most powerful remedial means, — 
that by which some of his highest triumphs are achieved. 

The water is generally used of moderate temperature, at sixty to 
seventy degrees Fahr., and, when long continued, is changed, as it 
becomes warm from tfye heat of the body. 

This bath may be used, 

First, as a means of cooling the mass of the circulation in the hot 
stages of fever, and in inflammatory attacks of every kind. 

Secondly, as a revulsive, or means of drawing blood in congestions 
or inflammations of the nobler organs, the brain, lungs, stomach, 
liver, etc. 

Thirdly, as a means of resuscitation in the shock of serious acci- 
dents, sun-stroke, and before, during, or after apoplectic and other 
fits. In drunkenness and delirium tremens, the half bath is a sover- 
eign remedy. 

Fourthly, as a middle means, and preparatory to the general bath 
in weak constitutions. 

In the latter of these indications, the bath is generally used but for 
a few minutes after the wet sheet, or at other times, as may be de- 
sired. In the former, much practical knowledge is necessary in order 
to proceed always with safety, and to obtain the best results. Thus, 
six, or even nine hours may be required, with the greatest persever- 
ance, the patient being thoroughly rubbed over the whole surface, 
and this to be kept up constantly by relays of assistants, the pa- 
tient's head and shoulders, meanwhile, being supported. 

The Plunge Bath. 

In sea, river, and lake, as well as by artificial means, and as a 
matter of luxury, religious observance, purification, and the preven- 
tion and cure of disease, the plunge bath has, in all periods of time, 
and in all parts of the world, been a favorite resort. So efficacious, 
indeed, has this simple means proved in healing the sick, that not a 
little superstition has been mingled with it. Springs and wells have 
often been supposed to possess some mysterious power, and for that 
reason has been named after some patron saint. In this respect, the 
world has loved mystery and marvellousness rather than the pure and 
simple truth. 

In hydropathic practice, the plunge is much used; but many pa- 
tients are not able to bear it. Those who are not sufficiently strong 
for it at first, should practise the rubbing wet sheet, the half-bath, 
drinking, exercise, etc., until the plunge can be borne. It is w favorite 
remedy at all the establishments, to be taken directly on coming from 
the wet-sheet pack. 



750 



PROCESSES OF THE HYDROPATHIC TREATMENT. 

4 



The Head Bath. 

From time immemorial, cooling applications to the head have been 
much depended upon in that violent and dangerous disease, inflam- 
mation of the brain. All other known means failing, certain obsti- 
nate affections of the head have been known to give way to affusion 
of cold water upon the part. In headache, drunkenness, delirium 
tremens, the delirium of fever, epilepsy, rheumatism of the head, dis- 
eases of the eye, earache, deafness, loss of smell and taste, and in 
nose-bleed, this highly energetic remedy is brought to bear. In 
taking it, the patient lies down, placing the back of his head in a 
shallow dish, filled only an inch or two with water. (Fig. 191.) 





Fig. 192. 



Fig. 192. 



The Leg Bath. 

This is useful in cases of ulcers, swellings, eruptions, gout, rheu- 
matism, sprains, wounds, etc., of the leg or thigh. The relief and 
strength obtained, often by a single application of this remedy, is 
truly wonderful. A variety of apparatus may be contrived for ad- 
ministering the leg bath. A common wooden tub, contrived for the 
purpose, like that represented in Fig. 192, answers a good purpose. 
In such a vessel, he covers the inflamed limb introduced, and cools 
the blood flowing to it. 

The Sitz=Bath. 

Convenient tubs, wooden or metallic, are constructed for this 
bath, but an ordinary wash-tub answers very well. The vessel should 
be large enough to permit the motion of the arms in rubbing the 
abdomen, sides, and hips, first with one hand, and then with the other. 
Water enough should generally be used to pretty nearly cover the 
belly. The more movement and friction while in this bath the better. 
It is more conveniently administered when the tub is elevated two 
or three inches from the floor. Some undress the patient completely, 
and place a blanket or sheet over the upper part of the body ; but 



PROCESSES OF THE HYDROPATHIC TREATMENT. 



751 



oftener only those parts are uncovered which are to be exposed to the 
water. (Fig. 193.) 

In a variety of ailments, this bath is highly valuable. It may be 
made one of the most powerful of all the hydropathic modes. Like 
all other powerful applications, it should be taken only when diges- 
tion is nearly or quite completed. 

As a tonic to the stomach, liver, bowels, womb, spine, etc., this 
bath is highly useful. In constipation and other irregularities it is 
famous. Those of sedentary habits will find its use of rare service. 
For the tonic effect, ten, twenty, twenty-five, or thirty minutes. If 
continued for some length of time the water is to be changed once or 
more, as it would otherwise become too warm. 





Fig. 193. 



Fig. 194. 



The Wash-Tub Bath. 

Under a great variety of circumstances, the wash-tub bath is an inval- 
uable remedy. For example, a patient is feverish ; by setting him in 
a wash-tub half filled with water, and at the same time, if we choose, 
putting his feet in a pail of water, cold or warm, according to the 
case, we may give him any desirable amount of cooling. We cannot, 
indeed, too highly prize this simple contrivance for using water, — a 
means which every family possesses. (Fig. 194.) 

The water, as a general rule, should be tepid, ranging from 72° to 
90°, and may be prolonged from two to fifteen minutes, according to 
the strength of the patient. It should never be carried to the extent 
of producing blueness of the nails. The patient should be dried with 
towels, or the dry rubbing sheet. 

This bath is useful in the treatment of eruptive fevers, bilious 
remittents, the hot stage of intermittents, and in hectic and typhoid 
fevers. It is often used after the wet sheet pack, in chronic affec- 
tions, and may then have a little cooler temperature, or else be fol- 
lowed by pouring a pail of cooler water over the shoulders to tone 
up the skin. 



752 PROCESSES OF THE HYDKOPATHIC TREATMENT. 



The Affusion. 

The patient stands in a wash-tub, bathing-tub, or other convenient 
place, when, by means of a pail, pitcher, or basin, the assistant pours 
water upon the head, neck, etc., either upon the whole of the body 
or only upon a part. The water is used in quantity and tempera- 
ture according to the necessities of the case. The affusion is one of 
the best of hydropathic modes. 

Fifty years ago Dr. Currie, of England, performed great cures in 
fever by the affusion, sometimes tepid, at others cold, according to 
the strength and heat of the patient. If there was great heat, the 
water was used cold; if not, the reverse. In a variety of febrile 
diseases, such as typhus fever, scarlet fever, small-pox, measles, 
tetanus, convulsions, etc., he used this remedy with remarkable 
success. 

Towel and Sponge Bath. 

With one or two coarse towels and a quart or two of water we 
may take a very good bath almost anywhere, even in a carpeted room, 
at a hotel, or wherever we may be, without spilling a drop of the 
water. After a person becomes accustomed to this form of ablution, 
none but the most indolent will be willing to do without it, unless 
they can have some other form of bath. A daily towel ablution, 
thoroughly performed, is an excellent prevention against colds, helps 
the appetite and digestion, and is a good means of preventing con- 
stipation. 

Some are in the habit of sitting in a half-bath or a sitz-tub, and 
with a large sponge making the water pass freely upon the head, 
neck, shoulders, and other parts of the body. At the same time the 
bather may pour water from a cup, basin or pitcher, upon the head, 
neck, etc. This is a mild affusion, and stronger in effect than the 
towel-bath. 

Wash=Down. 

The process to which this name is given by Dr. Edward Johnson 
is practised as follows : " The patient stands in an empty sitting- or 
wash-tub, beside which stands a pail of cold water with two coarse 
towels soaking in it. The bath attendant, taking his place behind 
the patient, lifts one of the towels all loaded with water, and lays it 
quickly on the patient's head. The patient immediately seizes it, 
removes it from his head, and rubs himself rapidly with it, — his face, 
his throat, shoulders, arms, chest, stomach, bowels, thighs and legs. 
having gone rapidly over the whole body once, he drops his towel 
into the pail again, which the bath-man presses down to the bottom 
of the water, then lifts it out, and places it on his head again. As 



PROCESSES OF THE HYDROPATHIC TREATMENT. 753 

before, the patient seizes it, and goes all over the same ground once 
more, and then drops it into the water again, when the bath-man 
again lifts it and places it on the head to be a third time removed by 
the patient, and applied as before, rapidly, actively and energetically, 
all over his body in front. The bath-man is industriously occupied 
all the time behind in the same manner, from the back of the neck to 
the back of the legs, wetting his own towel as often as he wets that 
used by tlie patient, viz., three times. This is called a wash-down of 
three towels. The patient is then dried in a dry sheet. It is a more 
powerful bath than the common towel-bath, but not in all respects so 
convenient to take. 

The Cold Foot=Bath. 

One of the first things people who are troubled with cold feet do 
is to plunge them into cold water. Nor is the assertion, put forth 
in some of the hydropathic works, that the cold foot-bath was pre- 
scribed by Priessnitz for the same purpose that the faculty order 
warm ones, correct. When the feet are already cold, neither Priess- 
nitz nor any one in his sober reason would prescribe cold water, which 
can only make the parts colder. To obtain the good effect of the 
cold foot-bath, so far as the feet are concerned, they should be warm 
whenever it is taken. For a tendency to coldness of the feet, — a 
very common symptom in these days of so-called luxury and refine- 
ment, and one that indicates a state of things in the system incom- 
parably more to be dreaded than the mere coldness of the feet, — 
this is the remedy. It may be taken at any convenient time ; just 
before the morning walk is a very suitable occasion, the parts being 
usually warm early in the day. 

At other times, if cold, they should, if at all practicable, be warmed 
by exercise and friction before subjecting them to the action of cold 
water. But in cases of old age, great debility, etc., the warm foot- 
bath and other warm applications may be resorted to before the cold. 
Thus with cold, exercise and friction, accustoming the feet daily and 
frequently to cold water, will beget in them a habit of remaining warm. 
In a great variety of ailments,, such as toothache, rush of blood to the 
head, headache, earache, inflammation of the eyes, gout, rheumatism, 
hemorrhage, etc., the cold foot-bath is a valuable remedy. It is or- 
dered deep or shallow, and of duration according to the nature of 
the case. 

Wading Foot= Baths. 

I have often directed patients to wade in water in some conven- 
ient place as a means of hardening the system and of giving tone to 
the nerves. Delicate ladies who were not able, as they supposed, to 
endure cold water applied to the feet, have by degrees, wetting the 
feet but little at first, become so accustomed to the coldest water that 



754 FKOCESSES OF THE HYDROPATHIC TREATMENT. 

in a few weeks they could bear as much as any one would desire. 
Caution and perseverance should be the rule. 

It is partly by sympathy and partly by the abstraction of heat, that 
foot-baths and wetting the feet act in so beneficial or deleterious a 
manner as we know them to do. The principle of sympathy is an old 
one in the medical art, but none the worse for that. 



The Warm Foot=Bath. 

I AM aware that some who consider themselves genuinely hydro- 
pathic object to the use of this remedy. Having truth for my object, 
however, I care not for such objections so far as I myself am concerned, 
and without stopping here to argue the question, I simply remark 
that warmth under some circumstances is as natural an application 
for the living body as cold under other circumstances. I have already 
remarked, under the head of the cold foot-bath, that putting the feet 
into warm water is often a good preparatory process to that bath. It 
is good also, now and then, for soothing divers aches and pains, and 
also for warming the feet of old and weakly people, who cannot 
exercise sufficiently. Soaking the feet in hot water for twenty min- 
utes, and taking five or six drops of spirits of Camphor in a tea- 
spoonful of sugar will often break up a cold, if taken in season. 

The Nose-Bath. 

In a variety of nasal ailments, catarrh, colds in the head, inflam- 
mation and ulceration of the nasal passages, nose-bleed, etc., the 
nose-bath is a salutary remedy. The water is used either tepid or 
cold, according to the case. It should be drawn back, if possible, 
so that it is ejected by the mouth. Those who have injured the 
nasal cavities by much snuff-taking will find advantage from sniffing 
water freely into the nostrils. If one is determined to leave off snuff, 
as every one addicted to it, if he regards either health or bodily 
comfort, ought, he will find it useful often to take cold water in- 
stead of the abominable weed. 



The Eye and Ear Bath. 

Various contrivances may be brought to bear in applying water 
to the eye and ear. Light, ascending douches and showers are 
useful for various diseases of the parts. There should not be much 
force used in this way. Immersing them also in water is often useful. 
The water should not, in general, be very cold, tepid or warm being 
often the best. 



PROCESSES OF THE HYDROPATHIC TREATMENT. 755 



Mouth, or Oral Bath. 

Foe inflammation of the gums, mouth, throat, and palate, in slimy 
secretions from the throat and stomach, in toothache, catarrh, colds, 
and chronic hoarseness, garglings and baths for the mouth are of 
great service. Pauley, a merchant of Vienna, has been thought 
singular for his zeal in recommending this bath. Clergymen and 
others who suffer hoarseness by much speaking will find that hold- 
ing very cold water in the mouth until it begins to grow warm, and 
then ejecting it, and by frequently repeating the process, much 
benefit will be obtained. Coughs and tightness of the chest may 
often be essentially relieved by this bath. In mucous secretions 
from the throat and stomach, by ejecting the water a number of 
times, it will surprise those who have not witnessed the remedy to 
see the amount of slimy secretion thrown off. 






DOMESTIC MANAGEMENT OF THE SICK 

ROOM. 



Choice of the Sick>Room, etc. 

Sleeping Apartment. — In every case of disease, however slight 
its nature, the sleeping apartment of the sick should be airy and well 
ventilated ; but, when Providence visits airy member of a family with 
disease of a serious and protracted description, all other considera- 
tions giving way to the necessity of the case, an apartment should be 
chosen and arranged in a special manner for the reception of the in- 
valid. It should be one calculated to administer to his temporary 
comfort, as well as to aid his recovery. It is not time, when the 
alarm is sounded and the danger is already urgent, to think of such 
arrangements ; forethought must be put in requisition ; every want 
anticipated; and whatever is likely to be required should not only 
be provided, but so arranged that it can be instantly found when it 
is needed. 

The sick-room should be large, lofty, and, if possible, with a north- 
ern aspect, in order to avoid the heat of the mid-day, or the after- 
noon sun; the windows should be capable of being opened by 
drawing down the uppermost sash.* If possible, choose a room with 
an open fireplace or a ventilator opening into the chimney in the 
upper part of the room. No article of unnecessary furniture should 
be permitted to remain in the room; and that w^hich is left in it 
should be of a description fitted to administer to the convenience of 
the invalid. 

Two tables are sufficient. One of them may be small, to stand 
near the bed, for the immediate use of the patient: namely, to hold 
his jug of barley-water, or toast-water, or other beverage ; — a small 
tea-pot, or what is preferable, a halt-covered cup with a spout, to 
enable fluids to be administered without raising the sufferer in bed; — 
his medicines for the day; — and any other thing which he may fre- 
quently require. 

The other table should be large, for the accommodation of medi- 
cines not in immediate use, and also for spare glasses, jugs, cups, 
spoons, both large and small, and other necessary articles. This 

756 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 757 

table should have one drawer, at least, which ought to be furnished 
with the following articles: broad and narrow tape; two or three 
half- worn ribbons ; a bundle of old, soft linen ; a sponge ; a few 
ounces of lint ; scissors, large and small ; a bone spatula for spread- 
ing ointment; a couple of rolls of muslin, and the same quantity of 
flannel bandage two inches broad ; a pin-cushion well supplied with 
pins; needles and thread; and about half a yard of simple adhesive 
plaster. 

A Sofa or Reclining Chair. — A sofa, if the apartment be suffi- 
ciently large to admit of it, is a very important piece of furniture in 
the sick-room; the erect or the sitting posture being injurious in 
many diseases; and, when the sick-bed requires to be made, a sofa 
affords the means of removing the patient from the bed with as little 
inconvenience to him as possible. 

If there is not a space for a sofa, there should be an invalid or re- 
clining chair; and, when circumstances will permit, it should be of 
that kind which is susceptible of a variety of changes, so as to vary, 
at pleasure, the position of the patient. There should not be more 
than two other chairs in the room. If there is a looking-glass in the 
apartment, in a situation which admits of the patient seeing himself 
in it as he lies in bed, its place should be changed, or it should be 
altogether removed from the room. A chest of drawers is essential ; 
but none of the drawers should be appropriated for the reception of 
dirty linen, which ought never to be allowed to remain a moment in 
the sick-room. One drawer should be especially allotted for towels, 
of which an ample supply is, in every case, necessary. The washing- 
stand will require two additional basins ; an additional water-bottle 
and a tumbler ; and a large water-pitcher, under the table, always 
full of water. 

No Cooking in Sick=room. — There should be no kettle, nor any 
implement of cooking, in the sick-room; even in winter, and when a 
fire is required. In general, a fire in the sick-room is only necessary 
for the comfort of the attendants. The lamp termed a Night-nurse, 
consisting of a water-bath placed over a lamp in a wire-worked cylin- 
der; a small tin kettle which enters the top of the cylinder; and a 
covered earthenware vessel which fits into the water-bath, are use- 
ful for keeping fluids warm, and at the same time for preserving a 
light in the room, when an unshaded lamp or a candle would be 
hurtful. 

In continued fevers, the sense of hearing is often so morbidly acute 
that ordinary sounds become causes of pain. In this case, if the 
floor of the sick-room be not wholly carpeted, every precaution to 
lessen the intensity of the sound should be taken. One of the most 
effectual is to have a couple or more pairs of large list shoes outside 
the door, into which the feet, even of the doctors, may be advanta- 
geously thrust, when their shoes make a creaking noise, or when a 



758 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

visitor or nurse treads with a heavy foot. On the same account, 
when more than one nurse or attendant is required to be in the room 
at the same Lime, no conversation, although it may be carried on in 
a whisper, should be permitted. Whispering, indeed, is apt to ex- 
cite delirium, and to augment it when it is already present. 

Beds and Bedding. — Beds without curtains are those best adapted 
for the sick-room. In every case of disease, indeed, especially when 
it is attended by fever, the patient should be kept cool, and the most 
perfect freedom be given to the breathing ; the hair mattress should 
be used, never a feather bed, and the pillows be firm and elastic. 
The coverlets, which are spread upon beds during the day, and often 
retained at night, are heavy, and calculated rather to increase than to 
subdue fever; consequently they should be wholly discarded from 
the sick-bed. Indeed, when the disease is fever, and when it is 
accompanied with great restlessness, owing to the evening exacerba- 
tion, if the bedroom be sufficiently large, two beds should be placed 
in it; or if two adjoining bedchambers can be obtained, a bed ought 
to be put in each, so that the patient can be moved from one bed to 
the other every morning and evening. This both aids sleep, and it 
also tends greatly to insure the personal cleanliness of the patient. 
The bedclothes of the bed from which the patient is moved, should, 
on his removal, be immediately turned down and fully exposed to the 
air ; a precaution which will set aside the necessity of so frequent a 
change of linen as would be otherwise required. When there is 
only one bed, and when the disease is fever (unless the patient is too 
ill to permit his being moved), the sheets which have been used at 
night should be replaced by others in the morning, and hung up in 
the free air during the day, to be again used at night. But, when it 
can conveniently be done, in every case of continued fever, especially 
of an infectious kind, the sheets should be changed once in twenty- 
four hours ; a practice which is likely to prevent the fumes of in- 
fection from being communicated to the blankets, or to any of the 
furniture of the room. 

Ventilation is always of primary importance ; and that period, 
happily, is gone by, in which air was carefully excluded from the 
chambers of the sick, even when they were suffering under febrile 
disease. 

Ventilation is particularly demanded in those fevers in which 
miliary eruptions display themselves; under no circumstances is it 
so essential as in febrile diseases of an infectious kind. It may, how- 
ever, be consolatory to those whose duty it is to attend such cases, to 
know that infection communicated through the air rarely extends 
above a few feet from the body of the patient ; and even in the most 
malignant diseases, with the exception of confluent small-pox, and 
malignant scarlet fever of the worst kind, its influence does not ex- 
ceed a few yards, if the room be well ventilated. On the contrary, 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 759 

if ventilation be neglected, the power of infection becomes greatly 
augmented from its concentration in confined and quiescent air ; it 
even settles upon the clothes of the attendants, and on the furniture 
of the room ; and these imbibe it most readily when their texture is 
wool, fur, or cotton, or any loose or downy substance capable of re- 
ceiving and readily retaining the air. Smooth and polished surfaces 
do not easily receive or retain infectious matter; consequently the 
nurses and attendants, in cases of infectious diseases, should have 
glazed gowns, and aprons of oiled silk. 

In no infectious diseases are these rules more essentially necessary 
than in small-pox and scarlet fever. It is well known that, if the 
bedclothes of a patient laboring under either scarlet fever or small-pox 
be closely folded up, they will retain the infectious matter, and com- 
municate the disease at a great distance of time ; but the influence of 
free ventilation is so great, that medical practitioners who are attend- 
ing small-pox patients, and who go from them into the open air, do 
not spread the disease. Indeed, all infection is weakened by dilu- 
tion with air. The danger of infection is augmented, if, along with 
bad ventilation, the atmosphere of the room be moist from any cause. 

It is further consolatory to know that the infectious matter, even 
of the most virulent description, is not poisonous to everyone who 
is placed within the sphere of its influence. A predisposition of the 
body to receive the infection must exist before it can be communi- 
cated; a condition which is augmented by fatigue and watching, 
defective nourishment, mental depression, or anything which can 
lower the vital powers. The necessity, therefore, of maintaining 
these powers by attention to rest, a sufficient quantity of good and 
generous diet, and cheerfulness of mind, need not be insisted upon. 

In every case of infectious disease, the attendants, even in the 
best ventilated rooms, should stand on the windward, or on that side 
of the sick-bed from which the current of air comes ; as, by neglect 
of this rule, and by standing in the current which has passed over 
the patient, the infectious exhalations are blown upon them in a direct 
stream from the body of the patient. The attendants should never 
lean over the sick, nor should they receive their breath. The health 
also of the nurses should always be supported by nutritious and gen- 
erous diet ; but not by brandy, nor any other ardent spirit. 

The term infection, in its most extensive signification, implies some 
deleterious matter, originating from any source, and transmitted 
through the air, which is capable of causing diseases in the human 
body. When this matter is emanated from the diseased bodies of 
men, the term is frequently regarded as synonymous with contagion; 
but, in strictness of language, the latter refers only to the communi- 
cation of disease by contact. Whatever may be the matter of infec- 
tion, it may enter the body through the medium of the lungs, which 
is the most ready inlet, or by the saliva, or even through the surface, 
if the skin be abraded, or if any ulceration be present. The influ- 



760 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

ence of infectious matter is evidently exerted on the nervous system, 
displaying itself by debility, inertness, dislike to motion, great sus- 
ceptibility of cold, irritability and despondency of mind, and by the 
production of a disease similar to that of the person from whom the 
infectious matter has proceeded. The infection may be supposed to 
have taken effect, and to have produced the actual disease, when the 
person who has been exposed to its influence is attacked with giddi- 
ness, pain in the head, irregular heat and chills, nausea, and, if the 
infectious disease be small-pox, convulsions. These symptoms are 
sufficient to denote the* necessity for immediate medical advice. 

Temperature. — Next to ventilation nothing is of more importance 
than the regulation of the temperature of the sick-room, avoiding both 
extremes of elevation or of depression ; but much depends on the 
nature of the disease. 

The best general temperature of a sick-room is 60° (Fahr.) ; and 
it is preferable to regulate this rather by the thermometer than by the 
sensations of the patients or the attendants. Under some circum- 
stances, however, the feelings of the patient, and his susceptibility of 
impressions upon the skin, should not be overlooked. Thus if the 
temperature be a little above that of summer, and the patient, never- 
theless, feel chilly, it should be raised five or six degrees. This chil- 
liness is very apt to be felt in a dyspeptic state of the habit, and 
more especially when it is accompanied with hypochondriasis. It dif- 
fers from that more severe but transient coldness which accompanies 
intermittent fevers, and some other periodical affections ; and it 
requires an elevated temperature of the air for its removal, whilst the 
cold stage of intermittent diseases is best relieved by the warm bath, 
either general or local. 

So important is the regulation of temperature, especially in fevers, 
that it often does more good than any other remedial measure. I 
have seen patients laboring under high delirium in a close, ill-venti- 
lated room become rapidly quite collected by merely lowering the 
heat of the apartment twelve or fifteen degrees. 

In convalescence, as the air of the sick-chamber should be fre- 
quently renewed, the temperature in spring and autumn ought to be 
maintained as near as possible at 55° to 60° (Fahr.) ; and it should 
be very gradually lowered as the invalid acquires strength, so as to 
enable him to bear with impunity the varying temperature of these 
seasons in the open air. Even then, if the previous disease has been 
pulmonary, the air admitted to the lungs should be tempered by the 
use of the Respirator, or a muslin handkerchief tied around the mouth. 
When the invalid first ventures out of doors, nothing, indeed, is so 
essential, in a prophylactic point of view, as avoiding extremes and 
sudden transitions of temperature. 

Cleanliness. — Although cleanliness in the sick-room is essential, 
yet it may be carried so far as to become an annoyance to the invalid, 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 761 

and consequently to prove injurious. It is not requisite to sweep 
the room daily, nor to dust and arrange the furniture every morning, 
provided order be preserved in the room, and nothing but what is 
immediately necessary for the comfort and convenience of the invalid 
be permitted to remain in it. It is truly distressing to observe the 
confusion which prevails in some sick-rooms ; everything being out 
of place, and to be searched for when it is wanted. 

The period chosen for cleaning and arranging the sick-room should 
be the morning, as after a night's rest the patient is more able to 
bear the little noise and bustle which it always more or less occasions. 
The carpet should be sprinkled with moist tea-leaves, or newspaper 
torn in small pieces and wet, and lightly swept. 

It is scarcely requisite to insist on the necessity of the utmost 
attention to the cleanliness of everything in the sick-room. The 
moment after any vessel or implement is used by the invalid, it should 
be removed from the apartment, and returned as soon as it is cleaned. 
Nothing in the form of a slop-basin or slop-pail is admissible ; they 
only administer to the laziness of nurses. 

The necessity of cleanliness in the vessels used for the food of in- 
valids is strikingly illustrated in the bad effects arising from the 
neglect of it when an infant is brought up by hand. In such a case, 
if the feeding-bottle which is employed be not instantly cleansed after 
the meal has been given, the small portion of the pap or food which 
remains in the vessel becomes sour, and taints the whole of the fresh 
food mixed with it, causing colic and convulsions in the infant. The 
same risk of injury occurs in the sick-room, if the vessels used for 
administering food to the invalid be not instantly and well cleansed 
after every time they are used. 

It is too common, also, to use one glass or cup for administering 
medicines, and to leave it unrinsed from time to time, — a custom 
which may prove as deleterious as a defect of cleanliness in vessels 
employed for food. Some medicines, when they are exposed to the 
air, rapidly undergo changes which alter their properties ; and this 
alteration having been undergone by the small portion which is always 
left, in the glass or cup, communicates the disposition to be decom- 
posed to that which may be next poured into the cup. An active 
medicine may be thus rendered inert ; or one which is mild in its 
operation may be so changed as to operate with hazardous energy. 
The same precaution, as to cleanliness, is also requisite as to the 
minim measure, when medicines are directed to be administered 
in a form which requires its employment. 

Darkening the Sick-room. — It is a common error to imagine that 
a sick-room should always be either partially or wholly darkened. In 
some diseases, as, for example, fevers, when the eyes are acutely sen- 
sible to light, so that they remain half-closed, and the eyebrows are 
contracted, the greatest relief is experienced from darkening the 
room. When delirium is present, a certain degree of darkening is in 



762 DOMESTIC MANAGEMENT OF THE SICK-BOOM. 

some instances serviceable ; whilst in others, especially when the de- 
lirium is accompanied with visual illusions, nothing so readily dispels 
these, and consequently abates the delirium, as the admission of the 
full daylight into the sick-room. There is much difficulty, however, 
in determining which state of the apartment is likely to be most ser- 
viceable in any particular case. Observation of the effects of light 
and darkness, in the individual case, must be our guide. 

These illusions of the sight are generally the result of former im- 
pressions,' renewed at a moment when the brain is in such a disturbed 
condition as to set aside the exercise of judgment. In this condition 
of the brain, the renewed conceptions are not readily corrected, as in 
health, by impressions received from the external world; hence, they 
become more vivid in the mind of the invalid when the sick-room is 
darkened, and all visible objects are shut out. They are usually dis- 
pelled by new impressions on the organ of sense chiefly implicated ; 
on which account, those which are connected with sight seldom occur 
during the day, when real objects are presented to the eye, unless the 
brain be so over-excited as to bring the conceptive faculty into in- 
tense exercise, sufficient to awaken those false perceptions which 
create a belief of the presence of individuals not only not present, 
but who have been long dead. This state of the mental organ is 
similar to that on which depend the spectral illusions of the insane, 
but differing from it in its transient nature. I have frequently wit- 
nessed the conversation with one of these spectral beings instantly 
terminated, and the whole illusion dispelled, on opening the window 
curtains of the room ; whilst the invalid has thus expressed himself : 

" Bless me ! I thought I was talking with Mr. , just now ; I 

must have been dreaming; for now I recollect he has been dead many 
years." A twilight obscurity in the sick-room is often more produc- 
tive of these illusions than darkness. 

Fumigation. 

After every contagious disease, like diphtheria, scarlet fever, etc., 
the room, furniture, bed, etc., are to be thoroughly disinfected, to pre- 
vent the development and spreading of the germs. 

Sulphur fumes have been used for many years for this purpose, 
but this method is not secure, agreeable nor efficient. It no doubt 
kills many germs exposed any length of time to its fumes, but never 
destroys their spores. So much so-called fumigation, as usually prac- 
tised, is useless, that it might as well not have been done, as it 
gives a false impression of security. Most virulent germs are capa- 
ble of reproduction and dissemination years after their original occu- 
pation of a house. Old bedding and clothing, brought out months 
after the so-called fumigation, have caused the death of many a little 
one, and the dangerous sickness of others. 

Sulphur and its allies have been found to be so altogether uncer- 
tain and untrustworthy that boards of health are no longer willing 
1 1 endorse its usefulness. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 763 

The only reliable, practical measure against the life of contagious 
germs is the same as now used in case of surgical diseases. Corro- 
sive sublimate, carbolic acid, boiling water, steaming, and baking are 
sure and safe remedies. 

Of this number cor rosive sublimate is easily the leader in efficiency. 
It is not the dangerous drug to use as commonly supposed, since the 
quantity necessary to kill cannot be collected in a room subjected to 
its use. Every piece of furniture and all woodwork, even the paper 
of the wall, can be safely washed in a solution of this drug, made by 
dissolving one tablet in two quarts of water, and fear need not be 
entertained, either, of its efficacy or its harmfulness. Doors, windows, 
and other woodwork should be thoroughly washed with it. Carpets 
should be first wet with it from a sprinkler, dried and beaten. The 
paper need not be removed, if only it can be wiped with this solution. 
Bedding should be steamed, bed-clothing boiled, and all articles not 
readily washed may be likewise steamed. A solution of carbolic acid, 
1 part to 40 of water, is likewise efficient. The great danger of 
doing poor work in the matter of fumigation lies in the practice of 
carrying things out of the room during the illness, before fumigation 
has been commenced. The nurse or mother travelling from one 
room to another may carry in her clothing germs sufficient to infect 
a whole neighborhood. The attendants of such a case should wear 
some thin linen, cotton, cambric, or other washable dress, that may 
now and then be put into the boiler, and thus thoroughly cleansed. 

The hair of patient and attendant should be thoroughly washed in 
the corrosive wash on leaving the room, before disinfection of same. 
Hands are to be scrubbed in soap and water, and then washed in 
corrosive solution on leaving the room, and finally the room is to be 
thoroughly aired. 

If the work is done well and care has been exercised not to have 
contaminated other portions of the house except that occupied by 
the patient, all will be well. Frequently during the illness sheets 
wrung out of the corrosive solution are hung up on one side of the 
door to filter the air passing out of the room. It has also been found 
that the evaporation of some mild antiseptic in the room during the 
sickness not only modifies the virulence of the germ, but is actually 
beneficial in the treatment of these diseases. Of these drugs the 
following is an excellent combination, which may be evaporated in a 
tin dish-cover placed over a light, a stove, or other heated surface. 
It should be burned during the continuance of the disease. 

Carbolic Acid, 1 oz. 

Turpentine, 1 oz. 

Oil of Eucalyptus, 1 oz. 

Alcohol, 1 pint 

Let the rate of evaporation be very slow, and, if much carbolic acid 
be used in case of children, see that the drug is not absorbed into the 
system to such extent as to cause black urine or a-backache. 



764 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Sulphur Fumigation. — This mode of fumigating chambers after 
measles, scarlet fever, and diphtheria is perhaps the most common, 
and, while not an ideal method, it is very easy of application, and 
quite practical. 

Buy two sulphur candles for every room to be fumigated, and, 
having lit them, shut up all windows and doors, and stuff all crevices 
in the doors with cotton batting. Allow the fumes to penetrate 
every closet and drawer for twenty-four hours. The room may then 
be occupied. 

Nitric Acid Fumigation. — The efficiency of nitric acid in the form 
of gas, in arresting contagion, and in cleansing infected rooms, ships, 
and other places, is well established. To obtain the gas, pour one 
ounce of sulphuric acid upon two ounces of nitrate of potash in a 
large tea-cup, — the cup being placed in a basin containing hot water. 
The gas or vapor will be immediately disengaged. 

This quantity will thoroughly cleanse a small apartment, but if 
used in a sick-room, should be placed at some distance from the pa- 
tient. In a large room two cups will be required ; and if a whole 
house is to be fumigated, let several be placed in various apartments, 
and the doors and windows be closed for half an hour. 

Chloride of Zinc. — A solution of the chloride of zinc has great 
power in arresting contagion, and in cleansing infected places. A 
small quantity of it will, in a few minutes, cleanse the most offensive 
apartments. 

Chloride of Lime. — This is one of the most powerful disinfecting 
or cleansing agents known. To prepare it for use, add four gallons 
of water to a pound of the chloride of lime ; stir the mixture well, 
and after allowing it to settle for a short time, pour off the clear solu- 
tion, and keep it in well-corked bottles. 

Chloride of Soda. — This, in disinfecting power, is about equal to 
the chloride of lime. In order that it may retain its properties, it 
must be kept from the light, in a well-stopped glass bottle. AY hen 
used, it must be mixed in the proportion of one ounce, or two large 
spoonfuls, to the pint of water. It is excellent for cleansing car- 
buncles, gangrenous sores, bad ulcers, ulcerated sore throat, and fetid 
discharges of every kind. A weak solution should be frequently 
applied. 

Uses of Chlorides of Lime and Soda. — These articles almost in- 
stantly destroy every bad smell, and all effluvia arising from animal 
and vegetable decomposition, and entirely prevent their bad influ- 
ence. 

While infectious or contagious diseases prevail in large towns or 
cities, the rooms should be sprinkled, morning and evening, with 
some of one of these solutions. Some of it should be placed in the 
different rooms, in shallow dishes, — the small bed-rooms -being par- 
ticularly remembered. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 765 

It must be remembered that whatever can be boiled, like linen 
sheets, towels, etc., and whatever can be subjected to prolonged 
steaming, or the presence of boiling water, can be made absolutely 
clean and germ-free. No fear need be caused after such a disinfec- 
tion. 

In houses where there are typhoid and putrid fevers, and infectious 
complaints, it is highly proper to sprinkle the solution about the 
rooms, and occasionally upon the bed-linen ; and the air of the room 
should be frequently renewed. A wineglassful added to the cham- 
ber-vessel or the bed-pan will remove all smell. The most frequently 
used disinfectants for the stools of typhoid patients is carbolic acid, 
in the strength of one teaspoonful to the pint of water ; of this use 
half or third of the quantity for each stool. 

Before sending the bed and other linen to the wash, let it be im- 
mersed, five or six minutes, in one of these solutions, diluted, as mere 
washing will not always remove the infection. But the linen should 
be immediately rinsed in pure water after the immersion ; to allow it 
to dry without such rinsing might injure it. 

By pouring a quart of one of these mixtures, added to a pailful of 
water, into drains, sewers or cesspools, and repeating the application 
as may be required, will destroy all their offensive effluvia. 

Meat will keep for some time without any taint, and without the 
molestation of flies, if immersed in one of these solutions for an in- 
stant, and hung up ; and all tainted meat, fish, game, etc., will be 
rendered sweet by a little sprinkling of the same. 

To purify water in cisterns, and destroy the animalcules in it, add 
to every one hundred gallons about a pint of one of the solutions. 

The washing of bedsteads with one of the solutions, and putting 
it into all the crevices, will destroy bugs. 

A room just painted may be slept in safely, if one of the mixtures 
be sprinkled about, and left in shallow dishes. 

Stables, slaughter-houses, hog-sties, privies, and all places from 
which offensive smells arise, may be thoroughly purified by these 
mixtures ; or, still better, by the use of sulphur-naphtha, " oil of 
milk," which is to be diluted in the proportion of one teaspoonful to a 
quart of water, and used very freely. This is one of the most excel- 
lent wound dressings now known, but should be used in one-half 
strength solutions. 

Being guardians of the public health of such wide application, and 
of so great utility, it is surprising that they are not more used. 

Freezing Mixtures. 

In treating wounds, inflammation, etc., it is often quite important 
to have ice, where it is not to be obtained without manufacturing it. 
Accordingly, I give here a few directions for its immediate produc- 
tion. 



766 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

The salts used should be in a crystallized state, with as much water 
in them as possible without being damp. They should be coarsely 
pulverized at the time of using, and put into the water contained in 
a basin, or other suitable vessel. The water to be frozen should be 
inclosed in a thin vessel, and immersed in the freezing mixture. To 
obtain extreme degrees of cold, the ingredients and the vessel should 
be cooled by one mixture before being mixed for another. 

To five drams of pulverized hydrochlorate of ammonia, and five 
drams of pulverized nitrate of potash (nitre), add two ounces of 
water, in a tin, stone-ware, or glass vessel, and you may freeze 
water, sea- water, milk, vinegar, or oil of turpentine. It will cause 
the thermometer to sink from 50° above zero to 10° above; that is, 
forty degrees. 

A mixture of five drams of sulphate of soda, and four drams of 
diluted sulphuric acid, will sink the thermometer seven degrees lower 
than the above, namely, down to 3 ° above zero, or twenty-nine degrees 
below the freezing point. 

If six drams of sulphate of soda, four drams of hydrochlorate of 
ammonia, two drams of nitrate of potash, and four drams of diluted 
nitric acid be put together, the mixture will lower the thermometer 
60° ; that is, to 10° below zero, or 42° below the freezing point. 

Besides the above the following combination may be used : 

Muriate of ammonia, five ounces ; nitrate of potash, five ounces ; 
water, sixteen ounces. Mix. 

Nitrate of ammonia, four ounces ; crystalized carbonate of soda, 
four ounces ; water, four ounces. Mix. 

Nitrate of ammonia and water, equal parts. Mix. 

Nitrate of ammonia and nitrate of potash, five parts each ; sul- 
phate of soda, eight parts ; and water, sixteen parts. Mix. 

Phosphate of soda, nine parts ; diluted nitric acid, four parts. 
Mix. 

Sulphate of soda, eight parts ; muriatic acid, five parts. Mix. 

Sulphate of soda, six parts ; nitrate of ammonia, five parts ; diluted 
nitric acid, four parts. Mix. 

Freezing Mixtures with Ice. — Snow or pounded ice, two parts ; 
salt, one part. Mix. This will sink the thermometer to 5° below 
zero. 

Snow or pounded ice, four parts ; salt, two parts ; muriate of am- 
monia, one part. In this mixture the thermometer will go down to 
12° below zero. 

Snow or pounded ice, twenty-four parts ; common salt, ten parts ; 
muriate of ammonia, five parts ; nitrate of potassa, five parts. Mix. 
Gives 18° below zero. 

Snow or pounded ice, twelve parts ; common salt, five parts ; 
nitrate of ammonia, five parts. Mix. Gives 25° below zero. 

Snow, eight parts; muriatic acid, five parts. Mix. Gives 27° 
below zero. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 767 

Snow, seven parts ; diluted nitric acid, four parts. Mix. Gives 
80° below zero. 

Snow, four parts ; chloride of calcium, five parts. Mix. Gives 
40° below zero. 

Snow, three parts; potassa, four parts. Mix. Gives 51° below 
zero, or 83° below the freezing point. 

The Nurse. — When all the arrangements are completed in the 
sick-room, little benefit can be anticipated if a proper nurse be not 
obtained to render them available to the invalid. Every female who 
wishes to act as a sick-nurse should be obliged to serve a certain 
time as an assistant nurse in one of the public hospitals, and to re- 
ceive a certificate of her efficiency before she leaves the establish- 
ment. The advantages which the public derive from a body of nurses 
educated in this manner must be obvious to every one. 

In hiring a sick-nurse, the qualifications which should regulate our 
choice refer to age, strength, health, temper, disposition, habits and 
education. 

Age. — She should not be under twenty-five, nor above fifty-five 
years of age. This period is fixed upon on account both of the 
physical powers and the moral conduct of the individual. Under 
twenty-five, the strength of a woman has not reached its maturity, 
and is scarcely adequate for lifting patients in and out of bed, and 
for many other duties which require strength, connected with the 
office of a nurse ; but the strength and the muscular power in females 
begin to fail after fifty-five, when the natural transition from maturity 
to decay takes place. 

Strength. — The foregoing remarks respecting age render it almost 
unnecessary to say that a woman of a naturally delicate frame of 
body is unfit for a sick-nurse ; at the same time, a coarse, heavy, 
and masculine woman is, for many reasons, objectionable. Whilst 
strength is requisite, the frame should be such as to indicate activ- 
ity. 

Health. — None of the qualifications of a sick-nurse are of more 
importance than health. An individual who herself requires atten- 
tion is ill-calculated to attend upon others. A woman who is asth- 
matic, or has any difficulty of breathing, or a habitual cough ; who 
is rheumatic or gouty, or has any spasmodic affection ; who is af- 
flicted with palpitation ; or suffers from periodical headache, vertigo, 
or a tendency to paralysis ; or who is consumptive, or scrofulous ; or 
has defective sight or hearing; or anything which causes decrepitude, 
is disqualified for a sick-nurse. It is important, also, to ascertain that 
there is no hypochondriacal or Irysterical tendency, nor predisposition 
to mental depression. 

Temper and Disposition. — It is scarcely requisite to say that an 
attendant upon the sick should possess a happy, cheerful, equal flow 



768 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

of spirits ; a temper not easily ruffled ; and kind and sympathetic 
feelings; but, at the same time, not such as to interfere with firm- 
ness of character. The expression of the countenance should be 
open and winning, so as to attract the good-will and confidence of 
the invalid: a pleasing and gentle manner being more likely to gain 
esteem, and insure obedience to the orders of the physician, than the 
most persuasive arguments which can be addressed to the under- 
standing of the patient. 

A collected, cheerful expression of the countenance, in the attend- 
ant on the sick, is likely to inspire hope, and to aid the efforts of the 
physician for the recovery of his patient. 

The general disposition of a sick-nurse should be obliging. Every 
little office, which the invalid may require to be done, should be per- 
formed at once, and without the smallest apparent reluctance, even 
when the necessity for its immediate performance is not absolute. 
There is also an earnestness of manner, which should, if possible, be 
obtained or acquiesced in by the sick-nurse, as it impresses the idea 
that she feels deeply interested in the case ; a circumstance which is 
always highly appreciated by the patient. 

Finally, it is unnecessary to say that a nurse should be honest, as 
no description of servant has so much in her power. But the honesty 
of the nurse is not to be measured by her respect for property ; she 
must be above imposing on the physician, with respect either to 
medicines or to diet. Her religion, also, should be sincere, but not 
pharisaical ; and although she may occasionally persuade her charge 
" to put his trust in God, the fountain of health," * }^et she must rec- 
ollect that preaching is not her province ; and, when mistimed, even 
the best advice may prove not only profitless, but injurious; and this 
is especially likely to be the result when the doctrines she professes 
are of a controversial kind. 

With respect to gossiping, it is a detestable habit under any cir- 
cumstances ; but in a nurse it may be productive of the greatest 
danger, produce family feuds, and a thousand other evils. 

In her Habits, a sick-nurse should be sober, active, orderly, and 
clean, and neat in her person. 

The first of these habits — namely, sobriety — is so essential a 
qualification in every attendant in the sick-room, that it requires no 
comment. Happily, the desire for ardent spirits is now less frequent 
than formerly, when women were seldom employed as nurses until 
they were nearly superannuated, and until their habits, good or bad, 
were too firmly rooted to be removed. 

The Activity essential for a good nurse does not imply a bustling or 
fidgety manner, but a quiet, steady method of proceeding in the per- 
formance of her duties, equally devoid of fluster, turbulence or noise. 
This activity is generally associated with orderly habits ; a most valua- 

* Fuller. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 769 

ble qualification, and without which the sick-room becomes a scene of 
confusion and disgust. Every medical man must have witnessed this 
state of disorder with regret, when, on visiting his patient, he finds no 
chair to sit upon until some article of bedding or of clothing be re- 
moved from it, and the seat dusted with the apron of the nurse; and 
when a former prescription, or anything else, is wanted, he must 
wait until the nurse rummages out half a dozen of drawers in search 
of it. 

Another quality, usually conjoined with activity and orderly habits 
in a nurse, is cleanliness in her own person and in that of her charge, 
as well as that of the sick-room. The dress of a nurse should be 
simple and neat, without trimmings. Nothing is more out of place 
than a fine lady attempting to perforin the duties of a nurse. 

Education. — It may appear a refinement to talk of. the education 
of a nurse ; but there is not a greater difference between noon-day 
and midnight than between an educated and an ignorant nurse. The 
former is often an aid to the physician, not only in carrying his orders 
into effect, but by observing and informing him of symptoms of great 
importance which have occurred during his absence ; whereas the lat- 
ter is a source of constant anxiety, and too often assumes the privi- 
lege of acting in direct contradiction to his orders, and according to 
her own opinion. 

Unhired Attendants. 

The selection of a good nurse, however eminently qualified she 
may be for her duties, does not supersede the attendance of a rela- 
tive or friend in the sick-room ; on the contrary, I can conceive no 
condition so deplorable as that of an invalid left altogether to the care 
and management of a hireling. It is, nevertheless, too true that few 
ladies, even those who are wives and mothers, have any acquaintance 
with the arrangements of the sick-room, and the management of the 
invalid ; they are, consequently, too often forced to be guided by, and 
to rely for instruction on, the nurse, instead of being able to superin- 
tend her conduct, to ascertain that she performs her duty, and to 
correct her failings. 

The degree of intelligence which is demanded in a nurse is very 
different from that which is requisite for a wife or a relative in the sick- 
room. The intelligence of the nurse is directed to supply the wants 
of the invalid, to administer to his comforts, and to obey the instruc- 
tions of the physician ; that of the friend or relative involves the 
power of discriminating disposition and temper ; of watching the 
progress of the disease, and judging of the propriety of not pursuing 
certain measures, which, although indicated by the symptoms at the 
1 ime of prescribing, yet may require to be altered, and consequently 
detailed to the physician, whose presence maybe requisite before his 
next intended visit. It is of the utmost importance, also, that rela- 



770 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

tives attending in the sick-room should be able to control their feel- 
ings in the presence of the invalid. 

Nothing is more essential, in the domestic management of diseases, 
than a knowledge of the natural disposition and temper of the inva- 
lid. An irritable or a passionate man requires a very different man- 
agement from that which is proper for a man of naturally mild and 
easy disposition. Disease awakens, in an augmented degree, the irri- 
tability of the former ; he becomes impatient of contradiction ; and 
every time his opinions are injudiciously opposed, the turbulent agi- 
tation of the nervous system which follows either increases the dis- 
ease or weakens the influence of the remedial agents. On the other 
hand, a mild and gentle disposition often leads to extreme sensitive- 
ness, when disease attacks the body ; a word, a look, is sufficient to 
touch some sympathetic cord: to unstring the whole nervous system; 
and to augment the morbid susceptibility already present in the habit 
to a degree that is not always devoid of danger. Much discretion 
and judgment, therefore, are requisite in both instances ; in the one 
case, to prevent ebullitions of temper ; in the other, to refrain from 
anything that might be construed by the invalid into harshness ; and 
yet at the same time, in each case, to maintain that influence over 
the patient which the treatment of every disease demands in an at- 
tendant on the sick. 

Prejudice and Antipathies. — In those who are imperfectly or erro- 
neously educated, the judgment is apt to be biassed by prejudice and 
antipathies ; and, under the influence of these, it is misdirected in a 
manner of which the individual is often wholly unconscious ; thence 
the necessity of freedom from prejudice in the attendants in the sick- 
room, and the farther importance of the friends or relatives of the 
sick being able to superintend the conduct and the management of 
hired nurses. On the other hand, the judgment, even in the well- 
educated, is apt to be misled by the affections, the influence of which 
is as much opposed to the healthy exercise of discrimination as the 
prejudices of the ignorant. Self-control, therefore, is also an essen- 
tial qualification of the sick-room. 

It is only from knowing that the attendants of the sick are pos- 
sessed of intelligence and self-control, that a physician can rely upon 
having his orders correctly and duly executed ; when those qualities 
are absent, he has to dread, on the one hand, the presumption of 
ignorant prejudice ; and on the other, the improper yielding of sensi- 
tive indulgence. To the invalid, also, it is important to know that 
the directions of his physician are filled b}' an intelligent person; 
for, even in the most severe diseases, as long as the mental faculties 
remain unaffected, a sick man is capable of detecting ignorance, or 
the effects of prejudice, in his attendants; and, when he is convinced 
of the existence of either, all the influence of the individual, whether 
nurse, or friend, or relative, is at an end. 

Were the business of the sick-room ( independent of the wants and 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 771 

comforts of the invalid) confined to the mere observation and collec- 
tion of facts — namely, the noting of the symptoms of disease — and 
reporting them to the physician, it would be superfluous to urge the 
necessity of superior intelligence in its superintendent ; but many of 
its duties require not only a well-regulated understanding, but an 
equally sound condition of the moral feelings and the benevolent 
affections, with a recognition of the authority of conscience in the 
whole operations of life. In the period of sickness, under the direc- 
tion of the judicious and discreet, an invalid may be led to the in- 
vestigation of his moral and religious condition, and to review his 
past conduct, with the determination of turning the result to his 
future welfare, should he happily recover and re-enter society. Surely 
such important duties as these cannot be intrusted to the unqualified, 
or the ignorant, or the hireling ; nor can more be required to demon- 
strate the importance of adding to the other branches of female edu- 
cation a knowledge of the various important duties of the sick-room, 
which females, whether as mothers or daughters, or wives or friends, 
are likely to be called upon to fulfil. 



Prognostics. 

In every disease the medical attendant is naturally called upon to 
deliver his opinion of the degree of danger which hangs over the 
patient : hence, it is unnecessary to enter into any minute details on 
the subject of prognostics. But, as in many diseases changes occur, 
in the absence of the practitioner, which ought instantly to be ex- 
amined into, in order that the danger likely to accrue from them may 
be averted, it is important that the friends and ordinary attendants 
of the sick should be aware of their presence, so as to obtain the im- 
mediate assistance of the medical attendant. Were this information, 
also, more generally diffused, many unnecessary visits would be saved 
to the physician, and much unfounded suspicion of danger prevented 
from distressing and torturing the minds of the friends of the sick. 

In Fevers delirium alone should excite no alarm, unless it be very 
high, or of the low, muttering, incoherent kind. In jaundice, and in 
diseases of the chest, it is alarming ; and in the latter stages of pul- 
monary consumption, its presence always indicates the approach of 
death. 

Great confusion of thought, loss of recollection of the most recent 
occurrence, a restless, wandering eye, and a correspondent vacancy 
or confusion of countenance, are always to be dreaded in fevers and 
in diseases of the brain. An expression of great anxiety is equally 
alarming in all acute diseases ; and a presentiment of death is still 
more to be dreaded. 

Hoarseness, with constant spitting, occurring at an early period 
in small-pOx, is very unfavorable. 



772 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Squinting in affections of the head ought to be particularly noticea, 
aud mentioned to the attending practitioner; and the same remark 
applies to a greatly contracted, or a dilated, or an immovable condition 
of the pupil of the eye ; or the turning up of the pupils under the 
upper eyelids. 

Deafness is not an unfavorable occurrence in continued fever ; but 
a sudden attack of headache in pulmonary diseases ought instantl}' 
to be mentioned to the physician. 

The Sudden Disappearance of Pain in inflammator}^ affections of 
the bowels is always to be dreaded ; but it does not in every instance 
portend the existence of mortification. 

Cough, depending on inflammation of the bronchial membrane, 
suddenly supervening on a suppressed eruption, is always to be 
dreaded. 

In Croup, when the breathing is audible, or when there is a crow- 
ing sound in inspiration, or a cooing or croaking respiration, danger 
is present. 

In Whooping-Cough, when the paroxysms suddenly increase in 
violence, and the face becomes livid, and the thumbs are drawn 
across into the palms of the hands, the appearance of convulsions 
may be anticipated : hence immediate notice of these symptoms 
should be communicated to the medical attendant. 

Rigors invariably excite alarm ; but they are only dangerous in 
chronic internal diseases, in which they often indicate the formation 
of pus, or the existence of suppuration. 

Pallidness of the countenance, with a slight degree of lividity,&Te 
symptoms of hazard in inflammation of the lungs. 

The Position of the Patient as he lies in bed, especially in fevers, 
is of much importance. Constantly lying on his back, with a ten- 
dency to sink to the bottom of the bed; a propensity to keep the 
arms and the feet out of bed, and to uncover the trunk ; or to pick 
the bed-clothes ; tremors ; twitching of the tendons ; grinding of the 
teeth, and sleeping with the eyelids half open, and the white of the 
eyes only seen ; are all justly regarded as symptoms of great danger. 

Fainting (Syncope) is to be considered alarming in diseases of the 
heart, or during profuse bleeding from the nose, or from any other 
part: deep sighing, also, under such circumstances, is most unfavora- 
ble, and often indicates rapid dissolution. 

Hiccup, in the advanced stages of either acute or chronic diseases, 
is invariably alarming. 

Difficulty of Swallowing, also, in the advanced stages of fever, 
palsy, and affections of the head, always indicates extreme danger; 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 773 

vomiting, on the contrary, is not unfavorable, unless it be very severe 
and protracted; but, if the ejected matters be putrid, or feculent, 
then the vomiting is always to be dreaded. 

Coma, or an irresistible propensity to sleep, following the sudden 
suppression of gout, or the cessation of periodical bleeding in piles, 
or the healing of old sores, is always alarming, and requires prompt 
medical assistance. 

Convulsions without fever or any affection of the head seldom 
prove dangerous ; but they are never free from danger when they 
are accompanied with stupor or coma. They are also dangerous 
when inflammatory fever is present. They are less dangerous in 
women than in men, in the young than in advanced age. In infancy, 
convulsions are more to be dreaded in the robust than in the delicate 
and irritable child. 

Diarrhoea is, under every circumstance, an unfavorable event f 
when it occurs either in fevers, or in the termination of chronic dis- 
eases ; and the passing of involuntary stools, when scarcely any 
diarrhoea exists, is equally to be dreaded. 

Retention of the Urine, as well as its involuntary discharge, is 
always an unfavorable symptom. 

Purple Spots appearing on the skin, livid lips and cheeks, oozing 
of blood, sudden flushings followed by pallor, are unfavorable symp- 
toms ; and the appearance of oedematous swellings of the legs and 
skin in the last stage of organic diseases always indicate approaching 
death. When purple spots, also, appear in small-pox, with flattening 
of the pustules on the trunk of the body, and a white, pasty aspect 
of the eruption in the face ; and if, at the same time, the extremities 
become cold, any hope of recovery can scarcely be entertained. 

Great and continued or progressing emaciation in chronic diseases, 
and what is termed the fades Hippo cratica, are to be dreaded. 

Excoriations on the parts on which the body rests, — for example, 
the haunches, or the lower part of the back, — especially if these 
become livid and sloughy, always indicate extreme danger. 

Great Difficulty of Breathing, even to a feeling of suffocation, is 
not necessarily hazardous in asthma; for although few diseases are 
so little under control by the interference of the physician, yet 
asthma seldom proves fatal, unless it tends to the production of 
other diseases. 

In Consumption, partial sweating, as of the head, the chest, or the 
limbs, is always an unfavorable symptom. 

When pregnancy occurs in a woman laboring under consumption, 
the disease is arrested until after delivery, as if Providence threw a 
shield over the mother for the safety of the offspring. 



774 DOMESTIC MANAGEMENT OF THE SICK-KOOM. 

The Sudden Disappearance of Swelling of the Legs, in chronic 
organic diseases, is indicative of approaching death. 

When a child, instead of rallying after any acute disease, becomes 
emaciated, and the belly is large and tympanitic, there is always 
much danger. 

Bed-Sores. 

The danger of bed-sores is often in proportion to the carelessness 
of the nurse, although the condition of the patient has much to do 
with it. They attack first the skin at the end of the spine, the hip- 
joints, knees, elbows and heels. 

Debility from continued fever, from paralysis, old age, continued 
pressure, unclean bedding, and the untidy habits of the nurse, are 
the immediate cause. 

The first appearance of a bed-sore is to be noticed in redness of 
the skin ; soon a blister forms, the skin breaks away, leaving the sur- 
face raw and moist. Decomposition sets in very quickly if the 
symptoms are neglected, and the blister becomes an open sore. 

The outcome of the disease depends upon the condition of the 
patient, and the removal or non-removal of the cause. 

Treatment. — If there is much debility, tonics should be given. 
The various places of the body which are likely to become sore 
should be rubbed four times a day, from five to ten minutes, with a 
stimulating mixture like spirits of camphor or olive-oil and brandy ; 
a good liniment is alcohol or weak bay rum. Be careful not to irri- 
tate the skin, — simply cleanse and harden. The prominences of bone 
may be covered with surgeon-plaster if there is sweating of the body. 
Unless a blister forms, the part should be relieved of pressure by air- 
cushions. Collodion should be applied, and the parts kept dry. 

If the blister turns to an open sore, use poultices until it is open 
and the matter discharged, then use stimulating cleansing washes of 
borax- water or weak carbolic-acid. Peruvian balsam on cotton- 
wool is a good remedy. 

The best preventive measures are careful nursing, dry, smooth 
sheets, air-cushions, frequent changes of position. The bedding and 
night-robe should be absolutely clean, dry and smooth and frequently 
changed. 

Ovarian Disease. 

Or, as it is usually termed, ovarian dropsy, has hitherto proved 
incurable; but it is relieved by tapping; and, if the powers of life 
be sustained by proper food, and carriage exercise in the open air ; 
and if all medicines be let alone, except such as are required to 
regulate the bowels, life may be sustained for many years. 

All diseases not involving organic changes are, with a few ex- 
ceptions, more or less under the control of medicines, and are conse- 
quently curable. But some diseases, in which no organic changes 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 775 

have been discovered, are nevertheless incurable. This is the case 
with spasmodic asthma, which has rarely been cured. 

It is true that functional disturbances are not un frequently associ- 
ated with, organic diseases ; but, under such circumstances, it is the 
province of the attending physician to point out to the friends of the 
patient the greater or the less degree of danger in these complica- 
tions. 

Diet, etc., in Disease and Convalescence. 

In numerous instances, much hazard often exists after disease has 
disappeared, and when the patient is declared convalescent ; and as 
this period in the removal of diseases is left to the management either 
of the patient himself or of his friends, some general remarks re- 
specting it, and also in reference to particular diseases, are requisite. 

In every recovery from sickness, whether external or internal, be- 
fore the salutary advantages obtained from the treatment be confirmed, 
the organ or part which has suffered must be either left at rest or be 
used, according to the nature of the case. Thus, if any part have 
suffered from inflammation, it must not be used for some time after 
the inflammation is subdued. If the eyes have suffered, the person 
must neither read nor write, nor expose the eyes to the heat of the 
fire, nor to a strong light, until some days after every trace of the 
disease has disappeared. If the arm has been affected it must be 
kept at rest ; and if the leg, not only should walking be refrained 
from, but the limb should be placed rather higher than the trunk of 
the body. If the previous disease has affected the brain, every men- 
tal exertion must be avoided; and so on, whatever maybe the ergan 
which has especially suffered. Even when the exercise of the organ 
is resumed, it should not be carried to fatigue, nor, on any account, 
should it be such as to produce excitement. At the same time, it 
must not be forgotten that, in the treatment of external injuries, when 
it has been necessary to keep the limb long in a sling, in one position, 
— as, for instance, in fractures, — the muscles which bend the arm 
acquire from the habit a contraction which cannot be overcome by 
the antagonist muscles, owing to the length of time they have been 
on the stretch, weakening their contractile power. The arm, there- 
fore, should be frequently taken from the sling, and, being rested upon 
the elbow, a moderate weight should be held in the hand, and friction 
with oil employed upon the contracted muscles. It is true that sur- 
geons usually give directions for this operation, before they quit the 
management of the case ; but surgeons, as well as physicians, are 
sometimes dismissed before the convalescence is complete ; on which 
account, arms and limbs have remained contracted for life, from a 
want of the knowledge necessary to counteract the evil at an early 
stage. I say nothing respecting the continuance of remedies during 
convalescence from many diseases, except urging the necessity of 
regulating the bowels. 



776 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

The most important part of the management of convalescence cer- 
tainly refers to air, exercise, and diet. The errors daily committed, 
in all these matters, exert the most powerful influence in retarding 
complete restoration to health ; and often, indeed, induce evils of a 
more formidable kind than the diseases from which the patients have 
just emerged. 

1. Air. In every convalescence, whatever may have been the 
nature of the disease, if it has been so severe as to wear down the 
strength of the invalid, country air is essential. The benevolent 
Author of our existence has made medicinal the hills, the vales, the 
groves, and all the harmonies of nature ; and in the repose of these 
man finds a balm, not only for a wounded spirit, but for his stricken 
body. 

In selecting a country residence for a convalescent, care must be 
taken to ascertain whether any source of malaria exists in the neigh- 
borhood; as, in that case, even if all other circumstances be favorable, 
the place is exceptionable. 

2. Exercise. In convalescence, much caution is requisite in apoor- 
tioning the exercise to the degree of returning strength. When the 
convalescent is still too feeble to take sufficient exercise on foot, the 
best substitute for it is riding horseback; but, as soon as walking 
can be borne, it should be preferred to either horse or carriage exer- 
cise. 

3. Diet. In health, diet may be left, in a great degree, to the in- 
clination or the taste, as far as regards the quality of the food ; and, 
although diseases occasionally originate from repletion, yet, in gen- 
eral, the appetite may be considered as the best regulator of quan- 
tity, when the food is simple, and the appetite is not pampered by 
high seasoning and rich sauces. In disease, however, a very opoo- 
site rule is to be observed ; the regulation of both the quantity and 
the quality of the food is of the utmost importance. The taste is 
often so perverted as to desire that which would prove injurious ; 
and were appetite to be the guide of quantity, diseases would fre- 
quently not only be increased in severity, but life itself would be 
brought into jeopardy. 

As soon as solid animal food can be taken with impunity, that 
which is most digestible should be selected. An opinion has gener- 
ally prevailed that gelatinous matters, and meats which readily yield 
jelly, — such, for example, as veal and lamb, — are the most easily 
digested, and at the same time are also the mo^t nutritive. This is 
a mistake ; for, with the exception of poultry, the flesh of young ani- 
mals is stringy and of a lax fibre, and is even less easily digested than 
that of too old animals, which presents great density of texture. 
The middle-aged animals afford the most digestible food. 

Nothing tends to lessen the density of the fibre of every kind of 
animal food so much as keening it for a certain time before it is 
cooked. In this case the tenderness is the result of incipient decom- 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 777 

position or putrefaction; but the utmost caution is requisite to pre 
vent this from advancing so far as to present the slightest trace of 
taint in the food of the convalescent. In the low state of vitality in 
convalescence, the change which commencing decomposition (putre- 
faction) causes, renders animal food in that condition a source likely 
to occasion either a relapse into the disease from which the patient 
has recovered, or to form a new disease. 

In examining the relative value of other articles of diet adapted 
for the sick and convalescent, the first which presents itself to our 
notice is 

Milk. — As milk is the food of almost all young animals, its diges- 
tibility appears at once evident ; and there can be little doubt that it 
is very digestible, when it is drunk immediately after it is drawn 
from the udder of the cow or the goa^t, before its components have 
time to separate. When this separation is effected, either spon- 
taneously by time, or by means of rennet or other agents, its prop- 
erties are altered, and its digestibility is lessened. 

Cream, when intimately united with the other components of 
milk, — namely, the curd, or the caseous part, and the whey, — is 
not the same substance as after its separation. In the milk, it is 
more easily digested, and is the most nutritive part of the milk. But 
in its separate state it is ill adapted either for the sick or convales- 
cent except in the form of butter, which is not unwholesome unless it 
be eaten in excess or be melted. Although cream is not as digesti- 
ble as milk, yet it is much less liable to turn acid in the stomach ; it 
is often beneficial to dyspeptics, either alone or diluted with water. 
In the same manner the separate curd is indigestible ; and whey 
itself, although highly nutritive, yet is flatulent ; nevertheless, it is 
an excellent demulcent in many cases of disease. But none of the 
components of milk are equal to milk itself. It is often necessary, 
in convalescence, to dilute it with water. 

Eggs. — It is not uncommon to hear that the yolk of a raw egg, 
beaten up with water and sugar, with the addition of a small quan- 
tity of white wine, is a light and nutritive aliment in convalescence, 
and even in some states of disease ; but eggs are much less digestible 
in this form than when they are lightly boiled. In jaundice, however, 
arising from viscid mucus obstructing the orifice of the common 
duct, the yolk of a raw egg beaten up with cold water is serviceable. 

Fish, at least the white kind, stimulates much less than the flesh 
of land animals; hence it is a proper food for those laboring under 
some acute diseases ; and also for convalescents, when a sudden re- 
turn to more stimulating food would prove hurtful. But it is not 
adapted for convalescents when the object is to bring up rapidly the 
strength of debilitated habits. 

Raw oysters have been erroneously supposed to be both easy of 
digestion and nutritive. The latter opinion is, in some degree, true ; 



778 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

but tbe former is erroneous. Raw oysters are less digestible than 
plainly-cooked oysters. Both are improper for the sick and for early 
convalescents. Lobsters, crabs, prawns, cray-fish, scallops, and other 
shell-fish, are still more objectionable. 

If fish of any kind be admissible, it should be simply boiled; fried 
fish is even worse for invalids than the outside or the brown of roasted 
meat. 

Vegetables. — In reference to vegetable diet, it is only the mildest 
description of esculent roots that are fitted for the use of the siek. 
In preparing all of them for the sick room, they should be well boiled 
in two distinct waters, until they are soft and very soluble, and in a 
state not to leave undissolved anything which could act as a mechani- 
cal irritant on the intestinal canal. When properly cooked, they are 
moderately nutritive, and free from any stimulant properties ; and 
they are well adapted for the stomach of the sick, unless in cases in 
which the torpor of the organ is such as to permit them to run into 
acetous fermentation and to prove flatulent. 

Fruits. — With respect to fruits, they produce the most diversified 
effects ; and, consequently, are more or less proper for invalids, ac- 
cording to circumstances, either connected with themselves or with 
the condition of the patient at the time. The stone-fruits, with the 
exception of the ripe peach, or the nectarine, are to be rejected. The 
apple tribe, except very soluble pears, are still less admissible. The 
apple, however, when roasted, and when the seeds and the hard cen- 
tral parts, as well as the skin, are removed, is less objectionable ; and, 
as it possesses laxative properties, the roasted apple is well adapted 
for the sick, when food is at all allowable, and when the bowels are 
torpid. The orange, if fully ripe, is grateful and wholesome to all 
invalids, and is only equalled in these qualities by the grape ; but in 
using the orange, the pulp should be rejected. The juice of the 
grape-fruit is good and re f resiling, but care should be taken not to 
use any of the pulp, on account of its bitter taste. Care also should 
be taken not to swallow either the skin or the seeds of the grape. 
Strawberries are a little stimulant, of easy digestion, and more cool- 
ing than the other small fruits ; mulberries are also unexception- 
able ; but currants and gooseberries, and even raspberries, are not 
free from objection for invalids laboring under acute diseases. 

With the exception of oat and wheaten bread, especially that 
made from Franklin Mills flour (see receipt), all the varieties of 
farinaceous aliments may be regarded as modifications of starch, 
containing little nutritive matter, and therefore well adapted for the 
sick-room. It has been supposed that arrow-root, sago, tapioca, and 
similar substances, are very nutritive, because they form mucilages 
with boiling water; but this is not the fact; and were they very 
nutritive, they would be ill adapted for invalids. Rice, in every case 
where the stomach is in an acescent state, is preferable to the other 
farinaceae, because it is less fermentable. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 779 

The farinaceous food which is ordered in the convalescence of 
children from acute diseases, is often made of bread so as to consti- 
tute pap. No description of food has a greater tendency than this 
to become sour; a quantity only sufficient for a single meal, there- 
fore, should be made at a time ; for what remains is always sour 
before the next meal ; and even if the quantity be small, and it be 
mixed with fresh pap, it communicates its faculty of becoming sour 
to the whole mass. 

Fluid Aliments. 

Water. — The best and the most universal beverage for the sick 
is water : but the qualities of water differ, according to the sources 
whence it is procured. The fewer foreign ingredients it holds in so- 
lution the greater are its diluent properties. Distilled water, or rain 
or river water filtered, and that of soft-water springs which nitrate 
through silicious strata, are the only kinds proper for the use of the 
sick-room. Hard water, under whatever name it is found, whether 
as spring water, or pump water, or well water, should be excluded. 
The impurities of river and rain water are merely held in suspension ; 
consequently, they are readily removed by nitration. 
. Water itself is aliment; many individuals under certain circum- 
stances have lived for a considerable time upon it alone. Those 
who live chiefly on animal food require more drink than those who 
eat much vegetable matter. 

The influence of water on the animal economy may be regarded in 
two points of view : 

As an article of diet. 
As a medicinal agent. 

As an article of diet, in health, water is the beverage provided by 
nature for all animals, man not excepted. The sensation of thirst is 
the natural call for fluids, either to assist digestion, or to allay a dry, 
hot condition of the mouth and the gullet. The consequence of not 
satisfying this call is fever of a nervous kind ; and, if it be long re- 
sisted, inflammation of the air-passages. On the other hand, too 
much fluid is injurious ; for although the vital powers of the stomach 
counteract the tendency which it affords, by over-diluting the gastric 
fluid, to the fermentation of the aliment in the stomach, yet when it 
is in excess, those vital powers languish ; hence spontaneous chemi- 
cal changes in the contents of the stomach take place, and induce 
dyspepsia. For all the purposes of dilution in health, water is ade- 
quate, and it is the only truly wholesome beverage. 

As a medicinal age?it, water is demanded in every disease in which 
a dry skin and an elevation of the natural heat of the surface, con- 
stituting fever, are present. In this case, the desire is for cold water 
or cooling fluids ; and it should always be indulged. The degree of 
temperature, however, must be regulated by the condition of the in- 
valid ; but the best medium temperature is between 50° and 60° 



780 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Fahr., although even 60° is too low, when the debility oi the frame 
is considerable. 

The qualities of the various kinds of beverages proper, and gener- 
ally employed in the sick-room, should be known. 

Toast- water, when properly prepared, which it seldom is, forms a 
useful beverage in the sick-room. It is slightly nutritive, owing to 
its containing a small portion of gluten, in conjunction with fecula 
and sugar. It is one of the oldest and one of the best diluent de- 
mulcents ; diluting at the same time that it softens the acridity of 
the secreted juices of the stomach, in febrile diseases. 

Gruel, whether made of groats or of oatmeal, is less mild and de- 
mulcent than barley-water ; and it is more likely to undergo the ace- 
tous fermentation in the heat of the stomach; a circumstance which 
is greatly favored by the sugar and butter which is sometimes added 
to it. Unless gruel be very thin, it can scarcely be regarded as dilu- 
ent ; and when thick, it is too heating an aliment for patients labor- 
ing under febrile symptoms. 

Tea, in the form in which it is usually taken, is too stimulant and 
astringent to be a good diluent : and, when it is strong, the narcotic 
property which it possesses renders it improper for most invalids, 
whatever may be the nature of their diseases. As it is, nevertheless, 
agreeable to most palates, and very refreshing, it may be taken in 
moderate quantity, provided it be not strong, without any hazard. 

Sage, balm, and mint teas, are often substituted for common tea. 
Each of them undoubtedly allays the irritability of the stomach in 
some cases ; but, as general beverages in disease, they are less useful 
than toast-water. Raspberry vinegar, lemonade, tamarind tea, apple 
tea, and similar compound diluents, should never be administered 
without the consent of a physician. If a patient be taking an anti- 
monial, they will excite vomiting ; if a mercurial, griping ; and they 
are equally incompatible with many other medicines, and with many 
conditions of the stomach in disease. They are a description of 
beverage greatly recommended and largely distributed by the Lady 
Bountifuls in the country, and have frequently been productive of 
serious mischief. 

Coffee is more heating, and consequently less admissible than tea ; 
it may, however, be taken, if it be largely combined with milk. Cocoa 
and chocolate are still more objectionable than either tea or coffee in 
the sick-room. Shells are good and nourishing. 

With respect to the Number of Meals, and the periods best 
adapted for taking them, it is scarcely requisite to remark, that, 
although in health three moderate meals, at proper intervals, are 
customary, and well adapted for the support of the frame, yet, under 
the changed condition of the system in disease, it would be improper 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 781 

to take any regular number of meals, or to observe any stated periods 
for taking them : hence no general rules can apply. 

As a general rule, in the decline of diseases, and on the approach 
of convalescence, when the desire for taking food returns, the best 
time for the principal meal, dinner, is about two hours after noon. 
If the breakfast be taken at nine o'clock, and the evening meal at 
seven, the hour of two is the middle period of the day ; so that, when 
dinner is taken at that time, the intervals between breakfast and 
dinner, and between dinner and supper, are not only equal, but 
neither is too short to limit the complete digestion of the previous 
meal, nor too long to injure the powers of the weakened stomach 
by protracted fasting. 

All acute diseases require more or less abstinence, especially when 
the object of the treatment is to lower the system ; and in some 
chronic affections, abstinence is almost essential. If this be true, the 
necessity of the strictest observance of the directions of the physician 
on this subject must be obvious. It is one, however, which is not 
only neglected, but is often combated both by nurses and friends; 
and indulgences, which are supposed to be of too trivial a nature to 
cause any injury to the sick, have often been followed by fatal effects. 

But, although abstinence be requisite during the existence of an 
acute disease, yet it is injurious when it is too rigidly maintained 
after convalescence is actually established : it often induces a new 
train of symptoms, not very unlike those for which it was properly 
prescribed and the removal of which it has aided; namely, accelera- 
tion of the pulse, increased impetus of the heart, headache, and even 
delirium. 

General Diseases. 

Happily, in febrile affections, the appetite of the invalid is not in 
a condition to desire food ; and no stronger demonstration can be 
required of the impropriety of forcing it upon him under such circum- 
stances. Simple fluids, such as diluents, are all that he desires, all 
that the stomach can bear ; and such alone should be administered in 
fever, before that low condition of the system, which demands the 
use of wine or other stimulants, supervenes. In these cases, when 
the patient desires more nourishment than is usual, animal food 
ought not to be given, unless by the direct recommendation of the 
physician. Indeed, in general, the inclination of the invalid happily 
revolts from animal food, as much as experience condemns its ad- 
ministration. 

While febrile symptoms are present, farinaceous matters, little 
nutritious, such as barley-water, gruel, arrow-root mucilage, or sago, 
acidulated with lemon-juice, and sweetened to the taste of the patient, 
are most suitable ; but even these should be given in small quantity, 
and at considerable intervals. The beverage generally most agree- 
able, and also most salutary, to those suffering under fever, is cold 
water. * 



782 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

In the decline of fevers, even, as I have already remarked, although 
the severity respecting diet should be relaxed, yet much clanger may 
result from mistaken kindness and over-zeal, in urging animal and 
stimulant food at too early a period of the convalescence. Indeed, 
the necessity of caution at this time is greater than during the con- 
tinuance of the fever ; and the more acute the disease has been, the 
greater must be the caution in the convalescence, especially if the 
treatment has been of an evacuant and lowering description. 

The first change of diet, in the decline of fevers, should be to an- 
other article of the same kind of food which was allowed in the dis- 
ease ; for example, from simple arroiv-root mucilage to arrow-root and 
milk, or to some other of the farinaceous compounds ; whilst, at the 
same time, asses' milk may be given in small quantity in the morn- 
ing. Mice, one of the farinaceae, is generally supposed to be astrin- 
gent, but this is a mistake. It forms an excellent diet in all cases of 
early but decided convalescence. It should be well-boiled, and mixed 
either Avith broth and beef-tea, or gravy which has been cooled, and 
the fat taken from it. In the transition to animal food, beef-tea, 
chicken-broth, and muttorir-broth, and other liquid animal decoctions, 
should be first resorted to; then ivhite fish, simply cooked ; for, al- 
though fish is more digestible than animal food, yet it affords much 
less stimulant nourishment ; it is therefore better fitted for the early 
stage of convalescence. "When convalescence is completed, a more 
generous diet is admissible. 

With respect to beverage, water, toast-water or lemon-peel-water, 
is sufficient, until the medical attendant declares that a little wine is 
requisite. 

In convalescence from fever, it is an error to permit the patient to 
get up too soon. He should not leave his bed until his strength be 
considerably advanced. No danger can result from too strict an 
observance of this rule ; whereas much risk may be incurred by its 
neglect. 

If the head has been much affected, every mental exertion should 
be refrained from during the convalescence ; and, according to the 
degree of suffering in any local organ, precautions must be taken to 
guard that part of the frame against a fresh attack of disease. 

Eruptive Fevers require more precaution in convalescence than 
general fevers, both as regards diet and exposure to sudden alterna- 
tions of heat and cold. This is more especially essential after measles 
and scarlet fever. 

Measles are often followed by a distressing cough, and other symp- 
toms of pulmonary inflammation ; or by a harassing diarrhoea, which 
wears down the strength ; or by inflamed eyes, catarrh, or obstinate 
toothache. In infants, canker of the mouth occasionally makes its 
attack, and proves fatal. All these affections, after measles, might 
generally be prevented by taking care not to allow too soon a return 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 783 

to the use of animal food, or too early an exposure to cold or to night- 
air. Even in summer, flannel should be worn next the skin for some 
weeks after the disease has disappeared. 

Scarlatina is frequently followed by dropsical symptoms ; which, 
however, might generally be avoided by the same attention to diet 
and regimen as after measles. 

SmalUPox, when severe, and especially when confluent, is very apt 
to awaken into activity the dormant seeds of scrofula, if any heredi- 
tary taint exists in the constitution ; hence abscesses, ulcers, and 
swelled glands make their appearance. These demand the aid of 
the physician or the surgeon. But if the convalescent be properly 
dieted, and recourse be had to a change of air as soon as his strength 
will permit, these evils may be avoided. 

Erysipelas not unfrequently attacks convalescents from small-pox 
and other eruptive fevers. When it occurs, independent of any prior 
disease, the same attention to diet and regimen is requisite as in other 
eruptive fevers. 

Convulsions, it is well known, are not unfrequently the result of 
errors in diet, in individuals with an irritable condition of the stom- 
ach and bowels. Advice should always be demanded respecting the 
diet of those who are liable to, and who suffer from, convulsions ; but 
it must not be supposed that when they occur in children and have 
been subdued, a system of starvation is necessary to prevent their 
recurrence. As far as regards convalescence in such cases, it will be 
proper to bear in recollection the following rules : 

1. When the patient is of a full habit, has a short neck, and a ten- 
dency to diseases of the head, the diet should be spare. The use of 
animal food, indeed, in such a habit, should be wholly prohibited in 
childhood, and very sparingly employed by adults ; whilst vegetables, 
farinaceous matters, milk and weak broths, may be allowed. 

2. When the habit of body is spare, and when languor and chilli- 
ness are present, the diet, although free from stimulus, yet should be 
nourishing, and consist of the lighter kinds of animal food ; namely, 
poultry and fish, with a moderate share of vegetable matters. 

3. Under all circumstances, and at every period of life, fermented 
liquors and wine should be either wholly avoided, or very sparingly 
used, in almost all convulsive diseases connected with affections of 
the head. 

In convalescence from some varieties of convulsive diseases, the 
nature of the diet must depend on circumstances which cannot be 
judged of by the attendants of the sick-room; hence it should be 
referred solely to the medical attendant. In St. Vitus's Dance 
(chorea), for example, although a tonic plan of treatment may have 
been successfully pursued, yet the diet may be required to be mild, 
and wholly free from stimulus. 



784 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Attention to diet in Hysteria is most important. When the disease 
is connected with indigestion, the meals should be moderate : and 
rest in the horizontal posture should be indulged for an hour after- 
wards, and then moderate exercise taken. Pluid food, such as broths 
and gruel, are improper ; yet animal food should be eaten only once 
a day. Tea and coffee should be very sparingly taken ; and the sim- 
plest beverages, even water and toast-water, should be taken in great 
moderation after a meal, and should not be drunk during dinner. 

In convalescence from hysteria, change of scene and air are abso- 
lutely requisite. The mind should be directed to solid studies, and 
everything which can cherish morbid sensibility of the nervous system 
avoided. 

Dropsy. — An opinion was long maintained that fluids are to be 
withheld from dropsical patients. No opinion was ever founded on 
more erroneous principles. Dropsical patients, indeed, should be 
allowed the free use of fluids. With respect to diet, it should, gen- 
erally speaking, be light and unstimulating : but much depends on 
the causes of dropsy. There is, however, less necessity for a rigid 
adherence to low diet in this than in other inflammatory affections. 

In Palsy, abstinence from all stimulating food, solid or fluid, must 
be rigidly observed ; and the restriction should not be discontinued 
in convalescence. At the same time, change of air and of scene is al- 
ways of decided advantage. In every instance, an easy state of mind, 
and freedom from every source of irritation, as well as from the anxi- 
eties of business, are indispensable. 

Gout and Rheumatism. — In no diseases affecting the general 
habit are abstinence and repose more essential during the attacks than 
in the two which head this paragraph, when they assume an acute 
form. When they occur in weakened or in broken-down habits, it is 
too often supposed that the opposite plan of diet is to be pursued, 
and that stimulating food and a liberal supply of wine should be in- 
dulged; but nothing is more likely to prove injurious. 

When the paroxysm subsides, it is too customary to permit the in- 
valid to glide into his usual habits with respect to diet and regimen ; 
consequently the plethora which originated the disease gradually re- 
turns ; and the same plan being continued, paroxysm follows after 
paroxysm, at shortening intervals, until scarcely an}' interval occurs, 
and life is sacrificed on the altar of self-indulgence. 

For some weeks after the paroxysm of gout has subsided, in a 
young or middle-aged man, animal food should be sparingly taken, 
and fermented liquors altogether avoided. 

Chlorosis, or Green Sickness, is a state of the habit which seems 
to depend on an impaired condition of the blood itself. Its treatment 
is well understood, and recourse to medical advice should never be 
neglected; otherwise it may terminate either in mental derangement 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 785 

or in sudden death. In convalescence from it, the diet should be 
mild and light, but nutritious ; the exercise should be much within 
the limits of fatigue, and consist of both walking and horse exercise, 
daily, in the open air ; the body, more especially the lower extrem- 
ities, should be warmly clothed ; the mind ought to be amused ; all 
sedentary occupations thrown aside; and confidence placed in the 
honor of the physician, who should be made the repository of any 
mental anxiety, especially connected with the tender passion, which 
may be preying upon the vital energy of the body. 

Affections of the Head. 

Whatever may be the cause of Apoplexy, no disease requires more 
prompt and energetic treatment : the alarming nature of the symp- 
toms is always sufficient to prevent any time from being lost by at- 
tempts to relieve the sufferer without medical assistance. Should 
the attack not prove fatal at the time, and should it not be followed 
by palsy, still the utmost caution is requisite to prevent a recurrence 
of the disease. It is scarcely necessary to insist on the strictest ad- 
herence to temperance, both as to meat and to drink ; and the impor- 
tance of daily exercise, when the attack is over, and indeed for the 
remainder of life. Prolonged study and intense thinking must be 
given up ; the violent and exciting passions should be subdued ; and 
even the pleasurable moderated. 

Inflammation of the brain is one of those diseases which require, as 
observed respecting apoplexy, the most energetic treatment. When 
convalescence has fortunately been established, the attention of the 
physician is still requisite, during several weeks, until complete re- 
covery be fully confirmed ; for the brain, after suffering from inflam- 
mation, is very apt to relapse into the same state, from the excite- 
ment of too full a meal, or over-exercise, or even slight mental exer- 
tions or emotions. On this account, the convalescent must be kept 
perfectly quiet, and completely free from the smallest excitement, 
and the strictest regimen observed. His diet should not only be mild 
and unstimulating, but small in quantity. 

Inflammation of the eyes requires the same caution when convales- 
cence is secured as other inflammatory affections ; namely, quiet, 
great moderation in diet, and avoiding exposure either to much light, 
heat or cold, or whatever can stimulate the still highly excitable 
organ. 

Affections of the Chest. 

Inflammation of the Lungs (Pneumonia). — ■ In convalescence 
from this disease, the temperature of the room in which the patient 
sits should not exceed 60° F. ; and it should be free from currents of 
air ; but at the same time it should not be close. The necessity for 
continuing the same elevated position of the shoulders when in bed, 



786 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

which is demanded during the existence of the disease, remains even 
when the convalescence is advanced. The patient should be pre- 
vented from talking, and from exerting a*ny muscular motion that 
can accelerate the circulation. The diet should be of that descrip- 
tion which will support the strength without exciting or producing 
repletion. As the convalescence advances, and exercise is permitted 
by the medical attendant, it should be regular, but not hurried nor 
violent ; and evening air should be sedulously avoided. 

Pleurisy. — Inflammation of the lining membrane of the chest re- 
quires the same attention to diet and regimen during convalescence 
as the last-mentioned disease, except that a greater strictness with 
regard to abstemiousness in food is requisite ; the least deviation 
being likely to bring on a renewal of the inflammation. When the 
disease assumes a chronic character, and when the object is to remove 
fluid effused into the cavity of the chest, and pressing upon the lungs 
so as to circumscribe their action, the same degree of strictness with 
respect to diet is not necessary ; but, as in this condition of the habit 
the physician must continue his attendance, the regulation of the diet 
devolves upon him. 

Angina. — In that condition of the habit which is connected with 
a predisposition to gout, but in which, instead of a regular paroxysm, 
the heart and the pulmonary organs become affected, and the disease 
assumes that form which has been denominated diaphragmatic gout 
(Angina pectoris), the regulation of diet is of vital importance ; and 
it should be of as low a standard as the constitutional powers will 
admit. It should not be of a description either to nourish much, or 
to augment or to cause fullness of habit ; mild animal food, in mod- 
erate quantity, may be allowed ; but the staple should be of a farina- 
ceous kind: every stimulant, whether solid or fluid, should be 
avoided ; and wine and malt liquors regarded as poisons. The in- 
valid himself should be made aware that whatever tends to excite 
or to hurry the circulation is calculated to bring on a paroxysm ; 
nor is it sufficient that he avoids all stimulating viands and bever- 
ages ; he should also be instructed that the same deleterious effects 
are likely to follow a full meal, even of the most proper and mildest 
food. 

The same attention to diet, both as regards quantity and quality, 
is essential in palpitations depending upon organic disease of the 
heart. 

Asthma. — In no affection of the chest is attention to diet so im- 
portant as in asthma. Sir John Floyer, who himself suffered from 
the disease, recommends almost a degree of abstinence ; which is 
correct in reference to quantity ; but the diet, although of a light, 
yet should be of a solid, kind. This is especially necessary when 
dyspepsia is present to aggravate and excite the disease of the lungs. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 787 

In Whooping-cough, the diet, whether the patient be an adult or a 
child, should be of the mildest description ; and perhaps no nutri- 
ment is so well adapted to support the tone of the body, without 
exciting it, as milk. In infancy, nothing but the breast should be 
given ; the system of the nurse, at the same time, being kept as cool 
as possible by mild diet, and her mind in a tranquil state. If con- 
vulsions occur, these sometimes depend on the nature of the milk : 
in which case the nurse should be changed. It is still customary 
with non-professional persons to consider change of air essential in 
whooping-cough ; but it is only after the malady has run its course, 
and convalescence is progressing, when the cough remains as a 
habit, that change of air is really beneficial. It is unnecessary to 
combat the absurd opinion, that a change even to a worse air is 
salutary. 

Affections of the Stomach and Bowels. 

Although acute inflammation of the stomach rarely occurs, yet 
there is a chronic form of that disease, in which, during its actual 
existence, and also in convalescence from it, much of the safety of the 
invalid depends upon domestic management. Every source of excite- 
ment should be avoided ; the sick-room should be airy, and its tem- 
perature that of summer. The food should be of the blandest kind, 
given cold, or iced, and in small quantity : even when the 
convalescence is established the diet should consist of farinaceous 
matters, mixed with small quantities of beef-tea, or weak broths ; 
and this severe diet should be persisted in for a considerable time 
after recovery. 

Enteritis. — When inflammatory action extends to, or exclusively 
exists in, the mucous lining of the bowels, constituting this disease, 
the diet, during the early stage of it, should be confined to cold 
water, or iced almond-emulsion ; after which, milk and barley-water, 
or weak chicken or veal-tea, may be given in small quantities ; namely, 
two or three tablespoonfuls, at intervals of three or four hours. 
Nothing stronger should be ventured upon, unless expressly ordered 
by the medical attendant. 

Atonic dyspepsia, or simple indigestion. — During the attack, ab- 
stinence, to a certain degree, is necessary ; but, if this is not essen- 
tial, the diet should be somewhat stimulant, but simple ; namely, a 
small cup of moderately strong coffee, with little sugar or milk ; or 
beef-tea, with a small quantity of dry toast ; and, as the stomach 
begins to regain its tone, a little animal food of easy digestion, such 
as mutton or poultry. 

During the intervals of the paroxysms of indigestion, attention to 
diet is of the first importance. As a general rule, the patient should 
be confined to a spare animal diet, with a moderate share of well- 
boiled vegetables, and a considerable restriction with respect to the 
use of fluids. 



788 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Dysentery, which implies inflammation, acute or chronic, of the 
same membrane as in enteritis, but confined to the larger and lower 
bowels, requires the diet to consist of the mildest farinaceous matters, 
strictly avoiding all solid animal food. It should be given in small 
quantity at a time, and the whole allowance for the day should be 
moderate. The farinaceous food should not be either solid, nor yet 
altogether fluid ; the former may prove injurious as a mechanical 
irritant ; the latter is liable to excite griping, from the extrication of 
much flatus. 

Diarrhoea. — Much of the domestic, as well as the medical man- 
agement of diarrhoea depends on the nature of the attack, and its 
causes ; but too much attention cannot be paid to the regulation of 
the diet. It should be both small in quantity, and mild in quality. 
In the early stage, and the acute form of the disease, barley-water, 
arrow-root made with water, rice or grit-gruel, and light broths, are 
proper. In chronic diarrhoea, rice, properly boiled, and mixed with 
a small quantity of beef-tea, forms an excellent diet, as it nourishes 
moderately, and leaves scarcely any feculent matter behind it. 

In Cholera, convalescence is often tedious ; and nothing is so likely 
to cause relapse as even slight irregularities of diet. For weeks after 
the feverish symptoms have disappeared, the diet should consist of a 
very moderate quantity of vegetable matter only. The feet should 
be kept especially warm and the whole body clothed in flannel, to 
prevent that irregular distribution of blood which so strongly charac- 
terizes the disease. 

After inflammation of the lining membrane of the cavity of the 
belly (peritonitis) has been subdued, the invalid should still observe 
the strictest diet and regimen. He should return very gradually to 
the use of animal food and wine. The bowels should be moderately 
and daily opened, the feet kept warm, and the skin maintained in a 
healthy condition by wearing flannel next to it, for a very considera- 
ble time after every trace of the disease has disappeared. 

Diseases of the Liver. — In all cases of recovery from these dis- 
eases, whether inflammatory or otherwise, every precaution should 
be taken to guard against the deleterious influence of alternations of 
temperature, and also of damp, by clothing in flannel next the skin. 
Errors in diet should be avoided ; and fermented liquors and stimu- 
lating beverages of every kind refrained from. When pains of the 
side continue, after all the other symptoms of the disease have dis- 
appeared, the introduction of a seton, if prescribed, should not be 
objected to ; as the greatest benefit has often followed that mode of 
counter irritation. 



COOKERY FOR THE SICK-ROOM. 



It was said by the distinguished Dr. Rush, in his lectures before 
his class, that a physician ought to spend six months in a kitchen be- 
fore beginning practice. A knowledge of dietetic preparations fitted 
for the sick, and for those recovering from disease, however ap- 
parently unimportant, adds much to a physician's power over his pa- 
tient, and to his popularity and usefulness. 

In giving nourishment to the sick, who are suffering from low dis- 
eases, it is an important rule which should never be forgotten, to give 
but little at a time, and to repeat that often. In cases of great prostra- 
tion from disease, life may at times be endangered by a delay in giv- 
ing nourishment of even a few minutes beyond the proper time. 

Barley=Water. 

Pearl barley, two ounces ; boiling water, two quarts. Boil to 
one-half, and strain. A little lemon-juice and sugar may be added, 
if desirable. To be taken freely in inflammatory diseases. 



Rice=Water. 

Rice, two ounces ; water, two quarts. Boil an hour and a half, 
and add sugar and nutmeg. 

Rice, when boiled for a considerable time, becomes a kind of jelly, 
and, mixed with milk, is a very excellent diet for children. It has in 
some measure a constipating property, which may be increased by 
boiling the milk 

Decoction of Bran. 

New wheat bran, one pint ; water, three quarts. Boil down one- 
third, strain off the liquor, and add sugar, honey, or molasses, accord- 
ing to the taste of the patient. A bran tea may be made by using 
boiling water, and suffering the mixture to stand in a covered vessel 
for three or four hours. 

789 



790 COOKEKY FOR THE SICK-ROOM. 



Sage Tea. 

Dried leaves of sage, half - an ounce ; boiling water, one quart. 
Infuse for half an hour, and strain. Add sugar and lemon-juice as 
required by the patient. Balm and other teas are made in the same 
manner. 

The above infusions form agreeable and useful drinks in fevers, and 
their diaphoretic powers may be increased by adding a little sweet 
spirits of nitre. 

Barley Coffee. 

Roast one pint of common barley in the same way in which coffee 
is roasted. Add two large spoonfuls of this to a quart of boiling 
water; boil five minutes. Add a little sugar. 

Lemon-Water. 

Put two slices of lemon, thinly pared, into a teapot, a little bit of 
the peel and a bit of sugar. Pour in a pint of boiling water, and 
cover it close two hours. 

A Refreshing Drink in Fevers. 

Put a little sage, two sprigs of balm, and a little sorrel into a stone 
jug, having first washed and dried them. Peel thin a small lemon, 
slice it, and put in with a small piece of the peel ; then pour in three 
pints of boiling water. Sweeten, and cover it close. 

Another. 

Boil an ounce and a half of tamarinds, three ounces of cranberries, 
and two ounces of stoned raisins, in three pints of water, till the 
water is reduced to two pints. Strain, and add a bit of lemon-peel, 
which must be removed in an hour, as it gives a bitter taste if left 
too long. 

A Very Pleasant Drink. 

Put a teacupful of cranberries into a cup of water, and mash them. 
In the mean-time, boil two quarts of water with one large spoonful of 
corn or oatmeal and a bit of lemon-peel ; then add the cranberries, 
as much fine sugar as shall leave a smart flavor of the fruit, and a 
wineglassful of sherry. Boil the whole gently for fifteen minutes, 
and strain. 

Crust Coffee. 

Toast slowly one or two slices of brown or white bread, pour boil- 
ing water over it, and drink hot or cold, according to preference. 



COOKERY FOR THE SICK-ROOM. 791 



Infusion of Malt. 

To one pint of ground malt add three pints of scalding water, that 
is, water not quite brought to the boiling point; infuse two hours, 
and strain. Add sugar or lemon juice as desired. An excellent 
preparation in inflammatory fevers. 

Lemonade. 

Fresh lemon-juice, four ounces ; thin peel of lemon, half an ounce ; 
white sugar, four ounces ; boiling water, three pints. Let them stand 
until cold, and strain. When used in fevers, a little nitrate of potash 
or sweet spirits of nitre may be added. It may be further diluted to 
the taste of the patient. 

Water Gruel. 

Oat or corn meal, two tablespoonfuls ; water, one quart. Boil for 
ten or fifteen minutes, and strain, adding salt, and sugar if desired by 
the patient. 

Milk for Infants. 

Cows' milk, one part ; water, two parts ; sweeten slightly with loaf 
sugar. 

It is necessary, when children are to be raised by hand, to di- 
lute the milk. The above proportions may be altered as the child 
advances in age. 

Rice Gruel. 

Ground rice, one heaping tablespoonful ; ground cinnamon, one 
teaspoonful; water, one quart. Boil gently for twenty minutes, add- 
ing the cinnamon near the conclusion. Strain and sweeten. Wine 
may be added in some cases. 

Panada. 

White bread, one ounce ; ground cinnamon, one teaspoonful ; 
water, one pint. Boil them until well mixed, and add a little sugar 
and nutmeg. Wine or butter may also be added, if desirable. 

Compound Salep Powders. 

SALEP, tragacanth, and sago, each four ounces ; cochineal, half a 
dram ; prepared oyster shells, one ounce. Mix, and divide into pow- 
ders of one dram each. Stir one of these powders into a pint of milk, 
and boil for ten or fifteen minutes. To be drunk freely in diarrhoea 
and dysentery. 



792 COOKERY FOR THE SICK-ROOM. 



Another. 

Gum arabic, tragacanth, maranta, sago, tapioca, each two drams. 
Mix them well together, and boil in a pint of milk, flavored with nut- 
meg or cinnamon. To be used as a diet in dysentery, diarrhoea, etc. 



Sago Gruel. 

Sago, two tablespoonfuls ; water, one pint. Boil gently until it 
thickens, frequently stirring. Wine, sugar, and nutmeg, may be 
added, according to circumstances. 

Arrow- Root Gruel. 

Arrow-root, one tablespoonful ; sweet milk, half a pint ; boiling 
water, half .a pint. To be sweetened with loaf sugar. Excellent 
aliment for children when the bowels are irritable. 



Tapioca Jelly. 

Tapioca, two tablespoonfuls ; water, one pint. Boil gently for 
an hour, or until it assumes a jelly-like appearance. Add sugar, 
wine, and nutmeg, with lemon-juice to suit the taste of the patient, 
and the nature of the case. 



Jelly of Irish Moss. 

Irish moss, half an ounce ; fresh milk, a pint and a half. Boil 
down to a pint. Remove any sediment by straining, and add the 
proper quantity of sugar and lemon juice, or peach-water, to give it 
an agreeable flavor. 

Isinglass Jelly. 

Isinglass, one roll. Boil in one pint of water until it is dissolved. 
Strain, and add one pint of sweet milk. Put it again over the fire, 
and let it just boil up. Sweeten with loaf-sugar, and grate nutmeg 
upon it. When properly made, it resembles custard. 

This forms an excellent diet for persons recovering from sickness, 
and is well adapted to the bowel-complaints of children. 

Apple Water. 

Cut two large apples in slices, and pour a quart of boiling water 
on them. Or, pour the same amount of water on roasted apples. In 
two or three hours, strain and sweeten slightly. 



COOKERY FOR THE SICK-ROOM. 793 



Milk-Porridge. 

Wheat flour, cornmeal, or oatmeal, two tablespoonfuls ; milk, 
one pint; water, one pint. Mix the flour or meal with cold water, 
to form a thin paste ; put the milk and water over the fire, and when 
they come to the boiling point, add the paste, carefully stirring. 

French Milk=Porridge. 

Stir some oatmeal and water together ; let the mixture stand to 
clear, and pour off the water. Then put more water to the meal, 
stir it well, and let it stand till the next day. Strain through a fine 
sieve, and boil the water, adding milk while so doing. The propor- 
tion of water must be small. With toast, this is a good preparation 
for weak persons. 

Ground=Rice Milk. 

Boil one spoonful of good rice, rubbed down smooth, with a pint 
and a half of milk, a little cinnamon, lemon peel, and nutmeg. 
Sweeten when nearly done. 

Boiled Flour. 

Tie up as tight as possible, in a linen cloth, one pound of flour ; 
and, after frequently dipping it in cold water, dredge the outside 
with flour till a crust is formed round it, which will prevent the 
water from soaking into it while boiling. Place it in water and boil 
it until it becomes a hard, dry mass. 

Two or three spoonfuls of this may be grated, and prepared in the 
same manner as arrow-root gruel, for which it is an excellent substi- 
tute. 

Vegetable Soup. 

Take one turnip, one potato, and one onion, let them be sliced 
and boiled in one quart of water for an hour. Add as much salt as 
is agreeable, and pour the whole upon a piece of dry toast. 

This forms an agreeable substitute for animal food, and may be 
given when the latter is inadmissible. 

Beef=Tea. 

Lean beef, cut into shreds, one pound ; water, one quart. Boil 
for twenty minutes, taking off the scum as it rises. When it grows 
cold, strain. 

Essence of Beef. 

Lean beef sliced. Put a sufficient quantity into a porter-bottle to 
fill up its body, cork it loosely, and place it in a pot of cold water, 



794 COOKERY FOR THE SICK-ROOM. 

attaching the neck, by means of a string, to the handle of the vessel. 
Boil this for an hour and a half or two hours ; then pour off the 
liquor and skim it. 

To this preparation may be added spices, salt, wine, brandy, etc., 
according to the taste of the patient, and nature of the disease. 

Calf's-feet J^lly. 

Take two calf's feet, and add to them one gallon of water. Boil 
down to one quart. Strain, and when cold, skim off the fat. Add 
to this the white of six or eight eggs well beaten, a pint of wine, half 
a pound of loaf sugar, and the juice of four lemons, and let them be 
well mixed. Boil the whole for a few minutes, stirring constantly, 
and then pass it through a flannel strainer. 

This forms a very nutritious article of diet for the sick, and for 
those recovering from disease. The wine may be omitted or added 
according to choice. 

Chicken Water. 

Take half a chicken, divested of all fat, and break the bon'es ; add 
to this half a gallon of water, and boil for half an hour. Season 
with salt. 

Suet Ptisan. 

Sheep's suet, two ounces ; milk, one pint ; starch, half an ounce. 
Boil slowly for half an hour. This may be used as a common drink 
in dysentery. 

Rennet Whey. 

New milk, one quart; rennet, a large spoonful. Heat the milk, 
and then add the rennet. Boil until the curd separates, which is to 
be taken off. To many persons, this forms an agreeable nutriment. 

Vinegar Whey. 

Milk, one pint; vinegar, one tablespoonful. Boil for a few 
minutes, and separate the curd. 

Tartar Whey. 

Milk, one quart ; cream of tartar, one dessert spoonful. Boil, 
and separate the curd. 

Mustard Whey. 

Bruised mustard-seed, one tablespoonful ; milk, one pint. Boil 
together for a few minutes, and separate the curd. 

This has been found a useful drink in dropsy. A teacupful may 
be taken at a time. 



COOKERY FOR THE SICK-ROOM. 795 



Alum Whey. 

Alttm, one teaspoonful ; milk, one pint. Boil together, and strain, 
to separate the curd. 

Orange Whey. 

Milk, one pint ; the juice of an orange with a portion of the peel. 
Boil the milk ; then put the orange to it, and let it stand till coagu- 
lation takes place.. Strain. 

Sweet Whey. 

Skimmed milk, two quarts ; a piece of prepared calf's rennet. 
Mix and put in a warm place till coagulation takes place ; then 
strain. 

Whey with Tamarinds. 

Milk, boiling, one pint; tamarinds, two ounces. Boil them to- 
gether till coagulation takes place. 

Wine Whey. 

Milk, two thirds of a pint ; water, one third of a pint ; Madeira, 
or other wine, one gill ; sugar, one dessert spoonful. Place the 
milk and water together in a deep pan on the fire, and at the moment 
when it begins to boil, pour in the wine and the sugar, stirring assidu- 
ously whilst it boils, for twelve or fifteen minutes. Lastly, strain 
through a sieve. This is excellent in all forms of fever, given in 
small quantities. It may be drunk either cold or tepid, a wine- 
glassful at a time. 

Milk and Soda Water. 

Heat nearly to boiling a teacupful of milk ; dissolve in it a tea- 
spoonful of refined sugar ; put this into a large tumbler and fill with 
soda water. This is an excellent mode of taking milk when the 
stomach is charged with acid, and is oppressed by milk alone. 

Sippets. 

On an extremely hot plate, put two or three slices of bread, and 
pour over them some of the juices of boiled beef, mutton, or veal. 
If there be no butter in the dish, sprinkle over them a little salt. 

Restorative. 

Take two calf's feet, one quart of water, and one quart of new 
milk ; place all in a close-covered jar, and bake three hours and a 



796 COOKERY FOR THE SICK-ROOM. 

half. When cold, remove the fat. Any desired flavor may be given, 
by adding lemon-peel, cinnamon or mace, .while baking. Add sugar 
afterwards. 

Coffee-Hilk. 

Boil a dessertspoonful of ground coffee in nearly a pint of milk, 
for a quarter of an hour, then put into it a shaving of isinglass, and 
clear it. Let it boil a few minutes, and set it beside the fire to 
clarify. Sweeten with loaf-sugar. 

Nutritive Fluid. 

Take two teaspoonfuls of lump magnesia, one teaspoonful of sal- 
eratus, one teaspoonful of salt, two teaspoonfuls of flour, half a pint 
of milk, and one pint of water. Put the milk and water, united, 
over the fire, and rub up the flour with a little cold water to make a 
thin paste. Just when the milk and water begin to boil, stir in the 
paste. This will make a thin porridge, which should boil about five 
minutes. At the end of this time remove from the fire and pour 
into a pitcher. Now add the magnesia, pulverized, and mixed with 
the saleratus and salt. Sweeten to suit the taste. 

This may be drunk freely, several times a day, so as to produce 
two evacuations of the bowels in twenty-four hours, in those cases of 
dyspepsia attended by acidity of the stomach, and in many debilitated 
conditions of the system in which there is a tendency to loss of flesh. 

This is one of the leading fluids used by those who pursue what is 
called the " Nutritive System " of treating disease, and is really a 
valuable preparation, having the effect often to increase the flesh, even 
while it acts as a cathartic. 

Franklin Mills Bread, 

OH GERM-WHEAT BREAD. 

One quart milk or water ; one quart white flour ; one-half yeast- 
cake ; one-half cup sugar ; one-half teaspoon salt ; one quart Frank- 
lin flour. 

Put the white flour in the mixing-bowl, then add the milk and 
yeast gradually, until smooth. Cover; let it rise in the bowl all 
night. In the morning, if light, add sugar, salt and Franklin flour, 
a little at a time ; then let it rise again until light. Fill the pans 
two-thirds full, and rise. Bake one hour. 

Indian-Meal Gruel. 

Two tablespoonfuls of cornmeal to one quart of boiling water: 
one teaspoonful of salt. Cook about thirty-five minutes. If too 
thick, thin with milk or cream. 



COOKERY FOR THE SICK-ROOM. 797 



Oatmeal Gruel. 

Take one quart of boiling water, three tablespoonfuls of oatmeal, 
one-quarter teaspoon salt ; cook two hours, strain and add milk or 
cream. 

Flour Gruel. 

Take two teaspoonfuls of white flour, one cup of boiling water, 
one-half teaspoonful of salt. Make a smooth paste of the flour and 
salt before adding to boiling water. Strain and thin with milk or 
cream. 

Mutton Broth. 

Boil one pound of juicy mutton in two cups of cold water. Cook 
slowly for half an hour ; strain, and after it is cold, remove the fat, 
and serve with boiled rice. The rice should be boiled separately and 
added to the broth when it is warming. 

Beef Tea. 

Take one pound of round steak, remove the fat, and cut fine, and 
place the meat in a self-sealing jar without water ; cover closely, heat 
gradually in a kettle of water, one hour, or until there is no color in 
the meat. Press with a spoon all the juices from the meat. Serve 
with salt. 

Broiled Beef Essence. 

Place one pound of round of steak in the broiler and broil until 
the juice begins to flow. Cut into fine pieces and squeeze the juice, 
using a lemon squeezer. .Salt to taste. 

Flaxseed Lemonade 

Take two tablespoonfuls of whole flaxseed, and pour over it one 
pint of boiling water. Steep one hour and a half ; add the juice of 
one lemon and sweeten to taste. Excellent for colds. 

Clam Broth. 

Wash the clams ; put in kettle with enough water to cover ; boil 
until shells open, and serve hot. 

Egg-Nog. 

Take one tablespoonf ul of sugar and the yolk of one egg, and 
beat together ; add one-half cup of milk ; beat the white separately, 
and mix in lightly ; add brandy or wine. A little nutmeg is used to 
flavor. 



DIETING IN REGARD TO HEALTH. 



How to Grow Fat. 

It is often as annoying to many to be thin as it is in others to be 
fleshy. Here again the remedy consists in overcoming the natural 
or peculiar forces at work predisposing to the paucity of fat accumu- 
lation, and first of all to grow fat means for the thin person to grow 
lazy and good-natured. Worry, cares, much work and short hours 
for sleep, must be overcome. Clean skins, clean clothes, clean air 
and plenty of sunshine are the sine qua non for thin people to observe. 

Little work, long hours of sleep, plenty of rich food well digested, 
a merry disposition, regular hours for meals, with naps between 
times are also requisite principles to observe for him who would grow 
fat. 

Drink plenty of water, say one or two glasses of pure water on 
arising and again on retiring. Do not overload the stomach with 
water, but drink all it will comfortably stand. Ride in the open air 
often, enjoy the sunshine and fresh air, and bathe in cool water, 
especially sea-water when practicable. 

It will be found much more difficult for some than for others to 
observe all these principles, and again much more difficult for some 
to benefit by them than others; yet everybody can add pounds to 
their present weight if only they will persevere in all these instruc- 
tions. 

Of the food necessary to avoid, the chief articles are acids, spices, 
and condiments generally. 

Of those most productive of fat are the cereals and starchy food 
like potatoes, oatmeal, bread, puddings, etc. Again, fatty meats, 
cream, butter, and milk, chocolate, oils, etc., supply fat directly to 
the system. Sweets are also conducive to fat formation, like sugar, 
beets, custards, etc. Sweet wines and porter are likewise fattening. 

It must be borne in mind, however, that these very classes of food 
are often the cause of indigestion, which makes people thin, hence a 
good appetite and a good digestion are prerequisites for this sort of 
a dietary. It is often a benefit for those with weak stomachs to eat 
a little six times a day, say a light breakfast, dinner, and supper, and 
a glass of milk in the middle of the forenoon and afternoon. 

798 



DIETING IN REGARD TO HEALTH. 799 



To Reduce Flesh, 

Corpulence or obesity is generally more annoying to most 
people than the opposite extreme. It is, however, as natural for 
some people to be fat as it is for others to be thin. 

To reduce flesh, however, is legitimate within certain limits. The 
functions of the body should not be interfered with nor weakened by 
any sort of treatment directed to the reduction of flesh. There have 
always been kept on the market for sale medicines whose sole aim is 
to render people thinner, but most of them are neither trustworthy 
nor safe. 

Of new medicines the most reliable is Phytolene. The thyroid 
gland of the sheep, taken in five-grain doses on retiring, has quite 
recently been extolled as a reliable and harmless medicine against 
obesity. This medicine has been on the market for only a short 
time, but it is known to be perfectly harmless. 



Corpulence. 

All people are not formed in the same mould, some are as fat as 
others are lean. This is owing to a number of causes, namely : 
the easy digestion and absorption of food stuffs ; easy dispositions 
coupled with easy work and nourishing food ; the preponderance of 
fatty, sweet or starchy food in the diet list ; a certain hereditary pre- 
disposition, etc., etc. The style of one's diet (starchy), and the 
natural tendency in some to put on fat, have probably more to do 
with corpulency than any other two factors. This condition often- 
times is so distressing as to amount to disease. The heart walls and 
sac become so infiltrated with fat as to impede the easy action of the 
heart-muscle, as to retard slow, deep respirations and render all exer- 
tions a labor. One may die quite suddenly of fatty heart. The con- 
dition at all events often calls for treatment. 



To Reduce Flesh. 

The so-called Banting Treatment consists in the abstinence from 
all fats, sweets, and starchy food. Banting of England, after having 
tried all other procedures, very rationally invented this treatment. 
Whatever else may be tried, this plan of dieting stands pre-eminently 
in the foreground, and must be persisted in, either alone or as an 
adjuvant to other treatments. 

The following general rules will serve as a guide in the selection 
of proper foods : — 

Avoid starchy food, sugar and fat, milk, coarse cereals, pork or 
lard in all its forms. 



800 DIETING IN REGARD TO HEALTH. 

Can eat : — 

Of Soups : Mutton, chicken and clam broths, beef-tea. 

Of Fish : All kinds except salt or fatty, like bluefish and mackerel. 

Of Meats : The lean of mutton, beef or chicken in small quantities. 

Of Vegetables : All kinds but potatoes, turnips and parsnips. 

Eggs, bread, cornmeal, etc. All kinds of fruit and berries. 

Weak coffee with little sugar or milk, light wines, and the various 
mineral waters. Poland, Vichy, Londonderry, Hunyadi, etc., can 
be taken. 

Moderate gentle exercise is to be indulged in. The bowels are to 
be kept loose with some saline aperient each day, like Carlsbad salts. 

Recently cases have been reported of marked success in the use of 
the extract of thyroid glands in tablet form ; one each night, at the 
same time using Garfield Tea. Iodide of potash in ten-grain doses 
taken in one-half a glass of water three times daily, has been for a 
long time the favorite remedy in the treatment of this disease. This 
dose should be increased every third day till twenty grains are taken 
as a dose. If the mouth tastes very badly in the morning, or pimples 
on the face or back appear to any very annoying degree, the medicine 
may be discontinued for a short time, although these symptoms do 
no harm. 



DIETING IN DISEASE. 



In Dyspepsia, great care should be taken not to overload the 
stomach. It is better to eat often, and take smaller quantities at a 
time, and at regular intervals. Dyspepsia assumes so many different 
forms that experience should teach each patient what agrees with 
him best. Regularity is of importance, and in no case should a meal 
be eaten in a hurry or when the mind is disturbed. It is best to 
avoid pork in all forms, rich, fatty and highly-seasoned foods or 
liquors. Plain foods with few condiments are the best. A little 
warm water or milk taken with the food is better than tea or coffee. 
Vichy, Apollinaris, or Poland water are good drinks. 

The following is usually a safe diet in ordinary dyspepsias: — 
Plain soups ; oysters, raw or roasted ; fish, except fatty varieties and 
blue-skinned fish. Fish should be boiled or broiled. Lobster, blue- 
fish, mackerel and salmon, are the most difficult of digestion. 
Meats : mutton, roast or broiled ; chicken, beef, sweet-breads, tripe. 
Eggs can generally be taken. The various vegetables, if well 
cooked, — with the exception of boiled potatoes. Only stale bread 
should be eaten. That made from the Franklin Mills flour is the 
best. The various coarse cereals are good. It is best to avoid pud- 
dings and pies. Fruits of different kinds are good, especially apples 
and grapes. It is beneficial in some cases to drink hot water imme- 
diately on rising, and in others cold water, — experience is the best 
teacher. 

Dyspepsia accompanied by much gas and belching of wind is 
remedied oftentimes by avoidance of starchy food, such as bread, 
potatoes, etc. Dyspepsia of the small bowel, coming on one or two 
hours after meals, means less starchy food, and avoidance of heavy 
vegetables, fruits, cereals, etc. ; in other words, the patient should 
live on an animal diet of meat, eggs, milk, etc. 

For Consumptives, and those in an anemic state, the diet should 
be generous and and easily digested ; food should be taken in small 
quantities and often. It is best to take some light nourishment 
between meals and before retiring, such as Mellin's Food and milk, 
malted milk and egg-nog. In consumption, oils and fatty foods are 
beneficial if they can be digested. Various preparations of cod-liver 

801 



802 DIETING IN DISEASE. 

oil are excellent. The patient should avoid pork in all forms, fried 
foods, pies and pastry, and all starchy or sweet foods. 

Can take soups and broths, oysters, fish and eggs, if not fried, beef, 
poultry, game and mutton, — roasted or boiled ; fresh vegetables ; 
coarse cereals and stale bread. Desserts : baked apples, prunes, sago, 
tapioca and custards. Best to avoid strong tea or coffee. Vichy, 
Poland and ozonized waters, milk. Malted milk and koumiss are 
good drinks. 

In Albuminuria. — Do not eat to excess, or overload the stomach 
in any way. Eat the most easily digested food, such as plain soups, 
codfish, haddock, clams and oysters raw. Of meats, chicken and 
game, avoiding those that have most blood in them. Vegetables of 
all kinds, especially those of green variety. Laxatives, coarse cereals 
and stale bread. 

Do not take of pastry or rich dishes of any kind, sweets, coffee, 
tobacco or liquors. Avoid eggs and an excess of meats. Can take 
tea, milk, koumiss and large quantities of water, Poland if possible. 

For Gouty and Rheumatic People a generous diet is best. They 
should avoid all foods that have a tendency to acidity of the stomach, 
such as those of a starchy or sweet nature. 

Can take plain soups, broths, beef-tea, fish, — except fatty kinds, — 
and oysters ; meats, with the exception of pork, in small quantities ; 
fresh vegetables, — onions, cauliflower, celery, lettuce, spinach, peas 
and baked potatoes. Also various coarse foods and stale bread. 

For desserts avoid all rich puddings and pastry and sweets. Can 
eat baked or stewed fruits, lemons, oranges and baked apples. 

Should drink plenty of water and milk, rather than tea or coffee. 
Vichy, Poland and Lithia water are the best. 

For Diabetes. — Take easily-digested food, avoiding as much as 
possible sw T eet and starchy varieties. Avoid the use of sugar 
altogether, and substitute saccharin, both in the preparation of foods 
and for tea and coffee. Use meats, fats, oils and butter, cream and 
water especially, say one pint of cream daily. Use few or no potatoes, 
and those baked. May eat all kinds of soup, and various shell-fish ; 
fat meats and fresh vegetables that are not starchy. Various fruits, 
nuts, gluten bread, etc. Saja-bean meal contains only one per cent 
of starch, and is very well adapted to diabetes, — much better than the 
ordinary gluten flour, which, after all, is somewhat starchy. 

For beverages : weak tea or coffee without cream or sugar, milk, 
koumiss, ales and various mineral waters. It is well to avoid flours, 
coarse cereals, fruits and vegetables. 



BATHING, 



WITH ESPECIAL REFERENCE TO THE TURKISH AND RUSSIAN BATHS 
AND THEIR USE AT HOME. 



Bathing, as practised both for pleasure and cleanliness, has been 
the instinctive custom of every nation. Records date to the bathing 
in the Nile and Ganges. Jews, Greeks, Egyptians, and Assyrians 
were all lovers of the bath. 

The Romans surpassed all others in the variety and luxury of their 
baths, but to an excess of them may be ascribed much of the final 
effeminacy and physical degeneration of the Roman people. 

The Roman bather first entered the warm-air room or "tepida- 
rium," where he sweated with his clothes on ; here he was anointed, 
after which he passed into the " calidarium " or hot room, in one end 
of which was a bath ; here he sweated more freely, and afterwards 
had plenty of cold water thrown over him from above his head : first 
warm, then tepid, and after, cold. Succeeding the bath, he was 
scraped and rubbed most briskly and again anointed. The popular- 
ity of these baths caused structures to be erected in every part of the 
city, and in a style of architecture which surpassed all other art 
buildings. The immensity of these buildings may be imagined from 
the fact that ruins of the baths of Titus and Caracalla extend one- 
fourth mile on each side, while one room of the bath of Diocletian 
has been -converted into a church of imposing proportions. The 
baths of Diocletian contained 3,200 seats for bathers. To such a 
pitch of luxury did the Romans reach in their bath-houses, that Sen- 
eca said they were dissatisfied unless they trod on gems in their 
bath. These structures finally were also equipped for all literary 
pursuits, for sports and games. 

These facts show how a simple custom of bathing became a national 
system of luxurious living. The Roman hour for bathing was one 
o'clock (before dinner), as it was supposed to promote the appetite, 
as it does. But these baths which gave such invigoration to the 
body, and which were synonyms of the highest art and culture, finally 
were one great means of Roman degeneracy. 

To such excess did they carry their hot baths, that the nation 
finally exchanged its manly vigor for Eastern effeminacy. Un- 

803 



804 TURKISH AND RUSSIAN BATHS. 

bounded license in social evils took the place of gymnastic training 
and philosophical study. I mention these facts at length to show 
how bathing may be a most healthful practice and a most injurious 
custom. Modern baths are more or less the outcome of the old 
Roman bath, through the agency of the Mahometans, Turks, Rus- 
sians, and Crusaders. The Turkish bath is a modified Roman bath, 
while the Russian bath, so far as its vapor is concerned, was practiced 
among the Indians. 

The Russian bath is essentially a vapor bath. In the centre of 
the building is an open space where oue undresses. Around this 
space are doors opening into small rooms filled with vapor. In the 
centre of each room is a series of steps leading nearly to the ceiling. 
The bather lies on the lowest one of these steps and gradually ascends 
to higher and hotter ones. The first sensation is that of suffocation, 
the breathing is difficult, but soon perspiration bursts through the 
pores and breathing is easy and agreeable. These steps vary in heat 
from 96° to 110° F., and in olden times the temperature ranged very 
much higher than this. Bath attendants then flog the bather with 
birchen twigs or coarse towels, lather well with soap, and rinsing the 
latter off, the bather is rubbed down and put under a shower bath of 
ice-cold water. The shock is great, but the sensation is pleasant 
after a few moments. In olden times the bather was made to rush 
out, steaming hot, and roll in the snow. Milder customs, of course, 
prevail to-daj', yet the Russian bath is not to be indulged in by all 
people at all times with impunity. When there is any tendency to 
heart disease, palpitation, vertigo, or fulness of the head, the vapor 
bath should be indulged in with caution or not at all. 

The Turkish bath differs from the Russian bath in that the atmos- 
phere is dry. The bather first enters the "frigidarium," or cooling 
room, where he undresses and passes into the " tepidarium," or warm 
room, the temperature of which ranges from 110° to 140° F. The 
object of this room is to bring on a gentle perspiration, and to pre- 
pare the system for exposure to a still higher temperature. This is 
attained in the " calidarium," the temperature of which varies from 
140° to 200° F. In this room the bather undergoes the operation of 
kneading or shampooing. To get the full benefit of this bath this 
process should never be omitted ; the hands alone being the sole 
means of friction. After sweating, shampooing, and soaping, the 
bather passes into the "lavatorium " or wash room. In this room he 
begins with a warm shower-bath, which is gradually changed to cool, 
and then to cold. This not only washes off perspiration and soap, 
but also closes the pores and causes a vigorous reaction. 

The feeblest people react readily. The bather then returns to the 
cooling-room, where he lounges, wrapped in a sheet, to await the 
secondary perspiration. 

The Turkish bath is one of the most invigorating and refreshing 
institutions we have. It is devoid of danger almost to all, if used 



TURKISH AND RUSSIAN BATHS. 805 

in moderation. Very hot-air rooms, as well as very hot baths, are 
unnecessary and dangerous to many, as the heart begins to labor and 
the blood-vessels rapidly dilate. 

Fear is often expressed about passing from the hot-air room to the 
cold-water bath. There is absolutely no danger in passing into cold 
water while in a state of profuse perspiration. Adverse changes are 
brought about through the nervous system of the skin ; when this is 
elevated above the normal condition, cold water causes no shock ; 
but when the power of the nervous system is depressed by being 
chilled, weary, or by disease, then it is that ill results are apt to ensue. 

Precautions must always be taken in indulging in any bath. Never 
take a bath on a hungry stomach, as did the Romans, nor immediately 




Fig. 195. Method of taking a Vapor-Bath. 

after meals ; no more should a bath be taken when one is very weary 
or exhausted. 

Warm baths simply relax and cleanse ; but after all others, whether 
hot air, vapor, or sea bath, a good glow of the skin should follow. 

Elderly people should use tepid baths and mild Turkish baths ; 
cold bathing chills the skin and depresses the nervous system. Cold 
sponge-bathing is a useful adjunct to other health measures in the 
young and middle-aged, often being the best preventive against 
catching cold. 

The duration of a bath may last from fifteen minutes to two hours. 
Too much bathing, especially with soap, deteriorates the skin by de- 
priving it of its oily matters. The continued sweating of many 
water-cures causes bad eruptions and boils, which are difficult of cure. 
These « humors," so called by many hydropathists, are not evidences 
that bad blood thus escapes from the body, but that the system ,has 



806 TURKISH AND RUSSIAN BATHS. 

been much debilitated by too frequent bathing, or too prolonged 
sweating. Parts exposed like the face and hands must be frequently 
scraped and bathed, while the rest of the body needs soap and bath 
much less frequently. 

Sea-bathing should not be indulged in by the very old or young; 
by those whose circulation is languid ; by persons who have head 
disease, chronic lung disorders, brain trouble or local congestions. 

A full reaction and a good glow must ensue, and not much time 
spent in the water. Don't cool off before plunging in the water ; all 
the body warmth is needed for a full reaction ; no hesitancy should 
be harbored about plunging in at once, as less heat is thus lost from 
the body, and the consequent shock to the nervous system is thereby 
much diminished. 

For home use both the Turkish and Russian bath may be much 
simplified. 

The vapor for the Russian bath may be improvised as follows : 
The person sits on an open-work chair, preferably a stool made for 



...(- 






Fig. 196. 

the purpose, and is surrounded by a water-proof sheet fitting closely 
about the neck. Hot water is then poured over heated bricks placed 
underneath the chair. For more prolonged steaming, a hose may be 
run to the top of a boiler, on the stove, from whose tin cover pro- 
jects a tin pipe, to which the hose may be attached. (Fig. 195.) 

The shampooing and soaping and cold douche may then be taken. 

For Turkish bath, hot air may be obtained by burning an alcohol- 
lamp under the chair and using the covering mentioned above, or 
alcohol may be mixed with salt in a pan. (Fig. 196.) 

The shainpooing and kneading of the muscles should be done by 
an assistant. Rubber tubing attached to the hot and cold-water 
faucets of the bath-room will readily furnish the requisite shower-bath 
of warm, tepid, and cold water, as one or both of the rubber tubings 
are used. The essential features of both baths may thus very easily 
be procured by almost every household. 



PROOFS OF DEATH. 



The universal dread of being buried alive leads us to give an 
epitomized account of the various signs of death. 

Absence of Circulation. — The heart cannot be heard pulsating 
by one trained to the proper use of the stethoscope. If a band be 
tied around a toe or finger no change results; but if the circulation 
still exists, after a few minutes a livid hue will be noticed at the 
end of the member. 

Absence of Respiration. — A cold mirror placed against or close 
to the lips does not detect the presence of moisture. A flake of 
fine cotton or a feather similarly placed reveals no motion imparted 
by exhaled air. 

Cooling of the Body. — -After death the body temperature falls 
rapidly to that of the surrounding media. As a rule the corpse 
becomes cold in from , six to twelve hours after death, the viscera, 
however, requiring much longer time. 

Rigor Mortis. — Post-mortem rigidity is one of the most positive 
signs of death, and seldom occurs later than twenty-four hours after 
death. 

Putrefaction is, of course, absolute proof of death, but it does not 
occur early. The abdomen becomes green, and finally the whole 
body assumes this livid green color, with a sickish, putrid odor. 
These are the chief signs of death, although several minor ones 
might be mentioned. It may be said in general, that burial almost 
never takes place until death is sure. The evidences of apparently 
suspended animation, of the body turning in its casket, etc., may be 
explained otherwise. 

807 



MEDICINES AND THEIR PREPARATIONS. 



Materia Medica. 

That department of medicine which treats of remedies, their doses, 
modes of using, and influence upon the constitution, is called materia 
medica. The agents employed in the treatment of disease are taken 
from three kingdoms of nature, — the vegetable, the animal, and the 
mineral. 

The largest portion of medicinal substances are taken from the 
vegetable world. They consist of leaves, flowers, seeds, barks, and 
roots. These lose much or all of their medicinal powers unless 
gathered at the right seasons of the year, and are properly cured. 
The different parts of a plant are to be gathered when their peculiar 
juices are most abundant in them. 

The Roots of Annual Plants are best supplied with their- juices 
before they are in flower ; they should be gathered at this time. 

The Roots of Biennial Plants should be gathered in the autumn, 
after the first year's growth. 

The Roots of Perennial Plants should be gathered in the spring, 
before vegetation has begun. 

Before they are dried, the solid parts of these roots are to be cut 
in slices, after being washed, and the small fibres, unless they are the 
parts used, are to be thrown away. 

Bulbous Roots are to be gathered at the time their leaves decay. 
Their outer covering being rejected, they must be sliced, strung upon 
threads, and hung in a warm, airy room to dry. After being dried, 
roots should be packed in barrels or boxes, and kept as free as possi- 
ble from moisture. 

Barks, whether of the roots, trunk, or branches, must be gathered 
in autumn, or early in the spring, when they peel off most easily, and, 
the dead outside and all rotten parts being separated, they must be 
dried in the same manner as roots. The most active barks are gen- 
erally from young trees. 

Leaves are to be gathered when they are full grown, and just be- 
fore the fading of the flower. 

Those of biennial plants are not to be collected until the second 
year. For drying, they should be thinly spread on the floor of a 

808 



MEDICINES AND THEIR PREPARATIONS. 



809 



room through which a current of air passes. For preservation, they 
should be packed in vessels, and kept free from moisture and insects. 

Flowers must generally be collected about the time of their open- 
ing, — either a little before or just after. 

They should be dried as rapidly as possible, but not in the sun, and 
may be packed away in the same manner as leaves. 

Fruits, Berries, etc., may be spread thinly upon the floor, or hung 
up in bunches to dry. 

Articles to Accompany a Medicine-Chest. 

It is advisable for families who prepare their own medicines to 
supply themselves with scales and graduated glasses, as the medi- 
cines in this book are prescribed in this way. Still, in many instances, 
measuring with spoons will answer. 

The following articles should be kept in the medicine-chest : — 

1. A spatula for mixing ointments and pills, and for spreading 
plasters. 

2. A piece of smooth marble on which the above articles may be 
mixed, divided, and spread. 

3. A glass funnel. 

4. A domestic syringe for injection. 

5. Adhesive or sticking plaster. 

6. Lint. 

7. Scales and weights. 

8. A glass or wedge wood mortar and pestle. 

9. A graduated wineglass for measuring teaspoonfuls and table- 
spoonfuls of liquids. 

10. A graduated minim measure. 

11. A two-ounce graduated measure. 



3 Dram. 



Minims. 



3 Ounce. 



3 Dram. 




o 




16 

14 
12 
10 

JO 

•-? 
iQ 

M 


1 











Fig. 195. Minim Measure. 



Fig. 196. Two-ounce Measure. 



The minim measure is represented by Fig. 195, and contains one 
fluid dram, or sixty minims, which is divided by twelve lines, — each 
line representing five minims. A minim is considered about equal 
to one and a half drops. 

The two-ounce measure is represented by Pig. 196, and is divided 
off from half a dram upward. 



810 MEDICINES AND THEIR PREPARATIONS. 



Doses, Weights, etc. 

Apothecary's weights, by which all medicinal preparations ought 
to be weighed, are divided into pounds, ounces, scruples, drams, and 
grains. 

The characters marked on weights and graduated measures are 
explained as follows : — 



|j one ounce, 
f |j one fluid ounce. 
§ss half an ounce. 
3j one dram. 



f3j one fluid dram. 
3ss half a dram. 
^j one scruple. 
3ss half a scruple. 



The grain weights are stamped with punch-marks. 



20 grains make one scruple. 
3 scruples make one dram. 
8 drams make one ounce. 



60 drops make -one fluid dram. 
8 drams make one fluid ounce. 
16 ouuces make one pint. 



By apothecary's weight: — 

lb The pound is equal to 12 ounces. 3 The dram is equal to 3 scruples. 

\ The ounce is equal to 8 drams. 3 The scruple is equal to 20 grains. 

By apothecary's measure : — 

The pint is equal to sixteen ounces. 

3 The dram is equal to ninety drops, or sixty minims. 

The marks and words used by physicians and apothecaries may be 
a little more fully explained by the following table : — 

tx stands for recipe, and means take. 

da stand for ana, and mean of each. 

lb stands for libra vel librae, and means a pound or pounds. 

§ stands for uncia vel uncice, and means an ounce or ounces. 

3 stands for drachma vel drachmas, and means a dram or drams. 

3 stands for scrupulus vel scrupuli, and means a scruple or scruples. 

O stands for octarius vel octarii, and means a pint or pints. 

f| stands for fluiduncia vel Jluiduncice, and means a fluid ounce or 
fluid ounces. 

f3 stands for jliddrachma vel Jluidrachmce, and means a fluid dram 
or fluid drams. 

m stands for minimum vel minima, and means a minim or minims. 

Chart, stands for chartula vel chartulae, and means a small paper or 
papers. 

Coch. stands for cochlear vel cochlearia, and means a spoonful or spoon- 
fuls. 

Collyr. stands for collyrium, and means an eye- water. 

Cong, stands for conguis vel conguii, and means a gallon or gallons. 

Decoct, stands for decoctum, and means a decoction. 

Ft. stands tor fiat and means make. 

Garg. stands for gargarysma, and means a gargle. 

Or. stands for granum vel grana, and means a grain or grains. 

Ott. stands for gutta vel guttoe, and means a drop or drops. 



MEDICINES AND THEIR PREPARATIONS. 



811 



Haust. stands for haustus, and means a draught. 

Infus. stands for infusum, and means an infusion. 

M. stands for misce, and means mix. 

Mass. stands for massa, and means a mass. 

Mist, stands for mistura, and means a mixture. 

Pil. stands for pilula vel piluloe, and means a pill or pills. 

Pulv. stands for pulves vel pulveres, and means a powder or powders. 

Q. S. stands for quantum sufficit, and means a sufficient quantity. 

JS. stands for signa, and means write. 

Ss. stands for semis, and means a half. 

Domestic, or Approximate Measures. — A tablespoon contains 
about four drams ; a teaspoon, one dram ; a dessertspoon, three 
drams ; a wineglass, two ounces ; Spoons vary so much in size, that 
they should not be used as measures in giving powerful medicines. 

Spoons can also be used for measuring solid substances, but are 
not as accurate, as the solid substances vary very much in weight, 
so that I would not advise their use in measuring powerful drugs. 

One dram, or 60 grains, to a teaspoon ful. 

Four drams, or half an ounce, to a tablespoonful. 

The spoon should be level full for solids. 



The Approximate Value of French Decimal 
Weights. 



One centigramme is equal to 

Two centigrammes li 

One demi-decigramme " 

One decigramme " 

One gramme " 

One gramme and three decigrammes is equal to 

Two grammes " 

Four grammes il 

One decagramme is equal to 2 drams and 36 grains. 

Three decagrammes and two grammes is equal to 1 ounce. 

Demi- kilogramme " 1 pound. 

Kilogramme " 2 pounds 



i grain. 
i grain. 

1 grain. 

2 grains. 
18 grains. 

1 scruple. 
J dram. 
1 dram. 



The following table shows the relative doses for young people of 
different ages : — 

The dose for a person of middle age being 
That of a person from 14 to 21 years will be 

7 to 14 " " 

4 to 7 " " 

4 a u 

3 " " 

2 " « 

I u u 



u t 


i a 


cc t 


i (t 


u < 


( t( 


t< < 


l c< 


« « 


( (( 


<C ( 


( c« 



1 or 1 dram. 
| or 2 scruples. 
\ or I dram. 



" | or 1 scruple. 
" J or 15 grains. 
" £ or 10 grains. 
" J or 8 grains. 
" T2 or 5 grains. 
In administering medicines, it is always well to begin with the 



812 MEDICINES AND THEIR PREPARATIONS. 

smallest dose mentioned and gradually increase until the desired in- 
fluence is produced. 

The dose given should not only vary with the drug, but also with 
the condition, age and sex of the person. 

In giving medicine to children, care should be taken as to the 
amount administered. (See foregoing table.) 

It is of course necessary in all cases that the strength and con- 
dition of the patient should be taken into consideration. Especially 
where powerful drugs are used, it will be better to give smaller doses 

than mentioned in the table. 

« 

Tinctures. 

The preparations called tinctures are made by grinding or bruising 
the roots, leaves, or barks used, to a coarse powder, placing it in the 
proper amount of either alcohol or diluted alcohol, letting it stand 
from seven to fourteen days, — shaking each day, — and, finally, 
filtering through paper. A large proportion of tinctures are made 
by taking one ounce of the medicinal substance to one pint of the 
spirit ; and whenever tinctures are spoken of in this Materia Medica, 
and the quantities are not named, the above proportions are to be 
presumed. When a larger proportion of the medicine is to be used, 
I shall simply indicate the proportions in the fewest words, as under 
Black Cohosh, — " this tincture, four ounces to the pint of alcohol," 
meaning thereby, that the tincture is made by using four ounces of 
the root to the pint of alcohol. Most fluid extracts have the same 
strength, ounce for ounce, with the roots, barks, leaves, etc., of which 
they are made. Tinctures may therefore be made with very little 
trouble, by substituting, in each case, the same number of ounces of 
their fluid extracts to the pint of alcohol, which I name of the gross 
substance, or, when no quantity is named, one ounce to the pint. ' 

Infusions. 

These doses are for adults : — 

For young people from 15 to 21, give f of dose. 
" children " 7 to 15, " \ " 

" infants, \ " 

In administering medicines of all kinds the strength and condition 
of the patient should be taken into consideration. 

Infusions are solutions of vegetable medicines, generally obtained 
by pouring boiling water upon the substance, and letting it stand till 
it cools. When a more prolonged application of heat is desired, the 
vessel may stand for a while by the fire, but must not be permitted 
to boil. The vessel should usually be covered. 

As in the case of tinctures, I have uniformly, while writing this 
Materia Medica, briefly named the quantity to be used to the pint, 
whenever it varies from one ounce. 



MEDICINES AND THEIR PREPARATIONS. 813 

Acetic Acid. — This is a clear liquid, without color, and has a 
strong, sour taste, and an agreeable smell. When held to the nose, 
its line, pungent odor often relieves headache. A piece of cambric 
wetted with it and applied to the skin, excites heat and redness, and, 
very soon, a blister, — for which this acid may be substituted in in- 
flammatory sore throat, and other cases requiring speedy action. 
Applied to corns and warts, with a camel's-hair brush, it destroys 
them. 

Citric Acid. — This acid is extracted from lemon or lime juice ; it 
is also present in the cranberry, currant, strawberry, raspberry, tama- 
rind, and is very abundant in the red elderberry. It is refrigerant 
and antiseptic, and is chiefly employed as a substitute for lemonade. 
Nine and a half drams of the crystals, two drops of oil of lemon, 
and one pint of water, answers a good purpose in place of lemon- 
juice. 

Diluted Nitric Acid. — This, in the undiluted state, passes under 
the name of aqua-fortis. It is tonic and antiseptic. Largely diluted 
with water, it forms a good drink in fevers, especially typhus. Taken 
in large doses, it is a powerful poison. One-half dram of this prepara- 
tion, thirteen ounces of soft water, and one ounce of simple syrup, 
make a good drink in fevers, of which half a wineglassful is a dose. 
Excellent in cases of whooping-cough. Use with care. 

Nitro=Muriatic Acid. — This acid, when properly diluted, has a 
tonic and stimulant influence. It is much used as a foot-bath in 
affections of the liver, and in deficient secretions of the bile. 

Diluted Hydrochloric Acid. — This is known by the name of 
diluted muriatic acid. It is tonic, antiseptic, and diuretic, and is 
used in typhus, eruptions of the skin, and with other articles, as a 
gargle in inflammatory and putrid sore throats. Dose, from five to 
twenty drops, in a wineglassful of water. It is given in scarlet and 
typhoid fevers, about ten drops being put into a bowl of barley- 
water or gruel. 

Diluted Hydrocyanic Acid. — This is commonly known by the 
name of prussic acid. It is sedative and antispasmodic, and is useful 
in spasmodic coughs,, asthma, whooping cough, nervous affections, 
hiccough, palpitation of the heart, irritable stomach, and dyspepsia. 
Dose, from two to five drops, in a glass of water or tea of Peruvian 
bark. It is an active poison, and should only be taken when pre- 
scribed by a physician. 

Diluted Sulphuric Acid. — This acid, known by the name of 
diluted oil of vitriol, is tonic, antiseptic, refrigerant, and astringent. 
It is useful in dyspepsia, diabetes, menorrhagia, haemoptysis, erup- 
tions of the skin, hectic, and diarrhoea. It is often given with some 
bitter infusions, as cascarilla, Colombo, Peruvian bark, or quassia. 
The aromatic sulphuric acid is often used in place of it, being some- 



814 MEDICINES AND THEIR PREPARATIONS. 

times considered more grateful to the taste. Dose of each, from five 
to ten drops. 

Tannic Acid. — This is an astringent preparation, and passes 
under the name of tannin. It is prepared from galls. It is used in 
diarrhoea, dysentery, passive hemorrhages, and diabetes. Dose of 
the powder, from one to three grains. 

Tartaric Acid. — This is refrigerant and antiseptic, and is used in 
inflammatory affections, fevers and scurvy. It is much used in pre- 
paring what is called lemon syrup, and forms an agreeable and 
healthful drink. 

Alcohol. — Alcohol is the result of the fermentation of the juices 
of many vegetables. It is the intoxicating constituent in whiskey, 
rum, brandy, gin, wines, porter, ale, beer, and cider. Its principal 
use in medicine is in the preparation of tinctures, essences, and 
extracts. One part of pure alcohol to one part of water forms the 
diluted alcohol of the shops. 

Almonds. — The Amygdalus communis, or almond tree, grows in 
the south of Europe and Asia, and yields the sweet and bitter almond. 
The oil of the sweet almond is used as a demulcent, in coughs, etc. 
A dose is a teaspoonful. The oil of the bitter almond is poisonous, 
and is occasionally used as a valuable sedative. Its taste is like that 
of a peach-kernel. Dose, one-quarter of a drop. It owes its poison- 
ous properties to hydrocyanic acid. Cakes, etc., are sometimes 
flavored with an essence prepared from it. Do not confound the 
sweet with the bitter. 

Aloes. — This is the hardened juice of the leaves of several species 
of the aloe-tree, in North and South Africa, in the south of Europe, 
and in the island of Socotra. Aloes is purgative, acting chiefly upon 
the rectum, or lower bowel, in which it frequently produces irritation, 
and is apt to aggravate and induce piles. It is much used to excite 
the flow of the menses, and should never be given to women during 
pregnancy. It produces griping of the bowels, which may be dimin- 
ished by combining it with carbonate of potash. 

Alum (Alumeri). — The cheminal name of this is sulphate of alu- 
mina and potassa. In ordinary doses, alum is astringent and anti- 
spasmodic. In large doses, it is purgative and emetic, and is used 
both externally and internally. It is often used in solution as a gar- 
gle in sore throat, and falling down of the uvula, and as an injection 
in leucorrhoea. In doses of twenty or thirty grains, it acts as a pur- 
gative, and used in this way is useful in painter's colic. When 
exposed to heat in a vessel till it ceases to boil, it becomes dry, and 
is then called burnt alum, which, when pulverized, is applied with 
advantage to canker spots in the mouth, and to proud flesh. 

American Hellebore (Veratrum Viride). — This plant grows in 
many parts of the United States, usually in swamps, wet meadows, 



MEDICINES AND THEIR PREPARATIONS. 815 

and on the banks of mountain streamlets. The root is the part used. 
It is slightly acrid, alterative in a marked degree, very decidedly 
and actively expectorant and diaphoretic, and it is an excellent 
nervine, though not narcotic. But its most marked and valuable 
quality — that in which it has no rival — is its sedative action upon 
the circulation. In suitable doses, it can be relied upon to bring the 
pulse down from a hundred and fifty beats in a minute to forty, or 
even to thirty. In fevers, therefore, in some diseases of the heart, 
in acute rheumatism, and in many other conditions which involve 
an excited state of the circulation, it is an article of exceedingly 
great value, because it is always reliable. Use under physician's 
directions only. 

Preparations. — Veratum is used chiefly in the form of tincture, 
six ounces to the pint of diluted alcohol, or of fluid extract. The 
dose of each of these preparations, for a grown person, is two or 
three drops every hour or two, in a little sweetened water, and grad- 
ually increased, if necessary, till the pulse comes down to sixty or 
seventy. If taken in so large a dose as to produce vomiting, or too 
much depression, a dose of morphine or laudanum in a little brandy 
or ginger, is a complete antidote. 

Veratrin, the active principle of veratrum, is also used, in doses 
of one-fourth to one-third of a grain. 

American Ipecacuanha (Euphorbia Ipecac). — This plant is per- 
ennial and grows in sandy soils in the Middle and Southern States. 
When cut or broken it gives out a milky juice. The root is the 
medicinal part. It is emetic, cathartic, and diaphoretic. Dose, as a 
cathartic, eight or ten grains; as a diaphoretic, three or four grains, 
every three or four hours. 

American Ivy (Ampelopsis Quinquefolia). — This vine grows in 
all parts of the United States. It is known by the names of false 
grape and wild woodbine. It is alterative, tonic, astringent, and ex- 
pectorant. Used in scrofula and syphilis. 

Water of Ammonia (Liquor Ammonias). — This preparation, called 
hartshorn, or spirits of hartshorn, is formed by the union of water 
with ammonia gas. It has a powerful ammoniacal odor, and an alka- 
line, caustic taste. Taken internally it is stimulant, sudorific, and 
antacid, and applied externally, it is rubefacient. It stimulates par- 
ticularly the heart and arteries, without very much exciting the brain. 
It is an excellent remedy in heartburn, and for sick headache de- 
pendent on sourness of the stomach. A dose is from ten to twenty 
drops, largely diluted with water. United with oils, or with alcohol 
in about equal proportions, and applied externally, it reddens the 
skin, and, if the cloth wet with it be covered with oiled silk or with 
flannel, to prevent evaporation, it will sometimes quickly raise a blister. 
In cases of fainting, it is frequently applied to the nostrils, to excite 
the brain, and rouse the system. Aromatic spirit of ammonia is a 
better preparation. 



816 MEDICINES AND THEIR PREPARATIONS. 

Carbonate of Ammonia. — This is a white, moderately hard, crys- 
talline salt, having a pungent, ammoniacal smell, and a sharp, 
penetrating taste. When exposed to the air, it loses some of its 
ammonia, becomes a bicarbonate, and falls to powder. It is stimu- 
lant, diaphoretic, antispasmodic, powerfully antacid, and, in large 
doses, emetic. Internally, it is more often used than water of ammo- 
nia, and for similar purposes.. Coarsely bruised, and scented with 
oil of lavender, it constitutes the common smelling salts, so much 
used in fainting and hysterics. For internal use, the dose is from 
five to ten grains, taken in the form of pills, every two, three or four 
hours. 

Muriate of Ammonia QSal Ammoniac.} — This, also called hydro- 
chlorate of ammonia, is a white, translucent, tough, fibrous salt, in 
large cakes, about two inches thick, convex on one side, and concave 
on the other. 

It has a saline, pungent taste, but no smell, dissolves in one part 
of boiling water, and three parts of cold. Taken internally, it is 
stimulant and alterative. It is a valuable remedy in chronic bron- 
chitis, pleurisy, and inflammation of the serous and mucous mem- 
branes generally. But it must only be used after the first violence 
of these inflammations has abated. Pulverized, and placed over a 
spirit lamp in a tin cup, the fumes which arise when it sublimes may 
be inhaled five or ten minutes, once or twice a day, with great ad- 
vantage in chronic bronchitis, and in chronic inflammations generally 
of the air-passages. A solution composed of one ounce of the salt 
dissolved in nine fluid ounces of water and one of alcohol, may be 
used as a wash for bruises, indolent tumors, and ulcers. 

Solution of Acetate of Ammonia (Liquor Ammonice Acetatis). — 
This is known by the common name of spirit of Mindererus. The 
taste is saline, and is like that of a mixture of nitre and sugar. It is 
a valuable diaphoretic, and is much employed, alone or mixed with 
sweet spirit of nitre, two parts to one, in fevers and inflammations. 
It is a valuable external application iu mumps, applied hot upon a 
piece of flannel. One-half ounce mixed with seven ounces of rose- 
water and two drams of laudanum, forms a valuable wash for the 
eyes in chronic ophthalmia. The dose is from two to three drams 
mixed with sweetened water, every two or three hours. 

Aromatic Spirit of Ammonia (Spiritus Ammonice Aromaticus). — 
Taken internally, this answers the same purpose as other prepara- 
tions of ammonia, and is much used on account of it agreeable taste 
and smell. It is valuable as an antacid in sick headache. Dose, 
from twenty to thirty drops, sufficiently diluted with water. 

Anise (Pimpinella Annum). — This is a perennial plant, and grows 
in Egypt. Its fruit is called anise-seed. It is aromatic and carmi- 
native. It is much used to allay nausea, flatulency, and colic, par- 
ticularly in children. It is frequently added to other medicines to 



MEDICINES AND THEIR PREPARATIONS. 817 

make them more agreeable, and to lessen the griping effects of physic. 
The oil extracted from the seeds, dissolved in alcohol, an ounce of 
the former to a pint of the latter, forms what is called the essence of 
anise. Dose of the essence, from thirty drops to a dram in sweetened 
water. Anise forms a very valuable addition to cough preparations. 

Arnica (Arnica Montana.) — This is a perennial plant, growing in 
moist, shady places in Siberia, etc. It is often called leopard's bane. 
It is much used externally as a stimulating application to bruises, local 
inflammation, etc. 

Preparations. — It is chiefly used in the form of tincture, or fluid 
extract. Dose, ten to thirty drops. Half an ounce of tincture, five 
and a half ounces of boiling vinegar, and two drams of carbonate of 
ammonia, used warm, make in some cases a valuable fomentation. It 
is one of the leading homoeopathic remedies. 

Arrowroot. — This is prepared from the Maranta arundinacea, a 
plant of the West Indies. It is chiefly used in forming dietetic pre- 
parations, and belongs to the first or saccharine group of food-articles. 

Assaf oetida. — This is the hardened juice from the root of a Per- 
sian plant. It is stimulant, antispasmodic, and expectorant, and is 
much used in nervous complaints. A dose of the powder is from 
five to ten grains, and of the tincture, made by macerating two ounces 
in a pint of diluted alcohol, from thirty to sixty drops. 

Balm (Melissa Officinalis). — This is a perennial plant, growing in 
Europe and this country. It is moderately stimulant and diaphoretic. 
The warm infusion causes perspiration, and is used to relieve painful 
menstruation. 

Balm of Gilead (Populus Candicans). — This is a tree growing in 
the northern parts of our country. A tincture made from the buds, 
in doses of from one to four fluid drams, is useful in affections of the 
kidneys, in scurvy, and rheumatism. Steeped in lard they form a 
useful ointment for some purposes. 

Balmony (Chelone Glabra). — This is a perennial plant, common 
to the United States. It is tonic, cathartic, and vermifuge. It is 
used in indigestion, debility, and derangements of the liver. A dose of 
the powdered leaves is one dram ; of the tincture, two fluid drains ; 
of the decoction, one or two fluid ounces ; of the active principle 
called chelonin, one or two grains. A decoction of balmony com- 
bined with tincture of assafcetida forms a valuable injection for 
worms. An ointment made from the fresh leaves is valuable for 
piles, inflamed breasts, tumors, and painful ulcers. 

Balsam Copaiba. — This is obtained from a South American tree 
called the Copaifera Officinalis. It is a clear yellowish fluid, about 
the consistency of honey. It is a stimulating diuretic, and is much 
used in chronic gonorrhoea, gleet, irritable conditions of the bladder, 



818 



MEDICINES AND THEIR PREPARATIONS. 



and chronic bronchitis. In some persons it causes an eruption on the 
skin, with itching, etc. 

In large doses, it acts as a cathartic. 

Balsam Tolu. — This is the juice of the tree Myrospernum Tolui- 
ferum, growing in South America. It is soft, tenacious, and of a 
pale brown color; and, like balsam copaiba, is soluble in alcohol, 
ether, and volatile oils. It has been used in asthma, cough, bron- 
chitis, etc. Dose, from ten to thirty grains, in mucilage or syrup. 

Barberry {Berberis Vulgaris}. — This shrub grows along the At- 
lantic coast, from Canada to Virginia. The parts used are the bark 
and berries. It is tonic and laxative, and, in doses of a teaspoonful, 
powdered, is useful in jaundice, chronic diarrhoea, and chronic dysen- 
tery. A decoction of the berries forms an agreeable acid drink in 
fevers, cholera infantum, etc., and as a gargle it is useful for ulcers 
of the mouth, etc., as a wash, for chronic inflammation of the eyes, 
and as an injection for leucorrhoea. 

Bay berry (Myrica Cerifera, Fig. 197). — This is found in damp 
places, in many parts of the United States, 
and is very abundant in New Jersey. The 
bark of the root is the part used. It is astrin- 
gent and stimulant. Pulverized, and com- 
bined with powdered blood-root, it forms an 
excellent application to indolent ulcers. In 
the form of poultice, combined with powdered 
slippery elm, it is a useful application to 
scrofulous tumors or ulcers. The decoction 
is a good wash for sore mouth, and spongy, 
bleeding gums. It is chiefly used in the form 
of tincture, dose, half an ounce ; fluid extract, 
dose, one or two drams ; and the active prin- 
ciple, myricin, dose, two to ten grains. 

Bearberry ( Uva Ursi, Fig. 198). — This plant, also called upland 
cranberry, has a wide range, being found in the northern parts of Asia, 
Europe and America. It flowers from June to Sep- 
tember, and ripens its berries in the winter. The 
leaves are the only medicinal parts. It is astringent 
and tonic, and acts particularly upon the urinary or- 
gans, for complaints of which it is generally used. It 
is specially valued as an antilithic in gravel, and as a 
remedy for chronic inflammation of the kidneys, ul- 
ceration of the bladder, etc. 

Preparations. — Fluid extract, dose, one-third of a 
dram to a dram ; solid extract, dose, five to fifteen 
grains ; tincture, dose, one to two ounces. 

Beef's Galls (Fel Bovinum). — This being dried by evaporation, is 





MEDICINES AND THEIR PREPARATIONS. 



819 



sometimes used as a tonic and laxative, in torpor of the liver, jaun- 
dice, indigestion, and costiveness, in doses of from one to ten grains. 
Three drams of ox-gall, one dram of extract of conium, two drams of 
soda soap, and one ounce of sweet oil, make a valuable preparation, 
which, when applied externally, has a surprisingly rapid effect in 
reducing enlargement and hardening of the breasts, glandular tumors, 
particularly enlargement of the tonsils, and is useful in hypertrophies 
generally. For application to the tonsils, the gall may be rubbed up 
with water to the consistence of an ointment, and may be applied with 
a camel's-hair brush. 

Benzoin. — This is the hardened juice of a tree of Sumatra and 
Borneo. It is very brittle, of a reddish brown color, and is soluble in 
alcohol and ether. It is chiefly used for inhalation in chronic laryn- 
gitis and bronchitis. When used, for this purpose, it may be added 
to boiling water, and the vapor inhaled ; or it may be burned upon 
coals or a hot shovel, the fumes being inhaled. 

Benzoic Acid. — This is prepared by heating benzoin, and causing 
it to sublime. It consists of silky, feathery crystals, which are white 
and soft. It has been found useful in the phosphatic variety of 
gravel. A convenient way of giving it is to unite one part of it with 
four parts of phosphate of soda, the dose of which is from ten to 
twenty grains. 

Bethroot (Trillium Penduluni). — A perennial plant, growing in 
rich soils, in the Middle and Western States. The root is used, and 
is astringent, tonic, and antiseptic. It is useful in bleeding from the 
lungs and kidneys ; also in excessive menstruation, cough, asthma, 
and difficult breathing. Boiled in milk, it is used, in the western 
country in diarrhoea and dysentery. 

Preparations. — Fluid extract, dose, one to three drams ; trilliin, 
dose, four to eight grains ; infusion, dose, two to four ounces ; decoc- 
tion used as a local application to ulcers and sore mouth, and as an 
injection in leucorrhcea and gleet. A poultice made from the root 
is useful for carbuncles, indolent tumors, buboes, foul ulcers, and for 
stings of insects. 

Bitter=root QApoeynum Androsamiifolium, 
Fig. 199). — An indigenous plant, growing in 
rich soils in the United States and Canada. The 
root is the part used, and is laxative, tonic, 
diaphoretic, and alterative. It is employed in 
chronic affections of the liver, syphilis, scrofula, 
intermittents, and the low stage of typhoid fe- 
vers. Forty to fifty grains will cause vomiting 
without much nausea. 

Preparations. — Fluid extract, dose, as a 
tonic, ten to twenty drops; as a diaphoretic, 
fifteen to twenty-five drops ; as an emetic, half fig. 199. bttterkoot. 




820 MEDICINES AND THEIR PREPARATIONS. 

a dram to a dram. Solid extract, dose, two to eight grains ; apocy- 
nin, the active principle of the root, dose, half a grain to two grains ; 
tincture, dose, two to three drams ; infusion, dose a wine-glassful, 
three times a day. 

Bismuth. — The principal preparation of this metal used in medi- 
cine, is the trisnitrate of bismuth, also called nitrate, subnitrate, and 
white oxide of bismuth. It is a white powder, without smell or taste. 
It is used for various irritable and painful affections of the stomach, 
when there is no acute inflammation. It is particularly useful in 
chronic diarrhoea, more especially the diarrhoea of the latter stages of 
consumption, over which it has more control than any other known 
remedy. To show its best effects in this form of diarrhoea, it should 
be given in large doses, not less than fifteen to twenty grains, imme- 
diately after each meal. The small doses usually given are compara- 
tively useless. Given in these full doses, it is also almost a specific 
in heartburn and water-brash. 

Bittersweet (Solanum Dulcamara). — This is common in Europe 
and North America. It is a woody vine, the roots and stalks of 
which are used in medicine. It is slightly narcotic, and has altera- 
tive and diaphoretic properties. It is used in scaly and syphilitic 
affections of the skin. It is said to have antaphrodisiac properties, 
and is serviceable in mania connected with strong venereal propensi- 
ties. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, three to eight grains ; infusion, dose, one to three 
ounces, three or four times a day. 

Black Alder QPrinos Verticillatus) . — This shrub is common in 
the United States , its bark and berries are used. It has been found 
useful in jaundice, diarrhoea, intermittent fever and other diseases 
connected with debility. Applied locally in the form of a wash or 
poultice, and given internally, it is popular in chronic eruptions of 
the skin, and in flabby, ill-conditioned ulcers, and mortification. 

Preparatidns. — Fluid extract, dose, two drams; tincture, dose, 
two to four drams. 

Two drams of the fluid extract of black alder, one dram of the 
fluid extract of golden seal, and one pint of water, mixed, and taken 
in doses of four fluid ounces, three or four times a day, are valuable 
in dyspepsia. 

Blackberry (Rubus Villosus). — There are many species of this 
growing in the United States. The bark of the root is the part used. 
It is tonic, and strongly astringent, and is a valuable remedy in diar- 
rhoea, dysentery, cholera-infantum, relaxed condition of the bowels 
of children, and the passive discharge of blood from the stomach, 
bowels, and womb. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, four to six grains ; tincture, dose, two to four drams ; inf u- 



MEDICINES AND THEIR PREPARATIONS. 



821 




Fig. 200. 
Black Cohosh. 



sion, dose, one ounce. This last preparation is also useful as an injec- 
tion in gleet, leucorrhcea, and prolapsus of the rectum and womb. 
The syrup of the blackberry-root is also a valuable preparation ; so 
also is blackberry brandy, so called, which is the juice of the fruit 
mixed with brandy. This is excellent in summer complaints. 

Black Cohosh ( Cirnicifuga Racemosa, Fig. 200). — This grows in 
rich soils throughout the United States. The 
root is the part used. It is slightly narcotic, 
sedative, antispasmodic, antiperiodic, and exerts 
a marked influence over the nervous system ; 
being useful in St. Vitus's dance, epilepsy, ner- 
vous excitability, asthma, delirium tremens, and 
many spasmodic affections. It has an especial 
affinity for the uterus. 

It reduces the arterial action very materially, 
and hence is useful in palpitation of the heart. 
It has been used successfully in acute rheuma- 
tism, but more particularly in chronic rheuma- 
tism. 

Preparations. — Fluid extract, dose, half a 
dram to two drams ; solid extract, dose, four to 
eight grains ; tincture, four ounces to the pint of 
alcohol ; dose, one to three drams ; cimicifugin, the active principle, 
dose, one to six grains. 

Black Willow (Salix Nigra). — This tree is found in the Northern 
States, along the banks of rivers, especially in New York and Penn- 
sylvania, and is known by the common name of pussy-willow. It is 
a bitter tonic, and is sometimes used in fever and ague. A decoction 
made from the buds is said to be a powerful antaphrodisiac, and is 
accordingly useful in the treatment spermatorrhea. 

Bloodroot (Sanguinaria Canadensis, Fig. 201). — A perennial 
plant, growing in light, rich soils, in most parts of 
the United States. The root is the part used. It 
is emetic, narcotic, expectorant, alterative, escha- 
rotic, and errhine. It is used in typhoid pneumonia, 
bronchitis, rheumatism, dyspepsia, etc. Three to rive 
grains stimulates the digestive organs, and accele- 
rates the pulse. 

Preparations. — Fluid extract, dose, five to fifteen 
drops ; solid extract, half a grain to a grain and a 
half ; tincture, twenty drops to a dram ; sanguina- 
ria, the alkaloid principle, from one-twentieth to one- 
tenth of a grain. 

Four-grain pills, made of sanguinarin, twelve 
grains, caulophyllin, twelve grains, solid extract of 
cirnicifuga, twelve grains, are said to be efficacious 
in amenorrhcea, dysmenorrhea, and other female disorders. 




FIG. 201. 
BLOODROOT. 



822 



MEDICINES AND THEIR PREPARATIONS. 



Blue Cohosh (CaulopKyllum Thalictroides, Fig. 202). — A peren- 
nial plant, growing in low. moist grounds in most parts of the United 
States. The root is the part used. It is antispasmodic, diuretic, 
diaphoretic, alterative, emmenagogue, anthelmintic, parturient, and 
tonic. It is used in rheumatism, dropsy, epilepsy, hysterics, cramps, 
amenhorrhcea, dysmenorrhea, chorea, leucorrhoea, hiccough, to hasten 
delivery, and to relieve after-pains. 

Preparations. — Fluid extract, dose, fifteen to thirty drops ; solid 
extract, dose, one to three grains ; tincture, dose, half a dram to a 
dram ; infusion, dose, two to three ounces ; caulophyllin, the active 
principle of the root, dose, one-quarter of a grain to a grain. 

In cases of protracted labor, occasioned by fatigue or debility, the 
infusion is said to be fully equal to ergot in hastening delivery. A 
wash made by combining one <»>unce of fluid extract with one ounce 
of the fluid extract of golden seal, and eight ounces of water, is very 
excellent for apthous sore mouth. 





Fig. 202. Blue Cohosh. 



Fig. 203. Blue Flag. 



Blue Flag (Iris Versicolor, Fig. 203). — A perennial plant, grow- 
ing in damp places, in most parts of the United States. The root is 
the part used for medicinal purposes. It is cathartic, alterative, sia- 
lagogue, and diuretic. It acts particularly on the glandular system ; 
in large doses, it evacuates and exhausts the system, acting on the 
liver, and fulfilling the purposes of mercury. 

Preparations. — Fluid extract, dose, twenty to forty drops ; solid 
extract, one to three grains ; tincture, one to two drams. Iridin, the 
active and resinous principle, dose, half a grain to three grains. 
Equal parts of blue flag, mandrake, and prickly-ash bark, mixed, and 
given in five- to ten-grain doses, every two or three hours, will act as 
a powerful alterative, and cause free salivation, without making the 
breath offensive or injuring the gums. Three grains of iridin, five 
grains of leptandrin, and twenty grains of bitartrate of potassa, form 
an excellent cathartic in dropsy, producing free watery stools. 



MEDICINES AND THEIR PREPARATIONS. 



823 



Blue Pill {Hydrargyri Pilulce). — This mercurial preparation, gen- 
erally known by the common name of blue mass, or blue pill, is made 
by rubbing mercury, confection of roses, and pulverized liquorice-root 
together until all the mercurial globules disappear. The mass is di- 
vided into pills when wanted. It is the mildest of all the mercurial 
preparations, and the least liable to produce salivation or irritation 
of the system. But even this should be used sparingly, and with 
caution, and I do not recommend its use. 

The blue mass is alterative and cathartic, and is considerably 
given to stimulate the action of the liver, and to produce an altera- 
tive effect upon the digestive organs. The leptandra and the podo- 
phyllum have become its rivals, and will, I sincerely hope, finally take 
its place. 

Boneset (Eupatorium Perfoliatum, Fig. 204). — An indigenous 
plant growing in most parts of the United States. The tops and 
leaves are medicinal. It is tonic, diaphoretic, expectorant, and, in 
large doses, or when taken as a warm infusion, emetic and aperient. 

Preparations. — Fluid extract, dose, one to two drams ; solid ex- 
tract, dose, five to fifteen grains ; tincture, dose, one to one and one- 
half ounces ; infusion, dose, one to two ounces. Eupatorin, dose, one 
to three grains. 

Two scruples of eupatorin, one scruple of xanthoxylin, and one 
grain of strychnia, mixed, and made into twenty powders, is excellent 
for torpor of the liver or kidneys, and for rheumatism ; one powder 
being taken three or four times a day. 





Fig. 204. Boneset. 



Fig. 205. Buchu. 



Buchu (Barosma Orenata, Fig. 205). — It grows at the Cape of 
Good Hope. The leaves are the medicinal portion ; they are stim- 
ulant, diuretic, antispasmodic and tonic. Buchu is chiefly given in 
complaints of the urinary organs, attended with increased uric-acid 
gravel, chronic inflammation or morbid irritation of the bladder, 
urethra, and prostate, and retention or incontinence of urine. 

Preparations. — Fluid extract, dose, half a dram to tw r o drams ; 
tincture, dose, two to five drams ; infusion, one to five ounces. A 
combination of fluid extract of buchu half an ounce, acetate of 



824 MEDICINES AND THEIR PREPARATIONS. 

potash two drams, and water eight ounces, taken in doses of four 
ounces three or four times a day, is a valuable diuretic. 

This combination, however, may be improved by the addition of a 
little sweet spirits of nitre. 

Buckhorn Brake (Osmunda Regain). — This is a fern growing in 
moist grounds in most parts of the United States. The root, which 
is the medicinal part, should be gathered in the latter part of May, 
and in August, and very carefully dried, to prevent moulding. It 
is mucilaginous and tonic, and is used in coughs, diarrhoea and 
dysentery, and as a tonic while getting up from exhausting disease. 
One root infused in a pint of hot water for half an hour will convert 
it into a thick jelly. This mucilage may be sweetened with sugar, 
and freely taken. 

Buckthorn (Rhamnus Cathartieus) . — This plant grows in Europe, 
w T here it is much esteemed by practitioners. The berries and juice 
are actively medicinal. It is a powerful cathartic, producing large 
watery discharges. It is seldom used alone on account of the severity 
of its action. 

Preparations. — Fluid extract, dose, one dram ; syrup of buck- 
thorn, made by uniting four ounces of fluid extract with twelve 
ounces of simple syrup, dose, two drams. 

Bugleweed (Lycopus Virginicus). — This grows in shady and 
wet places throughout a greater part of the United States. The 
whole herb is used. It is a mild narcotic, sedative, sub-astringent, 
and styptic. It is a valuable remedy in bleeding from the lungs, 
incipient consumption and pneumonia. It quiets irritation and 
allaj's cough and nervous excitement. 

Preparations. — ■ Fluid extract, dose, one to two drams ; infusion, 
dose, two to four ounces. 

Burdock {Lappa Minor). — A native of Europe, and growing in 
the United States. The root is used, which is useful in scurvy, 
syphilis, scrofula, gout, leprosy, and disease of the kidneys. It needs 
to be used for a long time. It is said to be useful for persons 
afflicted with boils, stye, etc. An ointment prepared from it is 
serviceable in some diseases of the skin, and obstinate ulcers. 

Preparations. — Fluid extract, dose, one dram ; solid extract, dose, 
five to fifteen grains ; tincture, dose, half an ounce to an ounce. 

Burgundy Pitch. — This is the concrete juice of the Norway pine, 
Abies excelsa, growing in Europe and Northern Asia, and of the silver 
fir-tree of Europe, Abies picea. It gently excites the skin, and is 
used chiefly in the form of plasters, either alone or mixed with other 
gums and resins. 

Butternut (Juglans Cinerea). — This is a forest tree, growing in 
various parts of this continent, known also by the names of oilnut 



MEDICINES AND THEIR PREPARATIONS. 825 

and white walnut. The inner bark of the root is used, and is a mild 
cathartic, being useful in cases of constipation. It is much employed 
by families as a domestic remedy, in intermittent and remittent 
fevers. It evacuates the bowels without debilitating them. 

Preparations. — Fluid extract, dose, one to two drams; solid ex- 
tract, dose, five to fifteen grains ; juglandin, the active principle, dose, 
one to three grains. A very good pill is made by mixing one and a 
quarter drams of the solid extract of butternut, three-quarters of a 
dram of the solid extract of jalap, and ten grains of soap, and divid- 
ing the whole into sixteen pills. Two or three may be taken for 
a dose. 

Calcined Deer's Horn (Cornu Cervince Usturn). — The horns of 
the deer are said to be in velvet between August and December, and 
during this period those which fall are collected, coarsely rasped, and 
placed in an iron vessel, which is tightly covered and placed in an 
oven, or elsewhere, and subjected to a heat of 200° F., which is con- 
tinued until the rasped horn becomes of the color of roasted coffee. 
When cooled, it is reduced to powder by trituration, and preserved 
in closely stopped vials. It is a powerful styptic, taken in teaspoonful 
doses every half-hour ; or, a teaspoonful added to a gill of hot water, 
and a tablespoonful of this taken every five or ten minutes. It has 
much efficacy in floodings from the womb, and in excessive menstru- 
ation. 

Calomel (Hydrargyri Chloridum Mite). — This is prepared from 
mercury, sulphuric acid and common salt. It is alterative, antisyphi- 
litic, and anthelmintic, and, in large doses, purgative. It is much 
used in venereal diseases and chronic affections of the liver, combined 
with opium ; in dropsies, combined with squill, foxglove and elate- 
rium; and in rheumatism and leprosy, combined with antimonials, 
guaiacum, and other sudorifics. In the beginning of fevers and other 
complaints, it is often combined with purgatives, as gamboge, scam- 
mony, jalap and rhubarb. Given in small doses, not large enough to 
purge, it gradually excites salivation. Dose, from one to three 
grains. 

The tendency of this article to produce salivation, to injure the 
gums, loosen the teeth, etc., has given rise to much prejudice against 
it in the public mind ; and, indeed, it must be confessed that it has 
been used by many, from time immemorial, with great indiscretion. 
In the hands of sensible and prudent men, it is very serviceable in 
some cases; but the podophyllum and leptandra have so fine an 
action upon the liver, that they are fast taking the place of calomel 
and other mercurials, and possibly may in time wholly supersede 
them. I have not prescribed it in this book, and do not recommend 
its use. 



826 



MEDICINES AND THEIR PREPARATIONS. 




Camphor Tree. 



Camphor (Fig. 206). — This is obtained from an evergreen tree, 
growing in the East Indies, — Laurus cam- 
phor a. It is a white, shiny, crystalline sub- 
stance, extracted from the wood and roots of 
the above-named tree by boiling them, and is 
subsequently purified by sublimation. It has 
a penetrating, peculiar diffusible odor, and a 
pungent, cooling taste. It is moderately stim- 
ulant, diaphoretic, and antaphrodisiac. Dose, 
from one to ten grains. 

Canada Balsam. — This is the fluid ob- 
tained from the fir-balsam, Abies balsamea, of 
Canada, Maine, etc. It is a stimulating diu- 
retic, and, in large doses, cathartic. A dose is 
from ten to fifteen drops, two or three times 
a day, in pills, or in emulsion. It forms a part of several ointments 
and plasters. It is used to mount objects in microscopic investi- 
gations. 

Canada Fleabane (Urigeron Canadense). — An annual plant, grow- 
ing in the Northern and Middle States. It is diuretic, tonic, and 
astringent, and has been found useful in dropsical complaints and 
diarrhoea. The dose of the powder is from thirty grains to a dram ; 
of the infusion, from two to four fluid ounces ; of the solid extract, 
from five to eight grains ; to be repeated, in each case, every two or 
three hours. 

Canella (Canella Alba). — This is the bark of a South American 
tree, and is an aromatic stimulant and a gentle tonic, and useful in 
debility of the stomach. 

Caraway ( Carum Carui). — This biennial plant grows in Europe. 
The seeds are the part used, and are aromatic and carminative ; they 
are used in wind colic, and to improve the flavor of other medicine. 
The dose is from ten to sixty grains. The dose of the oil of caraway, 
extracted from the seeds, is from one to five drops. 

Cardamom (Alpinia Cardamomum). — This plant grows on the 
mountains of Malabar. The seeds, which are the medicinal parts, 
are aromatic and carminative, and are used to expel wind, and to 
flavor medicines. Dose, from ten grains to two drams. The volatile 
oil obtained from them has similar properties. 

Cascarilla. — This medicine is the bark of the West India shrub, 
Croton eleuteria. It has an aromatic odor, and a warm, spicy taste. 
It is a pleasant aromatic and tonic, and is used in dyspepsia, chronic 
diarrhoea and dysentery, wind colic, and other debilities of the stom- 
ach and bowels. It counteracts the tendency of cinchona to produce 
nausea. 

Preparations. — Fluid extract, dose, twenty to twenty-five drops ; 



c. 



MEDICINES AND THEIR PREPARATIONS. 827 

tincture, dose, one dram ; infusion, dose, one to two drams. An alka- 
line infusion, composed of fluid extract, three ounces ; carbonate of 
potassa, two drams; and water, ten ounces, is excellent in weak 
stomach, with acidity. Dose, one dram. 

Castor (Castoreum). — A peculiar substance obtained from the 
beaver. It is antispasmodic and emmenagogue. It is used in 
typhus, hysterics, epilepsy, retention of the menses, and in many 
other nervous diseases. Dose, from ten to fifteen grains. A medi- 
cine of no great value. 

Castor Oil ( Oleum Ricini). — This is obtained by expression from 
the seeds of the castor-oil bush, Ricinus communis. When exposed 
to the air, it becomes rancid and spoils. 

As a mild cathartic this oil is extensively used, but may be ren- 
dered less offensive by being mixed with a few drops of oil of winter- 
green, peppermint or cinnamon ; and its bad taste may be nearly 
destroyed by rubbing it up to a thick batter with carbonate of mag- 
nesia. Or, if boiled a few minutes with a little sweet milk, sweet- 
ened with loaf sugar, and flavored with essence of cinnamon or 
peppermint, it may be easily taken. Dose, for an adult, one to two 
tablespoonfuls ; for a child, one, two or three teaspoonfuls, according 
to its age. 

Catechu. — This is a solid extract, made from the wood of the 
Acacia catechu, a tree growing in Asia. It is in dark, brown, and 
brittle pieces, and is soluble in alcohol. It is a powerful astringent, 
and is used in chronic diarrhoea and chronic dysentery. . It makes a 
useful gargle in some forms of sore mouth, in elongated uvula, 
spongy gums and sore nipples. The dose of the powder is from ten 
to twenty grains, and of the tincture, from one to two teaspoonfuls. 

Catnip (Nepet-a Catarid). — A native of Europe, and widely nat- 
uralized in this country. The tops and leaves are the medicinal 
part, and are carminative and diaphoretic when drunk as a warm 
infusion. It is useful in fevers, in wind colic, nervous headache, 
hysterics, and nervous irritability. 

Preparations. — Fluid extract, dose two to three drams ; infusion, 
dose two to three ounces. Fluid extract of catnip, two ounces ; and 
the fluid extract of saffron, one ounce and a half, united, make a 
popular remedy for colds, and the rashes of children. In nervous 
complaints, a combination of fluid extract of catnip, six drams : fluid 
extract of valerian, four drams ; and fluid extract of scullcap, four 
drams, is a valuable remedy. Dose, one to two drams. 

Cayenne Pepper (Capsicum Annuum, Fig. 207). — This plant 
grows in hot climates, and is known by the common name of red 
pepper. The berry, which is the part used, has an intensely hot and 
pungent taste. It is a powerful, diffusible stimulant, and is about the 



828 



MEDICINES AND THEIR PREPARATIONS. 




only stimulus which the stomach will bear in certain forms of dys- 
pepsia. It is useful in all cases of diminished vital action, and is fre- 
quently united with other medicines, either to promote their action, 
or to lessen the severity of their operation. It 
is much used in colds, hoarseness, etc., as it 
promotes a free discharge of mucus and 
phlegm. Taken in small doses, it has a fine 
effect upon the mucous membrane of the 
stomach and bowels, lessening very much the 
severity of piles, and sometimes curing them. 
It may be sprinkled daily upon the food, or 
taken in the form of cayenne lozenges; it is 
frequently useful as a gargle in sore throats, 
scarlet fever, etc. Dose of the powder from 
one to eight grains. 

Preparations. — Fluid extract, dose, five to 
ten drops ; tincture, dose, half a dram to a 
fig. 207. Cayenne pepper. c | ram? use( q j n i ow forms of fever, and gastric 

insensibility; infusion, dose, one to two drams. A valuable gargle 
in scarlet fever may be made by combining fluid extract of cayenne 
one ounce ; common salt, one dram ; boiling vinegar, one pint ; boil- 
ing water, one pint. 

Celandine QChelidonium Majus). — This plant is indigenous to 
Europe, and is extensively naturalized in the United States. It is a 
drastic purge, producing watery stools, and is equal to gamboge ; it is 
useful in affections of the liver, and particularly in those of the 
spleen. In the form of a poultice it is effective in scrofula, indolent 
ulcers, skin diseases, and piles. 

Preparations. — Fluid extract, dose, ten to fifteen drops ; solid ex- 
tract, dose, five to eight grains ; tincture, dose, half a dram to a dram ; 
infusion, dose, two and a half to four drams. A very good hydra- 
gogue cathartic is made by compounding two and a half drams of 
fluid extract of celandine with half a dram of fluid extract of hen- 
bane, one ounce of sulphate of potassa, one grain of tartar emetic, 
six ounces of elder- water, and ounce of syrup of squill. 

Chalk. — On account of its gritty particles, it is unfit for medicinal 
use until it has been levigated, after which it is called prepa?-ed chalk. 
This is the only form in which it is used in medicine. It is an ex- 
cellent antacid, and is admirably adapted to diarrhoea accompanied 
with acidity. The most convenient form of administering chalk is 
that of the chalk mixture, which consists of prepared chalk, half an 
ounce ; sugar and powdered gum-arabic, two drams each ; cinnamon- 
water and water, four fluid ounces each, and rubbed together in a 
mortar till they are thoroughly mixed. Dose, a tablespoonful fre- 
quently repeated. 



MEDICINES AND THEIR PREPARATIONS. 



829 




Fig. 208. Chamomile. 



Cassia=Buds. — This spice is a product of China. It consists of 
the calyx surrounding the young germ of one or more species of cin- 
namon. Cassia buds have some resemblance to cloves, and are com- 
pared to small nails with round heads. They may be used for the 
same purposes as the cinnamon-bark. 

Chamomile (Anthemis Nobilis, Fig. 208). — This perennial plant 
grows in Europe, and its flowers, the whitest of which are best, are 
considerably used in medicine. They are 
gently tonic, and are generally used in cold 
infusion, in cases of weak stomach, dyspep- 
sia, etc. In large doses, the warm infusion 
will act as an emetic. 

Preparations. — Fluid, extract, dose, half 
a dram to a dram ; solid extract, dose, four 
to fifteen grains ; infusion, dose, half an 
ounce to an ounce. For dyspepsia, wind in 
the stomach, etc., thirty pills may be made 
by combining one dram of solid extract of 
chamomile with five grains of the solid ex- 
tract of rhubarb and ten grains of assafoe- 
tida, and taken, one pill at a time, two or 
three times a day, with advantage. 

Charcoal (Carlo Ligni). — Prepared charcoal is antiseptic and ab- 
sorbent, and is employed with great advantage in certain forms of 
dyspepsia, attended with bad breath and putrid eructations ; it has a 
good effect in correcting the fetor of the stools in dysentery : it is 
considerably used, and with much advantage, as an ingredient in 
poultices. Dose, when taken internally, from one to three teaspoon- 
fuls. 

Chloroform (Qhloroformum). — This is an ansesthetic, used to pro- 
duce insensibility during surgical operations. A teaspoonful or more 
is poured upon a handkerchief, which is held to the patient's nose, 
but not so closely as to prevent the admission of air. The numerous 
sudden deaths which have occurred from its use prove it to be an 
unsafe agent, and it is now seldom employed by careful surgeons. 
Taken internally it is sedative and narcotic ; applied externally, com- 
bined with other articles, it is useful in painful affections, as nervous 
headache, rheumatism, neuralgia, etc. The dose when taken inter- 
nally is from ten to twenty drops, in flax-seed tea. 

Cinnamon. — This is the bark of trees growing in Ceylon, Mala- 
bar, and Sumatra. It is a very grateful aromatic, being warm and 
cordial to the stomach ; it is also carminative and astringent. 

It is not often prescribed alone, but is chiefly used as an aid to less 
pleasant medicines, and enters into a great number of preparations. 
It is peculiarly adapted to diarrhoea ; and in treating this complaint 



830 MEDICINES AND THEIR PREPARATIONS. 

it is often joined with chalk and astringents. Dose of the bark, from 
ten to fifteen grains. The oil has properties similar to those of the 
bark. 

Cleavers ( G-alium Aparine). — An annual plant, common to this 
country and Europe, having an acid, astringent taste. The whole 
herb is used in infusion, as a cooling diuretic, in scalding of the urine, 
inflammation of the kidneys and bladder, in gravel, suppression of 
the urine, etc. 

It is also used in fevers and all acute diseases. The infusion is 
made by adding two ounces of the herb to a pint and a half of warm 
water. It should stand three or four hours, and be drunk freely when 
cold. Equal parts of elder-blows, cleavers, and maiden-hair, infused 
in warm water, make a refreshing drink in scarlet fever and other 
eruptive diseases. 

Cloves QCaryophyllus Aromaticus) . — The flowers of this tree, a 
native of tropical climates, collected before they are fully developed, 
form cloves. They are highly stimulant and aromatic, and are used 
to give tone to the digestive organs, particularly when flatulency 
exists, and to relieve nausea and vomiting. They are more generally 
employed to improve the taste and modify the action of other medi- 
cines. The dose in powder is from five to eight grains. The oil of 
cloves has similar properties ; dose, one to three drops. A little cot- 
ton moistened with the oil, and pressed into a decayed tooth, will 
frequently relieve the toothache. 

Cochineal {Coccus Cacti). — An insect found in Mexico, inhabit- 
ing different species of cactus. They are gathered for use by detach- 
ing them from the plant with a blunt knife, and dipping them, en- 
closed in a bag, into boiling water. Cochineal is anodyne, and has 
been used with advantage in whooping-cough and neuralgia. It is 
much used for coloring tinctures and ointments, and the color called 
carmine is prepared from it. A tincture is prepared by macerating 
two ounces of cochineal in one pint of alcohol for seven days, and 
filtering through paper. Dose, from twenty to twenty-five drops, 
twice a day. 

Cod=Liver Oil {Oleum Morrhuca). — This is obtained from the 
livers of codfish, and is nutritive and alterative. It is a popular rem- 
edy in consumption and scrofula, and in those complaints generally 
in which there is impaired digestion, assimilation, and nutrition. 
Dose, a tablespoonful three times a day. 

Inability to digest this oil, to eat fat meats, or to take fats in any 
form, is an unfavorable indication in consumption. 

Collodion. — This is gun-cotton dissolved in ether. It is applied 
with a camel's-hair brush, to cuts, burns, wounds, leech-bites, etc., 
over which it forms a thin pellicle or skin, protecting the injured part 
from the atmosphere. It should be kept in well stopped bottles, to 
prevent its evaporating and becoming unfit for use. 



MEDICINES AND THEIR PREPARATIONS. 831 

Colocynth ( Cucumis Colocynthis) . — A native of northern Africa. 
The part used in medicine is the fruit deprived of its rind. It is a 
powerful drastic, hydragogue cathartic ; causing, by its harsh action, 
griping, vomiting, and sometimes bloody discharges ; from the severity 
of its operations, it is rarely used alone. Useful in dropsy, derange- 
ments of the brain, and for overcoming torpid conditions of the di- 
gestive and biliary organs. 

Preparations. — Solid extract, dose, two to twenty grains; com- 
pound extract, dose, two to twenty grains. 

Colombo (Oocculus Palmatus). — A perennial climbing plant, 
growing in East Africa, and cultivated in the Isle of France. It is a 
pure, bitter tonic, and is used in dyspepsia, bilious vomitings which 
attend pregnancy, and during recovery from exhausting diseases. 

Preparations. — Fluid extract, dose, twenty to thirty drops ; solid 
extract, dose, four to eight grains ; tincture, dose, one to three drams ; 
infusion, dose, three drams to an ounce. A compound infusion made 
by uniting one dram of fluid extract, four drams of orange-peel, and 
one ounce of water, is useful in a weakened state of the bowels, 
showing itself in a diarrhoea. Dose, two drams every hour. Fluid 
extract of Colombo, one ounce ; fluid extract of ginger, two drams, 
and water, one pint, also make a useful compound for. the same pur- 
pose. Fluid extract of Colombo, one dram ; fluid extract of rhubarb, 
one dram ; fluid extract of ginger, half a dram ; water, one pint, — 
this is useful for a like purpose. The following is also a very good 
preparation for a similar use ; fluid extract of Colombo, half an ounce ; 
fluid extract of cascarilla, two drams ; tincture of orange-peel, two 
drams ; syrup of cinnamon, one ounce ; water, six ounces. Dose, one 
dram every hour. 

Coltsfoot (Tussilago Farfara). — A native of Europe, and natural- 
ized in this country, especially in the Northern States. It grows in 
wet places and low meadows. The leaves are principally used. 
They are emollient, demulcent, and slightly tonic ; used in coughs, 
asthma, and whooping-cough ; and externally in the form of poultice 
for scrofulous tumors. 

Comfrey (Symphytum Officinale). — A perennial European plant, 
cultivated in this country. The root is the part used. It is demul- 
cent, and slightly astringent, and is serviceable in diseases of the 
mucous tissues, and in scrofulous habits ; also in diarrhoea, dysen- 
tery, coughs, bleeding from the lungs, whites, etc. It may be taken 
as an infusion, or as a syrup, one ounce to a pint of water ; the dose 
being one to three fluid ounces, three to four times a day. The fresh 
root bruised forms a valuable application to ulcers, bruises, fresh 
wounds, sore breasts, and white swellings. 

Common Silk= Weed (Asclepias Syriaed). — This is a perennial 
plant, common throughout the United States. It gives out a milky 



832 MEDICINES AND THEIR PREPARATIONS. 

juice upon being wounded, and hence is often called milk-weed. 
The root is diuretic, alterative, emmenagogue, and anodyne; and is 
sometimes used in dropsy, retention of urine, suppressed menstrua- 
tion, scrofula, and rheumatism. Dose of the powder, from eight to 
twenty grains ; of the decoction, from one to two fluid ounces. 

Copper (Cuprum). — The following are the principal salts of cop- 
per used in medicine : — 

Subacetate of Copper (Cupri Subacetas). — This is known by the 
name of verdigris, and is used as a detergent and escharotic ; it is 
applied to warts and fungous growths, and to foul ulcers and ring- 
worm. When reduced to a fine powder, by trituration in a porcelain 
mortar, the finer parts of this are separated, and called prepared sub- 
acetate of copper; this is the preparation used for the purposes above 
named. 

Sulphate of Copper (Cupri Sulphas). — In small doses, the sul- 
phate of copper is astringent and tonic ; in large ones a prompt 
emetic. It is given in small doses in hysterics, epilepsy, and inter- 
mittent fevers ; and in large doses, to produce speedy vomiting in 
croup, and to eject poisons from the stomach. A weak solution is 
sometimes used for syphilitic ulcers, and as an injection in gleet. 
Dose, as a tonic, one-quarter of a grain to one grain in pill ; as a 
rapid vomit, from two to five grains, in two ounces of water. The 
medicines which are incompatible with copper, are alkalies, earths 
and their carbonates, borax, salts of lead, acetate of iron, and astrin- 
gent vegetable infusions, decoctions, and tinctures. 

Corrosive Sublimate. — This, in chemical language, is the bichlo- 
ride of mercury. It is one of the milder mercurial" preparations, 
although when taken in large doses, it is a violent poison, and oper- 
ates very quickly. It is less apt to salivate than any other mercurial, 
except blue pill. It is much used as a remedy in syphilis, particu- 
larly in the secondary stage, in which, in many cases, it does much 
good. It is also popular in many skin diseases, as leprosy. When 
employed for this purpose, it is generally associated with alterative 
and diaphoretic medicines, such as the compound decoction or syrup 
of sarsaparilla, preparations of }^ellow dock, etc. In order to avoid 
its irritating effects, it is often united with opium, or extract of con- 
ium. Dissolved in water, it is valuable as a wash in some skin dis- 
eases. It is an ingredient in many of the quack nostrums which are 
extensively advertised. It is the most powerful antiseptic known. 

Cotton (G-ossypium Herbaceum^). — Cotton is chiefly employed in 
cases of recent burns and scalds, — an application of it which sur- 
geons have learned from popular use. It diminishes the inflamma- 
tion, prevents blistering, and hastens the cure. It is applied in thin 
and successive layers. The absorbent should be used. The inner 
bark of the root is said to be emmenagogue, parturient, and abortive. 
It is excellent in chlorosis. 

Preparation. — Fluid extract, dose, three drams. 



MEDICINES AND THEIR PREPARATIONS. 



833 




Fig. 209. Cranesbill. 



Cranesbill (Geranium Maculatum, Fig. 209). — An indigenous 
plant, growing in all parts of the United States, in the open woods. 
The root is the medicinal part. It is a powerful astringent, similar 
to kino and catechu, and a valuable substi- 
tute for those articles, because less expensive. 
It forms an excellent gargle in sore throats 
and ulcerations of the mouth, and is valuable 
for treating those discharges arising from de- 
bility, after the exciting causes are removed. 
It has no unpleasant taste, and is therefore 
well adapted to infants and persons of deli- 
cate stomachs. As an injection, it is used in 
gleet and whites. 

Preparations. — Fluid extract, dose, half a 
dram to a dram ; solid extract, dose, three to 
ten grains ; geraniin, the active principle, 
dose, one to three grains ; tincture, dose, two 
and a half to three drams ; infusion, dose, one 
to two ounces. A valuable astringent wash 

for sore mouth, etc., and as an injection in leucorrhoea, etc., is made 
by uniting fluid extract of cranesbill, half an ounce ; fluid extract of 
black cohosh, half an ounce ; fluid extract of golden seal, half an 
ounce ; fluid extract of witch-hazel, half an ounce ; and water, one 
quart. Geraniin, dioscorein, and caulophyllin, united in equal parts, 
and given to an adult in six-grain doses, every fifteen or twenty min- 
utes, have an excellent effect in diarrhoea and cholera-morbus, when 
there is much pain and rumbling of the bowels. 

Crawley ( Corallorhiza Odontorhiza). — A perennial plant, growing 
on barren hills and hard clay soils in New York. The root is the 
part used. It is sedative and diaphoretic, and is used in inflamma- 
tory diseases, and in typhoid fever; also in flatulency, cramps, hectic 
fever and night-sweats. When the liver requires to be acted upon, 
it should be combined with mandrake or Culver's root. The pow- 
dered root should be kept in well-stopped vials; its dose is from 
twenty to twenty-five grains, in warm water, every hour or two. 

Creosote (Creosotum). — This is obtained by the distillation of 
tar. It is irritant, narcotic, styptic, antiseptic, and moderately escha- 
rotic. It has been given in diabetes, epilepsy, hysterics, neuralgia, 
bleeding from the lungs, and chronic bronchitis. It is an excellent 
remedy for arresting nausea and vomiting, when not dependent on 
inflammation. The dose, when given internally, is one or two drops. 
It is most easily taken in the form of pill. In some forms of bron- 
chitis, the vapor of creosote is inhaled with advantage. It may some- 
times be applied with excellent effect, to indolent or ill-conditioned 
ulcers, in which case, two, four, or six drops may be dissolved in an 
ounce of distilled water. In some cases the solution is mixed with 



834 MKDICINES AND THEIR PREPARATIONS. 

poultices. One or two drops of pure creosote, introduced into a hol- 
low tooth on a little cotton, is generally a speedy remedy for tooth- 
ache, but great care must be taken that it does not come in contact 
with the tongue or cheek. 

Croton Oil {Oleum Tiglii). — This is obtained from the seeds of 
the Croton Tiglium, a plant growing in the East Indies. It is a 
powerful cathartic, producing watery stools, and is used in torpidity 
of the bowels, dropsy, apoplexy, mania, inflammation of the brain, 
hydrocephalus, coma, and wherever a powerful revulsive action is 
needed to call the blood away from the brain. A drop placed on the 
tongue of a person in the comatose state, will generally operate. Two 
to six drops, rubbed upon the skin, produce an eruption of pimples 
in twelve hours. In this way, it is used in diseases of the throat and 
chest, and some other affections. If the skin is very sensitive, let it 
be combined with an equal quantity of sweet oil. Use only under 
the direction of a physician. 

Cubebs (Cubebce). — A climbing perennial plant, growing in the 
East Indies. The berries are the medicinal part. They are stimu- 
lant, purgative, and diuretic, acting particularly upon the urinary 
organs and arresting discharges from the water-pipe, and much used 
in the treatment of gonorrhoea and gleet. It should not be used dur- 
ing active inflammation. Dose of powdered cubebs, from thirty to 
forty grains. 

Preparations. — Fluid extract, dose, half a dram to a dram and a 
half ; ethereal fluid extract, dose, one to two drams ; solid extract, 
dose, two to twenty grains ; tincture, dose, one to two drams. A 
compound, made of fluid extract of cubebs, five drams ; fluid extract 
of ergot, one and a half drams; cinnamon water, half a dram ; and 
powdered loaf-sugar one dram, may be taken with advantage in 
gonorrhoea, gleet, and leucorrhcea ; dose, one dram. 

Culver's Root (Leptandra Virginica.) — A perennial plant growing 
throughout the United States in limestone districts, and flowering in 
July and August. The root is the medicinal part. It is frequently 
called black root. When dried, it is tonic, cholagogue, and laxative, 
and is a very valuable remedy in affections of the liver, as it acts 
upon this organ with energy, without purgation. It is also useful 
in typhoid fevers, and in dyspepsia, diarrhoea, and dysentery. A 
powder is made from it, containing its active principle, and called 
leptandrin, which has a fine effect in diarrhoea, cholera infantum, ty- 
phoid fever, some forms of dyspepsia, and in all diseases connected 
with derangements of the liver. 

Preparations. — Fluid extract, dose, one-third of a dram to a dram : 
leptandrin, the active principle, dose, in acute cases, one-fourth of a 
grain to one grain; in chronic cases, one to two grains: tincture, two 
ounces to a pint of alcohol, dose, one dram to one-half ounce. 



MEDICINES AND THEIR PREPARATIONS. 



835 



Dandelion (Taraxacum, Dens Leonis.) — This perennial herb is 
diuretic, aperient, and tonic, It is generally thought to act especially 
upon the liver. Used in dyspepsia, diseases of the liver and spleen, 
and in debilitated and irritable conditions of the stomach and bowels. 

Preparations. — Fluid extract, dose, one to two drams ; compound 
fluid extract, dose, one to two drams ; fluid extract of dandelion and 
senna, dose, one to two drams ; solid extract, dose, ten to fifteen 
grains; infusion, two ounces to one pint of water, dose, four to five 
ounces. In dropsical affections, the following compound infusion 
will be found useful : fluid extract of dandelion, six drams ; fluid 
extract of rhubarb, one and a half drams ; fluid extract of henbane, 
twenty-four drops ; bicarbonate of soda, half a dram ; tartrate of 
potassa, three drams ; water, three and a half ounces ; take one-third, 
three times a day. For jaundice and diseases of the liver and kid- 
neys, the following pills have mucli efficacy: Solid extract of dande- 
lion, one dram; solid extract of bloodroot, one dram; leptandrin, one 
scruple ; podophyllin, five grains ; oil of peppermint, five minims ; to 
be divided into fifty pills, and one or two taken three times a day. 

Deadly Nightshade. — (Atropa Belladonna, Fig. 210). — A per- 
ennial plant, growing in Europe and this country, and having a faint 
odor, and a sweet, nauseous taste. It is narcotic, diaphoretic, and 
diuretic ; is a valuable remedy in convulsions, neuralgia, whooping- 
cough, rheumatism, gout, paralysis, and many diseases having their 
seat in the nervous system. It has been much praised as a preventive 
of scarlet fever, though its powers for this purpose are doubtful. 

Preparations. — Fluid extract, dose, five to eight drops ; solid 
extract, dose, one quarter to one grain ; tincture, two ounces to a pint 
of diluted alcohol; dose, from thirteen to thirty drops. The solid 
extract is used, mixed with lard or with other substances, as a local 
application for relieving pain, dilating the pupil of the eye, for re- 
moving stricture of the urethra, the anus, rigidity of the mouth of 
the womb, etc. 




Fig. 210. Deadly Nightshade. 




Dogwood. 



Dogwood QCornus Florida, Fig. 211). — This is a small tree 
growing most abundantly in the Middle States. The bark is used 
as a medicine. It is tonic, astringent, antiperiodic and stimulant. 



836 MEDICINES AND THEIR PREPARATIONS. 

It increases the frequency of the pulse and elevates the temperature 
of the body. It has been substituted for Peruvian bark in inter- 
mittent fevers. Dose of the powdered bark, from ten to sixty grains. 
Preparations. — Fluid extract, dose, half a dram to two drams; 
solid extract, dose, live to eight grains ; tincture, four ounces to a 
pint of alcohol, dose, one to three drams; infusion, two ounces to a 
pint of water, dose, half an ounce to two ounces; cornin, the active 
principle, dose, one to eight grains. 

Dwarf Elder (Aralia Hispida). — A perennial under-shrub, grow- 
ing from New England to Virginia. The bark of the root is diui-etic 
and alterative. An infusion made from it is used in gravel, suppres- 
sion of the urine, and dropsy; to be taken in wineglassful doses, 
three or four times a day. 

Elder (Sambucus Canadensis). — The flowers, berries and inner 
bark of the elder are used in medicine. A warm infusion of the 
flowers is diaphoretic, and gently stimulant. A cold infusion is diu- 
retic, alterative and cooling ; used in erysipelas, liver affections of 
children, rheumatism, scrofula, and some syphilitic diseases. The 
bark, pounded with lard, forms a useful ointment for burns and 
scalds, and some diseases of the skin. 

Elecampane (Inula Selenium). — This perennial plant is a native 
of Europe and Japan, and is cultivated in this country. The root is 
stimulant, tonic, diuretic and expectorant, and is used in chronic 
affections of the lungs and air-passages. It is said a decoction from 
the root forms a good application for the itch and other skin diseases. 
Dose of the powdered root, from a scruple to a dram; of the infusion, 
one fluid ounce 

EIectro=Magnetism. — Within a few years, electro-magnetism has 
been employed extensively as a remedial agent, particularly in the 
various forms of nervous disorders. That it is a valuable agent in the 
treatment of disease, few thinking physicians doubt ; yet, like most 
other new things in medicine, it has had its enthusiastic admirers, 
who have claimed for it remedial powers beyond what it really has, 
and who have applied it to purposes beyond its sphere of usefulness. 

Feverfew (Pyrethrum Parthenium). — In warm infusion, this herb 
is valuable in recent colds, flatulenc}', worms, irregular menstruation, 
hysterics, and suppression of the urine. The cold infusion is a 
tonic. A poultice made of the leaves soothes and alleviates pain. 

Figwort (ScropJndaria Nodosa). — The leaves and root are diu- 
retic, alterative, and anodyne, and in some places are used in liver 
complaints, scrofula, dropsy, and diseases of the skin. Applied 
externally in the form of ointment, or fomentation, it is said to be 
useful in piles, painful tumors, bruises, ringworm, and inflammation 
of the breasts. Dose of the infusion, from two to three fluid ounces, 
three times a day. 



MEDICINES AND THEIR PREPARATIONS. 



837 




Flaxseed (Linum Usitatissimum). — This is demulcent and nutri- 
tive, and is much used in coughs, bronchial diseases, inflammation of 
the urinary organs, bowels and lungs; chiefly taken in the form of 
flaxseed tea. The infusion is sometimes used as an injection in dys- 
entery and piles. Linseed oil is prepared from flaxseed. 

Foxglove (Digitalis Purpurea, Fig. 212). — A biennial plant, grow- 
ing in the temperate parts of Europe. The leaves, 
in proper doses, are sedative and diuretic, reducing 
the pulse, and increasing the flow of urine. In 
large doses, they are a narcotic poison. The medi- 
cine has been much used in . inflammatory diseases, 
palpitation of the heart, and in dropsy connected 
with diseased heart or kidneys. When taken for 
some time, it is liable to accumulate in the system, 
and suddenly to manifest poisonous and alarming 
symptoms, as if a large dose had been taken. The 
American hellebore is sometimes used in its place. 

Dose of the powdered leaves of foxglove, from 
one to three grains ; of the tincture, from eight 
to ten drops. 

Frostweed ( HeliantJiemum Canadense). — This 
■u-Lii t_.li £ i • j. Fig. 212. Foxglove. 

herb, also known by the name ot rockrose, is tonic, 

astringent, and alterative, and has been considerably used in scrofula; 
combined with turkey-corn and queen's-root, it is said to have effected 
cures in secondary syphilis. A decoction forms a useful gargle in 
ulcerations of the mouth and throat in scarlet fever and other dis- 
eases, and as a wash in scrofulous inflammation of the eyes. Dose of 
the fluid extract, one to two drams, three or four times a day. 

Galls. — These are the unhealthy excrescences found growing on 
the young boughs of the dyer's oak, Quercus infectoria, growing in 
Asia. They are powerfully astringent. In the form of infusion, or 
decoction, made in the proportion of half an ounce to a pint of water, 
they are useful as an astringent gargle, wash, or injection ; and finely 
powdered galls, one part to eight parts of lard, make a valuable oint- 
ment for bleeding piles. Dose of powdered galls, from ten to fif- 
teen grains. 

Gamboge. — The hardened juice of trees growing in Siam and 
Cochin China. This gum-resin is a hydragogue cathartic, acting 
severely and harshly upon the bowels, and hence is not often used 
alone. On account of the severity of its action, it is improper to use 
it during inflammation of the stomach or bowels, piles, pregnancy, 
diseased womb, or excessive menstruation. Combined with cream of 
tartar and jalap, it is a valuable remedy in dropsy. The dose is one 
or two grains. 

Garlic (Allium Sativum). — The bulb is the part used. It is stim- 



838 



MEDICINES AND THEIR PREPARATIONS. 



ulant, diuretic, expectorant, and rubefacient; useful in coughs, 
hoarseness, whooping-cough, and in the nervous spasmodic coughs of 
clrildren. Dose, from twenty grains to three drams ; dose of the 
juice, mixed with sugar, half a teaspoonful to a teaspoonful. 

The bruised bulbs are sometimes usefully applied as a poultice to 
the chests of young children having inflammation of the lungs, and 
as drafts to the feet in inflammation of the brain, fevers, etc. 

Gentian {G-entiana Luted), — It grows among the Alps, Apennines, 
and Pyrenees. The root is the part used, and is brought to this 
country from Germany. This medicine has long maintained its rep- 
utation, having, it is said, derived its name from Gentius, king of 
Illyria. It is a pure and simple bitter, exciting the appetite and 
invigorating the digestive powers. It may be used in all cases 
dependent on pure debility. It is much employed in dyspepsia, and 
during recovery from exhausting diseases. 

Preparations. — Fluid extract, dose, half a dram to a dram ; com- 
pound fluid extract, dose, half a dram to a dram ; solid extract, dose, 
three to ten grains ; tincture, four ounces to one pint of diluted 
alcohol, dose, two to three drams. A valuable preparation is made 
by uniting fluid extract of rhubarb, two ounces ; fluid extract of 
gentian, half an ounce ; diluted alcohol, two pints ; dose, half an 
ounce to an ounce. 

Ginger [Zingiber Officinale). — This is a native of Hindostan, and 
is cultivated in all parts of India. The root is the part used. It is 
a grateful stimulant and carminative, and is much used for dyspep- 
sia, wind in the stomach, colic, gout, etc. It is an excellent addition 
to bitter infusions, and is much used to disguise the taste of nauseous 
medicines. Dose, from ten to twenty grains. 

Preparations. — Fluid extract, dose, half a dram to a dram ; tincture, 
four ounces to one pint of diluted alcohol, dose, two to four drams ; 
infusion, dose, one to two ounces ; syrup, dose, one to two drams. 

Ginseng {Panax Quinquefolium, Fig. 213). — A perennianl plant, 
growing in the Middle and Southern States. It is 
a mild tonic and stimulant, and has some reputa- 
tion for improving impaired appetite, and for ner- 
vous debility, weak stomach, etc. Some persons 
are in the habit of chewing it, and it is consid- 
erably used in this way. Dose of the powdered 
root, from ten to forty grains ; of the infusion, from 
two to three fluid ounces. 

Glycerin. — This is the sweet or sugary portion 
of oils, and is obtained from them during the man- 
ufacture of lead plaster. It is demulcent and an- 
fig. 213. ginseng, tiseptic, and has been recently recommended and 
used to some extent in place of cod-liver oil, in 
consumption. It has been still more used, however, as a soothing 




MEDICINES AND THEIR PREPARATIONS. 839 

and emollient external application in skin-diseases, and also in place 
of lard in the preparation of ointments. 

Gold. — The chief salt of gold used in medicine is the chloride or 
muriate of gold and soda. It is diuretic and alterative. It is used 
in scrofula, skin diseases, goitre, scirrhous tumors, ophthalmia, dropsy 
and syphilis. Also in the Keeley cure for inebriates. It will, in 
many cases, take away the craving for liquor, but we think there is 
great danger of the patient becoming insane and having a desire to 
commit suicide. The dose is from one-thirtieth to one-twelfth of a 
grain, and is given dissolved in water, or made into pill with starch 
or gum-arabic. 

Golden Seal (Hydrastis Canadensis, Fig. 214). — A perennial plant, 
growing throughout the United States, par- 
ticularly in the West. The root is the me- 
dicinal part. It is a tonic, having especial 
action upon diseased mucous tissues, and is 
particularly beneficial during rec6very from 
exhausting diseases. It is used in dyspepsia, 
chronic affections of the nervous coats of the 
stomach, erysipelas, and remittent, intermit- 
tent and typhoid fevers. United with gera- 
nium, it has a fine effect in chronic diarrhoea 
and dysentery. 

Preparations. — Fluid extract, dose, half 
a dram to two drams ; solid extract, dose, 
two to three grains ; hydrastin (resinoid), 
dose, one-half to three grains ; hydrastin 
(neutral), dose, two to five grains; hydras- 
tina (alkaloid), dose, one to three grains ; 
tincture, three ounces to one pint of dilut- 
ed alcohol, dose, from half an ounce to an FlG - 214 ; GoLDEN SEAL - 
ounce. For various forms of sore mouth and ulcerated sore throat, 
the following is a useful gargle : fluid extract of golden seal, half 
an ounce ; fluid extract of blue cohosh, half an ounce ; fluid ex- 
tract of witch-hazel, half an ounce ; pulverized alum, one dram ; 
honey, three drams ; water, one pint. As a stimulant for a sluggish 
liver, and as a tonic in enfeebled mucous membrane in epidemic dys- 
entery, and other complaints, the following powders are valuable : 
hydrastin, twenty grains ; leptandrin, twelve grains ; podophyllin, 
two grains ; pulverized cayenne, two grains ; sugar of milk, or pul- 
verized loaf-sugar, one dram ; rub together thoroughly in a mortar, 
and divide into twenty powders ; give one every two hours. 

Ground Ivy (JVepeta Gleehoma). — A perennial herb, common to 
the United States and Europe ; in some places known as i/ill-over-the 
ground. The leaves are the part used, which are stimulant, tonic. 




840 MEDICINES AND THEIR PREPARATIONS. 

and pectoral ; considered useful in jaundice, asthma, and diseases of 
the kidneys and lungs. 

Quaiacum. — This medicine is the shavings or chips of the wood 
of a tree growing in the West Indies, also resin obtained from the 
same tree. It is stimulant and alterative, and is used in chronic 
rheumatism, diseases of the skin, scrofula, and venereal complaints. 
The tincture of the resin is valuable as an emmenagogue. Dose of 
the tincture, from one-half to two teaspoonfuls, to be taken with 
milk. The wood is much used as an ingredient in alterative prepar- 
ations of sarsaparilla, etc. 

Gum- Arabic. — This is the hardened sap of trees growing in 
Egypt, Arabia, and other tropical countries, being several varieties 
of the acacia. It is demulcent, and a combustive nutritive, and is 
much used in forming mixtures for hoarseness, cough, sore throat, 
gonorrhoeea, inflammation of the bladder, strangury, bronchitis, and 
irritations of mucous membranes generally. Mucilage of gum-arabic 
is a preparation made by dissolving four ounces of powdered gum in 
a pint of boiling water. 

Gum, Hemlock This is the hardened juice of the hemlock, Abies 

Canadensis, a tree growing in Canada and Maine. This gum is a 
mild rubefacient, and like burgundy pitch, chiefly used to make plas- 
ters, etc., for which purpose it is very valuable. A tincture of the 
gum is diuretic and stimulant. The oil of hemlock is valuable, in 
combination with other oils, in preparing liniments. The bark is 
astringent, and is much used in tanning leather. 

Haemastasis. — This word is used to imply the retention of the 
venous blood in the limbs by ligatures. A cord or common handker- 
chief is tied round the upper part of the arms, or thighs, and a piece 
of wood being slipped under the cord, is twisted round until the cord 
is so tightened as to prevent the return of the venous blood, but not 
to prevent the outward passage of the arterial blood. In this way, 
the blood passing out continually in the arteries, and not returning 
by the veins, the vessels of the limbs become filled to their utmost 
capacity, and a great quantity, for the time being, is withdrawn from 
the trunk. This process is useful in bleedings from the lungs, stom- 
ach and womb, and inflammation of the brain, lungs, bowels, etc., 
and in whatever case it may be thought desirable, for the time being, 
to lessen the blood in the head or trunk, without debilitating the 
patient. 

Hair-cap Moss (Polytrichum Juniperum). — An evergreen plant 
growing on poor, sandy soils in the Northern States. A strong infu- 
sion of it is powerfully diuretic. In dropsical cases, two fluid ounces 
of the infusion should be taken every half hour. It is useful in 
fevers, inflammations, gravel, etc. 



MEDICINES AND THEIR PREPARATIONS. 



841 




FIG. 215. 

Hardhack. 



Hardback (Spircea Tomentosa, Fig. 215). — This is a beautiful 
shrub, common in the United States. Its leaves are of a dark green 
color above, and white underneath. It is tonic and as- 
tringent, and is much used in chronic diarrhoea, cholera 
infantum, etc. It agrees well with the stomach, and is 
deservedly a popular remedy in summer complaints of 
children. 

A fluid extract of it is the best preparation ; dose, four 
to twenty drops. It is much used in the form of infusion. 
The green herb boiled in milk forms a valuable preparation 
in chronic diarrhoea, when attended with much debility. 

Hardleaf Golden=Rod (Solidago Rigida). — A peren- 
nial plant, growing throughout the United States, espe- 
cially on the western prairies. It is tonic, astringent and 
styptic, and useful to arrest bleeding from, the nose, lungs, 
stomach, and bowels. The powder and infusion are used, 
both externally and internally. 

Helonias {Helonias Dioica) . — This herb is common in the United 
States, and is known by the name of false unicorn plant. The root, 
which is the part used, is tonic, diuretic, and vermifuge. In large 
doses it is emetic, and when used fresh, sialagogue. In five or seven 
grain doses, three times a day, it relieves dyspepsia, restores the appe- 
tite, expels worms, and relieves colic. It is a valuable womb-tonic, 
gradually removing debility of that organ, and curing whites, pain- 
ful menstruation, and a tendency to habitual abortion. Dose of the 
decoction, from two to four fluid ounces. The decoction is said to 
kill insects, bugs, etc. 

Preparations. — Fluid extract, dose, one to three drams ; helonin, 
the active principle, dose, one-fourth to one-half a grain. 

Henbane (Hyoscyamus Niger, Fig. 216). — This plant grows abund- 
antly in Great Britain, and on the continent 
of Europe, and is rare in this country. All 
the parts are active. It is narcotic, gently ac- 
celerating the circulation, increasing the gen- 
eral warmth, occasioning a sense of heat in 
the throat, and after a time inducing sleep. 
It is often used in the place of opium, because 
it does not bind the bowels. Used in rheu- 
matism, gout, bronchitis, asthma, consump- 
tion, whooping-cough, hysterics, and spas- 
modic affections generally. 

Preparations. — Fluid extract, dose, ten to 
fifteen drops ; solid extract, dose, half a grain 
to a grain ; tincture, two ounces to one pint 
of diluted alcohol, dose, half a dram to a dram; hyoscyamin, the ac- 
tive principle, dose, one-eighth to half a grain. In neuralgia, rheum- 




Henbake. 



842 



MEDICINES AND THEIR PREPARATIONS. 



atism, St. Vitus's dance, painful menstruation, etc., the following 
may be funnel useful : solid extract of hyoscyamus, two drams ; solid 
extract of valerian, two drams ; solid extract of aconite, one dram; 
sulphate of quinia, one dram. Mix, and divide into two-grain pills ; 
one pill every two or three hours. 

High Cranberry ( Viburnum Opulus). — This shrub grows in rich 
soils in Canada, and in the northern United States. The bark, which 
is the medicinal part, is antispasmodic, being used in cramps, spasms, 
asthma, hysterics, and is useful for those who are subject to convul- 
sions during pregnancy, and at the time of childbirth. It is popularly 
known by the name of cramp-bark. A decoction or infusion of the 
bark may be used in tablespoonful doses, two or three times a day. 
Dose of the extract, from one to three grains ; in womb troubles, it 
may be united with caulophyllin, cimicifugin, aletridin, senecin, and 
asclepidin ; and in flatulent colic, spasmodic pains of the stomach 
and bowels, it may be combined with dioscorein. 

Horehound {Marubium Vulgare, Fig. 217). — This well known 
perennial herb is a native of Europe, and has be- 
come naturalized in this country. It is tonic, ape- 
rient, pectoral, and sudorific. It is deservedly 
popular in domestic practice, for colds, asthma, 
throat-ails, bronchitis, and other pectoral affections, 
attended with cough. It is much used in candy. 

Preparations. — Fluid extract, dose, half a dram 
to one dram ; solid extract, dose, five to eight 
grains ; tincture, two ounces to one pint of alcohol, 
dose, half an ounce to an ounce ; syrup, three 
ounces fluid extract to one pint of simple syrup, 
dose, three to five drams. 

Hops (Humulus Lupulus). — The cones of this 
well-known plant are tonic, hypnotic, antilithic, 
and anthelmintic. They are chiefly used for pro- 
moting sleep, and relieving pain and irritability of 
the nervous system. Hops are valuable in the form of fomentation, 
either alone or in combination with boneset and other bitter herbs. 
An ointment of hops and stramonium leaves is sometimes used in 
salt-rheum, and upon painful tumors and ulcers. A pillow stuffed 
with hops, dipped in hot water, and placed under the head of the 
patient, relieves pain and procures sleep. 

Lupulin is the yellow powder obtained by threshing the hops, and 
is preferable to the hop itself. It is a powerful antaphrodisiac, com- 
posing the genital organs, and quieting painful erections, in gonor- 
rhoea, etc. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, five to fifteen grains; tincture, two and half ounces to 
one pint of alcohol, dose, three to five drams ; infusion, four drams to 




Fig. 217. 
Horehound. 



MEDICINES AND THEIK PREPARATIONS. 843 

one pint of water, dose, two to three ounces ; lupulin, dose, six to eight 
grains ; tincture of lupulin, two ounces to one pint of alcohol, dose, 
one to Wo drams, in sweetened water ; fifteen to twenty grains of 
lupulin, well rubbed up with white sugar in a mortar, is very effica- 
cious in priapism, chordee, and spermatorrhoea. 

Horsemint QMonarda Punctata). — This well-known plant, which 
is common to the United States, is stimulant, carminative, and diu- 
retic. A warm infusion may be used in flatulence, nausea, and vom- 
iting. If the body be kept cool while taking it, it will act as a diu- 
retic. The oil of horsemint is used for similar purposes with the 
plant. Dose, from two to five drops on sugar. Dose of the essence, 
from ten to twenty drops in sweetened water. The oil is frequently 
used as an ingredient in liniments. 

Horseradish QCochlearia Armor acid). — The fresh root of this 
well known perennial is stimulant, diuretic, antiscorbutic, and rube- 
facient. It is useful in rheumatic, paralytic, scorbutic, dropsical, and 
dyspeptic affections. It is said that a warm infusion of the fresh root 
in cider, drunk freely every night, will cause perspiration and a free 
flow of urine, and will consequently cure dropsy. The fresh root 
grated in vinegar, and eaten with meat at dinner, strengthens the 
stomach and promotes digestion. 

Houseleek (Sempervivum Tectorum). — The bruised leaves of this 
perennial form a cooling application to burns, stings of insects, ery- 
sipelas, and other inflammations ; valuable also for ringworm, shin- 
gles, and other skin diseases. 

Hydrangea (Hydrangea Arborescens) . — This grows abundantly 
in the Southern, Middle, and Western States. Its root is medicinal. 
It is diuretic, and has been much praised for its power of relieving 
the excruciating pain caused by the passage of stone through the 
urethra, as well as for infallibly removing such stones from the blad- 
der, provided they are not already too large for passage through the 
water-pipe. A concentrated decoction or the fluid extract may be 
taken in teaspoonf ul doses several times a day, — care being taken 
not to push the medicine to the extent of dizziness or oppression of 
the chest. 

Hyssop (Hyssopus Officinalis.) — This is a native of the continent 
of Europe, and is cultivated in this country. The tops and leaves 
are the parts used. They are stimulant, aromatic, carminative, and 
tonic. The infusion has been much employed in chronic bronchitis 
of old people, and those of debilitated habits. It makes the raising of 
mucus more easy. The infusion may be combined with sage and 
alum, and sweetened with honey. The fresh leaves bruised, and 
applied externally, relieve the pain and disperse the spots and marks 
caused by contusions. 



S44 MEDICINES AND THEIR PREPARATIONS. 

Iceland floss (Cetraria Islandica). — This plant is found in the 
northern latitudes, both of the old and new world, and is abundant 
on the mountains and in the sandy plains of New England. It re- 
ceived its name from its prevalence in Iceland, in which country, as 
well as in Lapland, it serves, in consequence of the gum and starch 
it contains, as food for the inhabitants. It is demulcent, tonic, and 
nutritious, and is well fitted to relieve affections of the mucous mem- 
branes of the lungs and bowels, connected with debility of the diges- 
tive organs; it is given therefore in 'chronic bronchitis and other 
affections of the chest, attended with copious expectoration, especially 
when the matter discharged is purulent; also in dyspepsia, chronic 
dysentery, and diarrhoea. It is usually employed in the form of de- 
coction; and is much used in the common article of diet called 
blanc-mange. 

Ice-Plant (Monotropa Uniflora). — This perennial plant, found in 
various parts of the country, is snow-white, resembling frozen jelly, 
and is juicy and tender, dissolving in the hands like ice. The flowers 
are in shape like a pipe; hence it is called the pipe-plant. The root 
is the medicinal part, and is tonic, nervine, and antispasmodic. It 
has also been considered sedative and diaphoretic ; and the powder 
has been sometimes used in the place of opium. It is said to be 
valuable in epilepsy, chorea, and other spasmodic affections. Dose of 
the powdered root, from thirty to sixty grains, two to three times a 
day. 

Indian Hemp (Apocynum Cannabinum). — This perennial plant 
resembles bitter-root, and grows in similar situations. The root is 
powerfully emetic, and in decoction, diuretic and diaphoretic. It 
diminishes the frequency of the pulse, and produces drowsiness. It 
has great efficacy in dropsy. 

Preparations. — Fluid extract, dose, as a tonic, five to ten drops ; 
as an emetic, twenty to twenty-five drops ; solid extract, dose, one 
to three grains ; tincture, dose, one to two drams, as a tonic, half an 
ounce to an ounce, as an emetic ; infusion, half an ounce to a pint of 
water ; dose, half an ounce to an ounce. 

Indian Turnip (Arum Triphyllum). — This is a perennial plant, 
growing in damp places in North and South America, and known by 
the name of dragon-root. The root when chewed is excessively acrid, 
producing a biting sensation which may be somewhat relieved by 
milk. The fresh root is acrid, expectorant, and diaphoretic, and has 
been used in asthma, whooping-cough, chronic bronchitis, chronic rheu- 
matism, and colic, and externally in scrofulous tumors, scald head, 
and other skin disorders. Dose of the grated root, in syrup or muci- 
lage, ten grains, three or four times a day. 

Iodine {Iodinurn). — This is prepared from the ashes of kelp, or 
sea-weed, and is in small bluish-black, shining scales. It is alterative, 



MEDICINES AND THEIK PREPARATIONS. 845 

tonic, and somewhat diuretic. It has been chiefly employed in dis- 
eases of the absorbent and glandular system, particularly scrofula, 
goitre, and glandular tumors generally. Dose, in substance, half a 
grain, two or three times a day, in form of pill ; in form of tincture, 
three to five drops. 

Iodide of Potassium (Potassii Iodidum). — This is one of the prep- 
arations of iodine, and is sometimes improperly called hydriodate of 
potassa. It is formed by decomposing the iodide of iron by carbonate 
of potassa. It is used for the same purposes as iodine, but chiefly as 
an alterative in tertiary syphilis, for which it is a specific ; also in 
some forms of chronic rheumatism, and in leprosy. Dose of the salt, 
from two to fifteen grains. It is much combined with bitter tinctures, 
and particularly with the compound preparations of sarsaparilla, yel- 
low dock, and queen's-root. The acids and metallic salts are incom- 
patible with it. 

Ipecacuanha. — This is a small perennial plant, growing in moist 
woods, in several countries of South America. The root is the part 
used. It is a very valuable emetic, in large doses ; in smaller doses, 
it is sudorific and expectorant. Used to produce vomiting in the 
commencement of fevers, inflammatory diseases, swelled testicles, and 
before the paroxysms of ague ; and to excite nausea in dysentery, 
asthma, whooping-cough, various hemorrhages, and inflammation of 
the lungs ; and, combined with opium, to produce diaphoresis in 
rheumatism, gout, and febrile complaints. Dose, as an emetic, from 
fifteen to thirty grains ; to excite nausea, from one to three grains ; 
and to produce diaphoresis, two to six grains, with one grain of 
opium. 

Preparations. — Fluid extract, dose, as an expectorant, five to eight 
drops ; as an emetic, half a dram to a dram ; tincture, half an ounce 
to an ounce ; wine of ipecac, three ounces to one pint of sherry wine, 
dose, a quarter to half a dram, as an expectorant; two and a half to 
three drams as an emetic. The following is a useful expectorant for 
young children : fluid extract of ipecac, two drams ; syrup of tolu, 
five drams ; mucilage of gum-arabic, one ounce ; sherry wine, three 
drams, — mix. Dose, one dram. 

Iron (Per rum). — As this is the most abundant, so is it the most 
useful of all the metals. It is widely diffused through the mineral, 
the vegetable, and the animal kingdoms. It is an essential constitu- 
ent in the blood of man, and as a medicine it has great value, being 
a powerful tonic. In most cases where the blood is thin and reduced, 
iron is our best remedy ; it raises the pulse, promotes the secretions, 
and gives color, body, and nutritive qualities to the blood. It is 
much used, in some one of its prepared forms, in chronic anaemia, chlor- 
osis, hysterics, whites, rickets, chorea, dyspepsia, neuralgia, and par- 
ticularly consumption. Care should be taken in using the various 
preparations of iron, not to let the remedy touch the teeth. It is 



846 MEDICINES, AND THEIR PREPARATIONS. 

well to take them, when not in pill form, through a glass tube. The 
following are most of the chemical preparations of iron used in medi- 
cine : — 

Ammonia=Citrate of Iron (Ferri Ammonio Citras). — This is in 
the form of thin scales, of a beautiful garnet-red color, and has a 
slightly acid taste. It is very soluble in water. Its great solubility 
gives it some advantage over the citrate. The dose is five grains, 
three times a da}*, in solution. 

Black Oxide of Iron (Ferri Oxidum Nigrum). — This is a dark, 
grayish-black powder, unchangeable in the air, and having magnetic 
properties. It is a valuable chalybeate, and may be given in five to 
ten-grain doses. 

Citrate of Iron (Ferri Citras). — This is a valuable preparation of 
iron. It is soluble in water. Usually given in the form of pill, in 
two to three-grain doses, three times a day. 

Citrate of Iron and Quinia (Ferri et Quinice Citras). — In the 
form of shining scales, garnet-colored, and soluble in water. An ex- 
cellent antiperiodic and tonic. Given in intermittents, when the 
blood is low, etc. Dose, five to eight grains, two or three times a 
day. 

Citrate of Iron and Strychnia. — It is a valuable preparation, and 
combines the properties of iron and strychnia, and has proved an 
efficacious remedy in atonic dyspepsia, absence of the menses, St. 
Vitus's dance, green-sickness, hysterics, etc. It is a beautiful salt, 
looking like citrate of iron, except that it is a little darker. Three 
grains of the iron are combined with one-sixteenth of a grain of 
strychnia. 

Hydrated Oxide of Iron (Ferri Oxidum Hydration). — This is in 
a reddish-brown, moist mass, not much used in medicine, except as 
an antidote to the poison of arsenic, for which it is very valuable. It 
should be given in tablespoonful doses, often repeated. 

Iodide of Iron (Ferri Iodidum). — The iodide of iron is a crystal- 
line substance, of a greenish-black color and styptic taste. It has 
tonic, alterative, diuretic, and emmenagogue properties. It is em- 
ployed chiefly in scrofulous complaints, swelling of the glands of the 
neck, chlorosis, absence of the menses, and leucorrhcea. In obstinate 
syphilitic ulcers, and in secondary syphilis, occurring in scrofulous 
and debilitated subjects, it has been used with success. Dose, three 
grains, gradually increased to five. It should never be given in the 
form of a pill, but preferably in combination with simple syrup (see 
Syrup of Iodide of Iron). 

Lactate of Iron (Ferri Laetas). — This has the general medicinal 
properties of the ferruginous preparations. It increases the appetite 
in a marked degree, and has been used with decided benefit in chlo- 



MEDICINES AND THEIR PREPARATIONS. 847 

rosis. Dose, one to two grains, three times a day. The dose may 
be gradually increased. Given in the form of solution, pill, or 
lozenge. 

Phosphate of Iron (Ferri Phosphas). — This is a slate-colored 
powder, insoluble in water. It is a valuable remedy in consumption, 
cancer, and nervous diseases, accompanied by a low state of the blood. 
Dose, one or two grains, three times a day. 

Persalt of Iron QMonseVs Styptic). — This is a most valuable 
styptic, and is used with success in restraining violent bleedings. It 
produces no irritant effects upon the tissues, and may be used with 
safety both in slight and extensive surgical operations. Physicians 
should have it by them, and will find it very serviceable in sudden 
emergencies of bleeding. It is prepared in solution and in the form 
of dry salt. The solution is the most convenient and eligible form, 
and may be applied as prepared. 

Powder of Iron (Ferri Pulvis). — This is what is often called iron 
by hydrogen, or QueVenne's iron. It is an impalpable powder, and 
of an iron-gray color. If black, it is worthless. It is used in anaemia, 
and in all those conditions characterized by deficiency of coloring- 
matter in the blood. The best metallic iron for medicinal use. Dose, 
from two to five grains, several times a day ; to be given in the form 
of pill. 

Precipitated Carbonate of Iron (Ferri Subcarbonas.) — This is a 
reddish powder, insoluble in water. It is tonic, alterative, and em-' 
menagogue, and is used in neuralgia, chorea, chlorosis, ansemia, epi- 
lepsy, scrofula, etc. Dose, five to twenty grains, three times a day, 
to be taken in a little water. 

Protoxide of Iron (Ferri Protoxidum). — This is of a dark-blue 
color, and has a tendency to absorb oxygen from the air, which con- 
verts it into the sesquioxide. It is a valuable preparation of iron. 
Dose, from two to five grains, three times a day. 

Solution of Protoxide of Iron. — The protoxide of iron is more 
readily absorbed and assimilated, and agrees better with the stomach 
than any other preparation of this metal. It is prepared in the form 
of a syrup, of which the dose is from one to two teaspoonfuls , three 
times a day. 

Solution Protoxide Iron, with Rhubarb and Colombo. — This is 
a composition of protoxide of iron with vegetable tonics. As a 
remedy in many forms of dyspepsia, it must prove of great value. 

Solution Protoxide Iron, with Quinine. — This has become a 
remedy of established reputation. Quinine combined with iron, par- 
ticularly with the protoxide, must have great advantages as a chaly- 
beate tonic. Each tablespoonful contains half a grain of quinine. 



848 MEDICINES AND THEIR PREPARATIONS. 

Solution Protoxide of Iron, with Iodide of Potassa. — In this 
preparation the valuable alterative properties of iodide of potassium 
are connected with iron. It is therefore alterative and tonic, and 
may be used in scrofulous and other weakened conditions of the sys- 
tem. It is a remedy of decided merit. Three grains of the iodide 
of potassium are contained in each tablespoonful. 

Sulphate of Iron {Ferri Sulphas). — This is in the form of transpa- 
rent crystals, of a pale, bluish-green color, and efflorescent in the air. 
It has a styptic taste, and is soluble in about twice its weight of 
cold water, but insoluble in alcohol. It is astringent and tonic. In 
large doses it produces nausea and griping of the bowels. Useful 
in scrofula and as an astringent in passive hemorrhages, sweats, dia- 
betes, chronic mucous catarrh, leucorrhcea and gleet. As a tonic it 
is useful in dyspepsia. 

Syrup of Iodide of Iron QSyrupus Iodidi Ferri). — This is an 
elegant preparation of iodine and iron, and is given in all debilitated 
conditions of the system, when there is a taint of scrofula. Dose, 
from twenty to sixty drops, well diluted, at the moment of taking, 
with water. 

Syrup of Iodide Iron and flanganese. — This is of a light straw- 
color, prepared from protosulphate of iron, protosulphate of man- 
ganese, and iodide of potassium. It is a remedy of unsurpassed 
efficacy in anaemic, scrofulous, syphilitic, and cancerous affections. 
It is considered superior to the syrup of iodide of iron. Dose, from 
ten to thirty drops. 

Tartrate of Iron and Potassa {Ferri et Potassce Tartras. — This 
is in the form of beautiful shining scales, of a dark ruby color, of a 
slightly chalybeate taste, and very soluble in water. It is one of the 
mildest of the salts of iron, and is considerably used in scrofula, weak- 
ness of the bowels, general debility, etc. It is much used as a remedy 
for syphilis, both externally and internally. The dose is ten to twenty- 
five grains in solution. 

Tincture of Muriate of Iron (Tinctura Ferri Ckloridi). — This 
has a reddish-brown, yellowish color, a sour and very styptic taste, 
and an odor like muriatic ether. It is one of the most active and 
certain preparations of iron, generally agreeing with the stomach, and 
much employed for purposes for which iron is used. It is useful in 
scrofula, gleet, and leucorrhcea ; also in hemorrhages from the womb, 
kidneys, and bladder, of a passive character. Dose, from ten to twenty- 
five drops, gradually increased to one or two drams, two or three 
times a day. It should be given diluted with water. 

Valerianate of Iron. — This salt is in the form of a dark-red pow- 
der, having a faint odor, and a taste of valerianic acid. It is soluble 
in alcohol, and insoluble in water. Given in hysterical affections, 
complicated with chlorosis. Dose, one grain, several times a day. 



MEDICINES AND THEIR PREPARATIONS. 



849 



Isinglass (Ichthyoeolla). — A gelatinous substance, prepared from 
the bladder of fishes. It is soluble in alkaline solutions and diluted 
acids. In boiling it dissolves and forms a jelly upon cooling, in which 
form it is chiefly used as a nutritive diet for the sick. 

Jalap (Ipomaia Jalapa). — This is a Mexican plant. Its root is 
an active cathartic, producing liquid stools, more or less griping. 
United with cream of tartar it becomes a hydragogue, and is useful 
in dropsy. The dose is from fifteen to twenty-five grains. 

Preparations. — Fluid extract, dose, a quarter to one dram ; solid 
extract, dose, three to five grains ; tincture, two ounces to the pint of 
diluted alcohol, dose, one to two drams ; jalapin, the active principle, 
dose, one to two grains. 

Juniper (Juniperis Communis). — This evergreen shrub is a native 
of Europe, and is naturalized in some parts of this country. The 
berries, which are the parts used, are wrinkled, of a dark-purple color, 
about the size of a pea. They are gently stimulant and diuretic, and 
have been used in scurvy and inflammation of the bladder, chiefly in 
connection with more active diuretics. The oil of juniper obtained 
from the berries is used for similar purposes. Five minims of the 
oil mixed with one fluid dram of sweet spirits of nitre, and given 
three times a daj r , is valuable in dropsy. Dose of the berries, from 
one to two drams ; of the oil, from five to ten drops. 

Kino. — This is the hardened juice of an East Indian tree, Ptero- 
carpus Marsupium. There are several varieties of it. It is a power- 
ful and valuable astringent, and is much used in diarrhoea, not 
attended with inflammation. Opium is often united with it, and it 
is a favorite addition to chalk-mixture. It is also used in chronic 
dyseutery, leucorrhoea and diabetes. It may be used in the form of 
powder, infusion, or tincture. Dose of the powder, ten to twenty 
grains ; of the tincture, one or two fluid drams ; the infusion is use- 
ful as an injection in leucorrhoea and gonorrhoea. The powder is 
sometimes sprinkled with advantage on indolent and flabby ulcers. 

Ladies* Slipper (Cypripedium Ifuhescens, Fig. 
218). — The fibrous roots are the parts used of this 
plant. It is tonic, nervine, and anti-spasmodic, and 
is employed in nervous headache, and other ner- 
vous affections, as excitability, hysterics, neuralgia, 
etc. 

Preparations. — Fluid extract, dose, half a dram 
to a dram ; solid extract, dose, five to ten grains ; 
tincture, two ounces to a pint of diluted alcohol, 
dose, half an ounce ; cypripedin, the active prin- 
ciple, dose, two to three grains. The following is 
a useful preparation for producing sleep, in wakeful 
and excited conditions : fluid extract ladies' slipper, 
one ounce ; fluid extract pleurisy root, one ounce ; ladies' slipper. 




850 MEDICINES AND THEIR PREPARATIONS. 

fluid extract skunk-cabbage, one ounce ; fluid extract, scullcap, one 
ounce ; mix : dose, half a dram to a dram, three times a day. 

For sick and nervous headache, dependent on an acid stomach, 
the following is useful: fluid extract ladies' slipper, half an ounce; 
fluid extract catnip, half an ounce ; fluid extract scullcap, half an 
ounce ; water, one pint ; mix ; dose, one and a half to three drams. 

Lead {Plumbum'). — Lead acts upon the system as a sedative and 
astringent. Internally, it is used for the purpose of reducing the 
force of the circulation, and for restraining improper bleeding and 
other excessive discharges. Externally, it is employed to subdue 
inflammation. ' It should not be excessively used, for, if taken in- 
ternally for a long time, it injures the nervous system, and brings on 
apoplexy, palsy, and particularly lead colic. [Nature generally gives 
notice when it is doing mischief, by drawing a blue line around the 
edge of the gums. The preparation of lead chiefly used in medicine 
is the following : — 

Acetate of Lead (Plumbi Acetas). — This is known by the name 
of sugar of lead and is a white salt, crystallized in brilliant needles. 
It has first a sweetish, and then an astringent taste. In medicinal 
doses, it is a powerful sedative and astringent ; in large ones an 
irritant poison. It is principally used internally for bleeding from 
the lungs, bowels, and womb. The dose is generally two grains, 
united with half a grain to a grain of opium, in the form of pill. Ex- 
ternally, it is employed in form of solution and applied to inflamed 
surfaces with cloths. Four grains of sugar of lead and four of pul- 
verized opium to the pint of water, make a good lotion for various 
purposes. 

Lemon (Citrus Limonum). — This is a well-known tropical fruit, 
the juice of which has a grateful acid taste, and is much used in 
fevers and inflammatory complaints, forming the agreeable drink 
called lemonade. The oil of lemon, obtained from the fresh rind of 
the fruit, is chiefly used in perfumery, and to render the taste of 
medicines more agreeable. 

Lettuce (Lactuca Saliva). — The medicinal properties of this 
garden-plant are contained in the milk. It is given when opium 
disagrees with the patient, to allay cough and irritability. It is one 
of the most wholesome vegetables for the table. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
solid extract, dose, two to five grains. The following is a useful 
compound syrup : fluid extract lettuce, two ounces ; fluid extract 
poppy, four ounces ; simple syrup, ten ounces ; mix ; dose, half a 
dram to a dram. 

Life=Root (Senecio Aureus). — This is a perennial plant, growing 
on the banks of marshy creeks in the Northern and Western States, 
and sometimes called ragwort. Both the root and herb are diuretic, 



MEDICINES AND THEIR PREPARATIONS. 851 

pectoral, diaphoretic, and tonic, considerably valued as a remedy in 
gravel and other urinary affections, particularly strangury. It is 
useful for promoting menstrual discharges. 

Preparations. — Fluid extract, dose, half a dram to a dram ; infu- 
sion, dose, one to three ounces; senecin, the active principle, dose, 
three to five grains. For chlorosis, accompanied by absence of the 
menses, the following is a useful preparation: senecin, aletrin and 
sulphate of iron, four grains each. Mix and divide into two-grain 
powders. Six grains each of senecin and geraniin, mixed and taken 
in doses of two to four grains, has a good effect in restraining an 
immoderate flow of the menses. In painful menstruation, the follow- 
ing is a good pill : senecin, two grains ; quinine, six grains ; solid 
extract belladonna, three grains ; make into ten pills, and take one 
every three hours till the pain is subdued. 

Lime (Calx). — This is one of the alkaline earths, and is an abun- 
dant natural production. It is used in several forms in medicine, of 
which the following are the chief : — 

Chloride of Lime (Calx Chlorinata). — This is a moist, grayish- 
white substance, having the odor of chlorine, and possessing powerful 
bleaching properties. Externally used, it is disinfectant, and, dis- 
solved in water, is applied with advantage to ill-conditioned ulcers', 
burns, chilblains and eruptions of the skin ; also as a gargle in putrid 
sore throat, and as a wash for ulcerated gums, and to purify the 
breath. It has been used with advantage in dysentery, both by mouth 
and injection, to correct the fetor of the stools. 

Lime=Water (Aqua Calcis). — This is made by dissolving four 
ounces of lime in a gallon of water, and letting the solution stand 
in a covered vessel, and pouring off the clear liquor when it is wanted 
for use. It is antacid, antilithic, tonic, and astringent, valuable in 
all complaints attended with acidity of the stomach. United with 
milk, and used as the sole diet, it is sometimes the only remedy for 
chronic diarrhoea of long standing. Dose of lime-water, half an 
ounce to an ounce. 

Liquorice (Glycyrrhiza Glabra). — This grows in the south of 
Europe and Asia. The root is the part used. It is demulcent and 
expectorant, and is useful in cough, chronic bronchitis, and irritations 
of the mucous surfaces generally. The pulverized root united with 
an equal amount of sulphur and a little molasses, is a valuable pre- 
paration for coughs. The black extract may be used for the same 
purposes as the root. 

Liverwort QHepatica Americana). — An indigenous plant, growing 
in woods, upon the sides of hills and mountains. The leaves with- 
stand the cold of winter, and the flowers appear early in the spring. 
The whole plant is medicinal. It is a mild demulcent tonic and 




852 MEDICINES AND THEIR PREPARATIONS. 

astringent, and has been used in fevers, liver-complaints, bleeding 
from the lungs, and coughs. 

Preparation*. — Fluid extract, dose, two to three drams ; infusion, 
four ounces to the pint of water, to be taken freely. 

Lobelia (Lobelia Inflata, Fig. 219). — This weed grows throughout 
the United States ; both its seeds and leaves are used in 
medicine. The plant is emetic, expectorant, sedative 
and antispasmodic. As an emetic it is generally 
used in combination with other articles for that pur- 
pose. It is of great advantage in spasmodic asthma, 
as well as in bronchitis, croup, whooping-cough, and 
other throat and chest affections. Whenever relaxa- 
tion is required to subdue spasm, or for other pur- 
poses, lobelia will be found useful. 

Preparations. — Fluid extract, dose, as an ex- 
pectorant, ten to fifty drops ; as an emetic, one-fourth 
of a dram to a dram ; tincture, two ounces to a pint 
of diluted alcohol, dose, as an expectorant, one to 
fig. 2i9. lobelia three drams, as an emetic, half an ounce ; infusion, 
dose, an ounce every half hour till vomiting ensues ; 
lobelin, the active principle, dose, half a grain to a grain and a half. 
The following mixture will be found excellent, as an expectorant 
and sudorific in spasmodic croup, whooping-cough and asthma, and 
for subduing mucous inflammation about the throat and air-passages: 
tincture of lobelia, half an ounce ; tincture of bloodroot, two ounces ; 
oil of spearmint, half a dram ; empyreumatic syrup, five ounces ; 
dose, half a dram every two hours. A poultice made of lobelia, elm- 
bark and weak h~e, relieves sprains, bruises, rheumatic pains, erysip- 
elatous inflammations and poison from ivy or dogwood. 

Logwood (Hcematoxylon Campechianurn) . — This tree is a native 
of tropical America. The wood is used in medicine. It is tonic and 
astringent, and is used with advantage in diarrhoea, dysentery, and 
in the relaxed state of the bowels after cholera infantum. Used 
freely with other treatment, it also benefits constitutions broken down 
by disease or dissipation. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose* five to twenty grains ; infusion, half an ounce to a pint 
of water, dose, four drams every three or four hours, in diarrhoea. 

Magnesia (Magnesia Ustd). — Calcined magnesia is obtained from 
carbonate of magnesia, by exposure to a strong heat. It is a white, 
inodorous, light powder, of a feeble alkaline taste. It is antacid and 
laxative, and is much used in dyspepsia, sick headache, gout, and in 
other complaints attended with sour stomach and costiveness ; like- 
wise a favorite remedy in complaints of children. Dose, as a laxative, 
from thirty to fort} T grains ; as an antacid or antilithic, ten to twenty- 
five grains, once or twice a day. 



MEDICINES AND THEIR PREPARATIONS. 



853 



Carbonate of Magnesia (Magnesia* Carbonas). — This is prepared 
from sulphate of magnesia, by carbonate of soda. It is antacid, and 
when it meets with acid in the stomach and bowels it is laxative. 

Sulphate of Magnesia (Magnesia Sulphas). — Obtained from sea- 
water. This is the well-known Epsom salts and is purgative and 
diuretic. Used in all cases which require purgatives. It generally 
operates without griping, and, when united with an acidulated infu- 
sion of roses, will remain on the stomach when all other things are 
rejected. The less it is diluted the better and more easily it oper- 
ates, provided a draught of warm water be taken an hour afterwards. 
It may be made to act as a diuretic by keeping the skin cool, and 
walking about after it has been taken. 

Male Fern (Aspidium Filix Mas). — This perennial plant is found 
in both Europe and America, also in Asia and northern Africa. The 
root, which is the medicinal part, should be gathered during summer, 
as the active principle is more abundant at that season than any 
other. It is also said to deteriorate by age, and become nearly worth- 
less in two years. It is slightly tonic and astringent, but its chief 
value consists in its power to destroy and expel the tapeworm. 

Preparations. — Solid extract, dose, nine to twelve grains. The 
following compound pills are adapted to the destruction of the tape- 
worm : solid extract male fern, two scruples ; gamboge, fourteen 
grains ; calomel, fourteen grains ; scammony, eighteen grains. Mix, 
and divide into twenty pills. Dose, two to three pills. 

Mandrake (Podophyllum Peltatum, Fig. 220). — This is exclu- 
sively an American plant. The root is the 
medicinal part. It is cathartic, alterative, 
anthelmintic, hydragogue, sialagogue, and, 
in large doses, emetic. It stimulates and 
quickens the action of the liver and kidneys, 
promotes expectoration and determines the 
blood to the surface. Combined with cream 
of tartar, it produces watery stools and is use- 
ful in dropsy. It is used in jaundice, dysen- 
tery, diarrhoea, bilious, remittent, and inter- 
mittent fevers, puerperal fever, typhoid fever, 
and all glandular enlargements. But it has a 
more particular action upon the liver, and is 
especially useful in derangements of that organ. 

The severity of its action seems to be the only objection to its very 
extensive use. Its harshness, however, maybe much lessened by its 
combination with alkalies, ginger, or caulophyllin. 

Preparations. — Fluid extract, dose, half a dram to a dram ; com- 
pound fluid extract, dose, one to two drams ; solid extract, dose, three 
to twelve grains ; tincture, three and a half ounces to one pint of al- 
cohol, dose, one to three drams ; podophyllin, the active principle. 




Fig. 220. Mandrake. 



854 



MEDICINES AND THEIR PREPARATIONS. 



dose, as an alterative, one-eighth to a quarter of a grain ; as a cath- 
artic, one to two grains. 

Manna. — This is the concrete juice of the tree called Omus 
Europcea, growing in Sicily, Calabria, and Apulia, as well as of 
several other species of tree. Manna is a gentle laxative, operating 
mildly, though sometimes producing wind and pain. It is consider- 
ably used as a gentle physic for children and women in the family 
way. The usual way of prescribing it is in connection with senna, 
rhubarb, magnesia, or the neutral salts. Being sweet, it conceals the 
taste of these remedies in some measure, while it adds to their pur- 
gative effect. Dose of manna, for a grown person, from one to one 
and a half ounces ; for a child, from one to four drams, according to 
age. 

Marsh= Rosemary (Statice Caroliniana). — This plant grows on 
the coast from Maine to Georgia. The root of it is the medicinal 
part. A decoction of it is much used in diarrhoea, dysentery, etc., 
also as a gargle in ulcerated sore mouth and the throat affection of 
scarlet fever, and as an injection in gleet, whites, and falling of the 
womb and bowel. Dose of the decoction, one or two tablespoonfuls 
every hour or two. 

Marshmallow {Althaea Officinalis, Fig. 221). — A perennial plant, 
growing in salt marshes and other moist places in 
Europe. The root is the medicinal part, and its 
properties are those of a demulcent. A decoction 
of it is used in irritations and inflammations of 
mucous membranes, as in inflammation of the 
lungs, stomach, bowels and bladder, and some 
affections of the kidneys. The powdered root, 
and also the leaves and flowers, are sometimes 
employed in the form of poultice. 

Mastic. — This is the hardened gum or resin 
which flows from incisions in the small tree or 
shrub pistacia lentiscus, growing upon the borders 
of the Mediterranean. It is not much used in 
medicine, but is chiefly employed in manufactur- 
ing a brilliant varnish. I introduce it here principally for the pur- 
pose of recommending the following use of it in carious teeth, — 
particularly in those new parts of the country where dentistry is not 
much known. Dissolve, in a well-stopped bottle, four parts of 
mastic in one part of sulphuric ether. Saturate with this solution 
a small piece of cotton of the size of the cavity in the tooth, and then, 
having cleansed and dried the cavity, gently press the cotton into it. 
The ether will soon evaporate and leave the gum to attach itself to 
the sides of the tooth, and protect its inner surfaces from the action 
of the air and food. 




Fig. 221. 
Marshmallow. 




Hedge-Musfard. 




MEDICINES AND THEIR PREPARATIONS. 855 

Matico (Piper Angustifolium). — The leaves of this plant are 
styptic and somewhat stimulant and tonic. The leaves brought in 
contact with a bleeding wound, have considerable power to arrest 
the flow of blood. 

Preparations. — Fluid extract, dose, half a dram to a dram ; tinc- 
ture, four ounces to a pint of diluted alcohol, dose, two drams to one 
half ounce ; infusion, half an ounce to a pint of water, dose, one to 
one and a half ounces. 

Meadow~Saffron (Colchicum Autumnale, Fig. 222). — This is a 
native of the temperate parts of Europe, where it 
grows wild in moist meadows. The roots and seeds 
are used. Colchicum is justly regarded as a valuable 
remedy in gout and rheumatism, in which it is much 
and chiefly used. It is thought, also, to act upon the 
nervous system, allaying pain and producing other 
sedative effects. When not carried off by the bow- 
els, it produces sweating, and is occasionally diuretic 
and expectorant. Dose of the dried root, from two 
to eight grains. 

Preparations. — Fluid extract of root, dose, three fig. 

to ten drops ; fluid extract of seeds, dose, five to ten meadow-Saffron. 
drops ; tincture, four ounces to twelve ounces diluted alcohol, dose, 
ten drops to half a dram ; syrup, two ounces to fourteen ounces sim- 
ple syrup, dose, one third of a dram to a dram ; wine, three ounces 
of root to a pint of sherry wine, dose, twenty -five to thirty-five drops. 

Monkshood (Aconite'). — This is anodyne, sedative and diapho- 
retic. The leaves and roots are generally used separately. It is 
useful in inflammatory diseases, neuralgia, epilepsy, paralysis, gout, 
and particularly in fevers. 

Preparations. — Fluid extract, dose, two to five drops ; solid ex- 
tract, dose, one quarter of a grain to a grain ; tincture, eight ounces 
of the root to a pint of alcohol, dose, three to five drops. 

A preparation composed of one dram of the tincture of aconite- 
root, and two ounces of the tincture of black cohosh, and taken in 
doses of one teaspoonful every four hours, has great power in reliev- 
ing the various forms of neuralgia, and also chronic rheumatic pains, 
particularly among old people. 

For nervous headache, irritability, restlessness and wakefulness, 
the following combination of aconite is useful : — 

Solid extract of aconite, half a dram ; solid extract of stramonium, 
four grains ; valerianate of quinia, one scruple. Mix and divide into 
sixty pills, of which one is to be taken every two, three, or four hours, 
according to symptoms. 

Motherwort (Leonurus Cardiaca). — This perennial plant is sup- 
posed to be a native of Tartary, and introduced into this country. It 
is considerably used in domestic practice for nervous complaints and 




856 MEDICINES AND THEIR PREPARATIONS. 

many chronic disorders attended with restlessness, disturbed sleep, 
pains of the nerves, and affections of the liver. A warm infusion of 
the tops and leaves is useful in restoring menstrual suppression from 
colds. 

Preparations. — Solid extract, dose, three to five grains. Com- 
bined with blue cohosh and skunk-cabbage, the solid extract is a 
nervine, antispasmodic and emmenagogue. 

Mountain Laurel (Kalmia Latifolia, Fig. 223). — The laurel is 

found in most parts of the United States, on hills 

and mountains, flowering in June and July, and is 

very ornamental. It is sometimes called big ivy, or 

calico-bush. The narrow-leaf laurel, or sheep-laurel, 

kalmia angustifolia, is also common, and similarly 

medicinal. The leaves of these plants are used in 

medicine, and produce, when taken in large doses, 

vertigo, dimness of sight, etc. In medicinal doses, 

they are sedative and astringent. The saturated 

fig. 223. tincture is the best form of administration, which 

mountain laueel. m ^ ^ e taken in ten to fifteen-drop doses, every 

two or three hours, in syphilis, active hemorrhages, hypertrophy of 

the heart and jaundice. 

Mullein (Verbascum Thapsus). — The leaves and flowers of this 
biennial plant are antispasmodic, diuretic and demulcent. The in- 
fusion is frequently used in domestic practice, and is useful in colds, 
coughs, bronchitis, etc. ; and may be drunk freely. The leaves are 
sometimes boiled in milk, sweetened, and taken for bowel com- 
plaints. The leaves dipped in hot vinegar and water are very useful 
applied as a fomentation in mumps, acute inflammation of the tonsils 
and malignant sore throat ; a handful of them may also be placed in 
a teapot with hot water, and the steam be inhaled through the spout, 
in the same complaints. 

Mustard. — The seeds of the white mustard, Sinapis alba, were a 
few years ago much recommended as a cure for constipation of the 
bowels ; and, swallowed whole in teaspoonful, or even, in some obsti- 
nate cases, in tablespoonful doses, they afford a wholesome stimulus 
to the bowels, and accomplish some good. The ground mustard is a 
valuable condiment to eat in small quantities, at dinner, in dyspeptic 
cases. It finds its most important uses, however, as a prompt and 
almost instantaneous emetic in cases of poisoning, and also as a valu- 
able counter-irritant, when applied externally. The volatile oil of 
mustard, one part, and ten parts of sweet oil, may be applied to the 
skin instead of the mustard poultice, and with similar results. 

Myrrh. — The tree Balsamodendron myrrha, growing in Arabia, 
etc., yields a juice which hardens into a gum-resin, called myrrh. 
This pleasant, aromatic gum is stimulant, tonic, antiseptic, emmena- 



MEDICINES AND THEIR PREPARATIONS. 857 

gogue and expectorant. It is employed in chronic bronchitis, con- 
sumption, chlorosis, absence of the menses, etc. It is generally 
combined with iron and other tonics, and in amenorrhcea it is fre- 
quently combined with aloes. Locally, it is considerably used as a 
wash to improve spongy gums, ulcers of the mouth, etc. The dose is 
from ten to twenty grains, to be given in pill or in powder suspended 
in water. The tincture of myrrh is a useful external application. 

Naphtha This belongs to the class of native inflammable sub- 
stances, called bitumens. It is a transparent, yellowish white, very 
light and inflammable liquid, and is found abundantly in Persia. 
Said to have been used with advantage in Asiatic cholera. It is 
composed exclusively of carbon and hydrogen. Dose, from ten to 
twenty drops, given in half a glass of wine or mint-water. During 
the formation of coal-gas, an artificial naphtha is obtained, which, 
when purified, has the property of dissolving India rubber. 

Medicinally, it is chiefly used for purposes of inhalation in affec- 
tions of the chest. 

Naphthalin. — This is obtained from a distillation of coal-tar. Is 
is soluble in ether, alcohol, naphtha and oils, but not in water. It it 
an excellent expectorant, particularly in cases of impending suffoca- 
tion of old persons from chronic bronchitis ; also in asthma and other 
pectoral affections. Being stimulating, it is improper in acute bron- 
chitis, and pulmonary inflammation. The dose is from ten to twenty- 
five grains, given in emulsion, or syrup, every fifteen minutes, until 
abundant expectoration takes place. A scruple of naphthalin mixed 
with five drams of lard, makes a good ointment for psoriasis, dry 
tetter and leprosy. 

Nitrate of Silver (Argenti Nitras). — Nitrate of silver is a solu- 
tion of silver in nitric acid, and commonly passes under the name of 
lunar caustic. It is both in the form of small cylindrical rods and 
of crystals, the latter being more pure than the former. 

As an internal remedy, nitrate of silver is tonic and antispasmodic 
and is given chiefly in nervous diseases, as epilepsy, St. Vitus's dance 
and neuralgia of the heart ; also in some forms of dyspepsia, attended 
with pain in the stomach and vomiting. The dose is from one-fourth 
to half a grain in the form of pill. It should never be taken regu- 
larly as an internal remedy more than two months, as it is apt, after 
long use, to change the skin to an indelible slate-blue. Use only 
under the direction of a physician. 

But nitrate of silver is most used as an external remedy in pharyn- 
gitis, laryngitis, tracheitis and other chronic and acute inflammations 
of mucous membranes. For reducing these inflammations, it is very 
nearly a specific ; certainly, it is altogether the best remedy we have. 
It fails in some cases ; but when skilfully used it never does harm. 
The solutions to be applied to the throat require to have a strength 
of from fifteen to a hundred grains to the ounce of soft water. A 



858 



MEDICINES AND THEIR PREPARATIONS. 



solution containing one to four or more grains to the ounce of water 
is often used in inflammations of the eye, gonorrhoea, etc. 

Nitre (Potassa? Nitras). — Nitre, which also passes under the name 
of nitrate of potassa, and saltpetre, is both a natural and artificial pro- 
duction. As a medicine, it is refrigerant, diuretic, and diaphoretic, 
and is much used in inflammatoiy diseases. It increases the secretion 
of urine and sweat, and lessens the heat of the body and the frequency 
of the pulse. United with tartar emetic and calomel, it forms the 
well-known nitrous powders, which promote most of the secretions, 
particularly those of the liver and skin. One of these powders, con- 
stituting a dose, to be given every two or three hours, is composed of 
eight grains of nitre, one-eighth of a grain of calomel, and one-eighth 
of a grain of tartar emetic. Use with care. 

Sweet Spirit of Nitre (Spiritus JEtheris Nitrici). — Sweet spirit 
of nitre is diuretic, diaphoretic, and antispasmodic. It is deservedly 
much esteemed as a medicine, and is extensively employed in febrile 
diseases, either alone or in union with tartar emetic, or with spirit of 
Mindererus. It is often a grateful stimulus to the stomach, relieving 
nausea and vomiting, and promoting sleep. It acts especially upon 
the kidneys, augmenting the secretion of urine, and is often given in 
conjunction with squills, digitalis, and acetate of potassa. The dose 
is a teaspoonful, given in water every two or three hours. 

Nutmeg (Myristica Moschatd). — The nutmeg is from a tree grow- 
ing in the Molucca Islands. It is stimulant and carminative, and 
somewhat used to remove flatulency, as well as to render other med- 
icines palatable ; it is most employed, however, to flavor drinks, and 
articles of diet. In large doses it is poisonous, producing stupor and 
delirium. 

Nux Vomica (Strychnos Nux Vomica, Fig. 224). — The tree winch 
produces nux vomica grows in Bengal, Malabar, 
on the coast of Coromandel, and in other re- 
gions. The seeds are the medicinal part. 

Nux vomica is an emphatic excitant of the 
brain and spinal cord, and in large doses is an 
active poison ; frequently repeated in small 
doses, it is tonic, diuretic, and slightly laxa- 
tive. 

Given in full doses, it is apt to produce mus- 
cular contraction, as in lockjaw, together with 
frequent starts and twitches, as if from electric 
shocks. It is much employed in treatment of paralysis, and is more 
beneficial in general than in partial palsy. 

Preparations. — Fluid extract, dose, two to seven drops ; solid 
extract, dose, half a grain to a grain ; tincture, four ounces to the pint 
of alcohol, dose, five to ten drops ; strychnia, commonly called strych- 
nin, the active principle, dose, one-sixteenth to one-eighth of a grain.. 




Fig. 224. Ntrx Vomica. 



MEDICINES AND THEIR PREPARATIONS. 859 

Oil of Cajuput (Oleum Cajuputi). — This oil is obtained from the 
leaves of the East Indian tree cajuputi. It is diaphoretic and anti- 
spasmodic, and a powerful diffusive stimulant. Given in cramps 
of the stomach and bowels, colic, flatulency, hysterics, and chronic 
rheumatism. It is considerably used as an ingredient in liniments, 
to be applied externally in rheumatism and neuralgia. Dose, from 
one to three drops, on sugar. 

Oil of Turpentine ( Oleum Terebinthinoe) . — This is generally called 
spirits of turpentine, and is obtained by distilling turpentine. As a 
medicine it is stimulant, cathartic, diuretic, anthelmintic, and astrin- 
gent. In large doses it causes strangury and other unpleasant symp- 
toms. The dose is from five to twenty drops, repeated every two or 
three hours. Fifteen drops, taken every fifteen minutes or half hour, 
powerfully restrains bleeding from the lungs, and is, perhaps, the best 
remedy we have for this frightful accident. 

It is also very efficacious in checking other hemorrhages. Exter- 
nally, it is used considerably as an ingredient in liniments and rube- 
facients, in rheumatism, paralysis, etc. Combined with linseed oil, 
it is much used for burns and scalds. 

Olive Oil (Oleum Olivce). — This oil, often called sweet oil, is ex- 
pressed from the fruit of the olive tree, Olea Europcea. It is nutri- 
ent and emollient, and, in doses of one to two fluid ounces, laxa- 
tive. It is much employed as a constituent of cerates, liniments, and 
plasters. 

Onion (Allium Oepa). — The medicinal properties of the onion are 
much like those of garlic. The juice, mixed with sugar, is used to 
some extent as a remedy for the coughs and colds of infants. Roasted 
onions, applied as a poultice, hasten the suppuration of boils, tumors, 
etc. They are also useful, in some cases, applied as drafts to the 
feet. 

Opium. — This is the hardened juice of the unripe seed of the 
poppy, Papaver Somniferum. It is a stimulant narcotic. A moder- 
ate dose increases the fulness and frequency of the pulse, augments 
the warmth of the skin, invigorates the muscular system, quickens 
the senses, animates the spirits, and gives energy to the mental facul- 
ties. Its operation is directed with special force to the brain, which 
it sometimes excites to intoxication and delirium, which excitement 
subsides in a short time, and is followed by a delightful calmness and 
placidity of mind, all care and anxiety being banished, and the thoughts 
yielded to the control of pleasing fancies. At the end of an hour or 
more, this reverie is succeeded by sleep, which, at the end of eight 
or ten hours, passes off, and is followed by headache, nausea, tremors, 
and other nervous disturbances. Large doses are followed by 
shorter periods of exhilaration and excitement, and by more protracted 
sleep. 

Opium is used in medicine to produce gentle perspiration, relieve 



860 MEDICINES AND THEIR PREPARATIONS. 

pain, and lessen nervous excitability in all febrile and inflammatory 
diseases ; also as an antispasmodic in hysterics, colic, convulsions, 
coughs, etc. It should not be used in cases of constipation of the 
bowels. A solution, composed of two grains of opium to one ounce 
of water, is sometimes a valuable injection in gonorrhoea and spas- 
modic stricture. Dose, as a stimulant, one-quarter to one-half a 
grain ; as a narcotic, one to two grains ; in some spasmodic affections 
it is given in very large doses. Use only under the direction of a 
physician. 

Morphia, generally called morphine, is one of the alkaloid princi- 
ples of opium. It is used under the various forms of sulphate, muri- 
ate, acetate, and valerianate of morphia, — all having the general 
properties of opium, and are given for similar purposes, in doses of 
one-eighth to one-quarter of a grain. One-sixth of a grain is equal 
to one grain of opium. 

Strong coffee is an excellent antidote to the poisonous effects 
both of opium and morphia. A solution of morphia may be made by 
adding ten grains of the salt to one fluid ounce and a half of distilled 
water, and half an ounce of diluted alcohol, and then adding two 
drops of sulphuric acid, if it be the sulphate of morphia, or two drops 
of acetic acid, if it be the acetate of morphia, or two drops of muri- 
atic acid, if it be the muriate of morphia. The effects of morphia 
may be obtained by sprinkling some of it on a blistered surface. 

Orange=Peel (Aurantii Cortex). — The orange is the fruit of a 
tree belonging to the tropical climates. Orange- juice is a pleasant 
refrigerant, useful in fevers, and particularly in scurvy. Sick per- 
sons sucking the juice of the orange, should be careful not to swallow 
any of the skinny portion, or the peel. The peel of the orange is 
chiefly employed to give a pleasant flavor to other medicines, and to 
prevent their nauseating properties. It is a mild tonic, carminative, 
and stomachic, and improves the bitter infusions and decoctions of 
gentian, quassia, Colombo, and Peruvian bark. Orange-peel should 
never be given in substance. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
tincture, one ounce and three-quarters to a pint of diluted alcohol, 
chiefly used as an addition to infusions, etc. ; syrup, two ounces fluid 
extract or tincture to a pint of simple syrup, used with water as an 
agreeable drink. 

Origanum {Origanum Vulgare). — A perennial herb growing in 
Europe and this country. The warm infusion of it causes perspira- 
tion, and promotes the menstrual discharge, when interrupted by a 
cold. The oil of origanum is a very useful ingredient in several 
stimulant and rubefacient liniments. 

Parsley (Petroselinum Sativum). — The root of this biennial plant 
is aperient and diuretic, and is used in dropsy, scarlet fever, and 
diseases of the kidneys ; also in retention of the urine, gonorrhoea, 



MEDICINES AND THEIR PREPARATIONS. 



861 



and strangury. The dose of the infusion is from two to three fluid 
ounces, two or three times a day. 

The bruised leaves are applied with advantage to contusions, 
swelled breasts, and enlarged glands. 

Partridge Berry (Mitehella Repens). — This perennial evergreen 
creeping herb grows in dry woods and swampy places throughout 
the United States, and has white, fragrant flowers in June and July. 
It is parturient, diuretic and astringent, and is used in dropsy, sup- 
pression of urine, and diarrhoea. It acts as a tonic upon the repro- 
ductive organs, giving tone and vigor to the. womb, and making 
labor less tedious. Dose of the decoction, from two to three fluid 
ounces, two or three times a day. 

Peach (Amygdalus Persicd). — The leaves of the peach are seda- 
tive and slightly laxative, and are used in inflammations of the 
stomach and bowels ; likewise in irritable bladder, whooping-cough, 
sickness at the stomach, and dysentery. They are used in the form 
of cold infusion, a tablespoonful being a dose, to be taken every hour 
or two. A good tonic is made by adding four ounces of the bruised 
kernels to a quart of honey. 

Pennyroyal (Hedeoma Pulegioides, Fig. 225). — Pennyroyal is a 
gently stimulant aromatic ; it relieves wind colic 
and sick stomach, and qualifies the action of other 
medicines. Like most aromatic herbs, it has the 
property, when given as a warm infusion, of pro- 
moting perspiration and of exciting the menses 
when the system is already disposed to the effort. 
In cases of recent suppression, it may be given at 
bedtime as a warm tea, after bathing the feet in 
warm water. The oil of pennyroyal has the prop- 
erties of the herb. 

Peppermint (Mentha Piperita). — The pepper- 
mint is a native of England, where it is largely 
cultivated, as it is to some extent in this country, 
for the sake of its essential oil. It is a valuable 
herb, having a strong aromatic smell, and a pun- 
gent, warming taste. It may be used in the form of tea, which, 
when largely drunk, imparts warmth to the system. It is valuable 
in colds, flatulent colic, hysterics, spasms, cramps in the stomach, 
nausea and vomiting, and to disguise unpleasant medicines. 

The peppermint furnishes an essential oil, which, dissolved in al- 
cohol, forms the essence of peppermint. The dose of this is fifteen to 
twenty drops, on a lump of sugar, or in sweetened water, warm or cold. 
Persimmon (Diospyros Virglniand). — This is a tree growing in 
the Southern and Middle States. The bark and unripe fruit are used 
in medicine, — - being astringent and tonic. Persimmon has been 
found useful in chronic diarrhoea, chronic dysentery, hemorrhage 




Fig. 225. 
Pennyroyal. 



862 



MEDICINES AND THEIR PREPARATIONS. 



from the womb, and fever and ague. It is used in the form of infu- 
sion and syrup, in doses of a tablespoonful every two or three hours. 
The infusion is also used as a wash and gargle in sore mouth and 
throat, and as an injection in whites. 

Peruvian Bark (Cinchona, Fig. 226). — This valuable bark is 
derived from several species of the cinchona tree, on the western 
coast of South America. The remedy is said to have been first in- 
troduced into Europe in 1640, by the Countess of Cinchon, wife of 
the Viceroy of Peru, on her return to Spain. 

There are three varieties of this bark : the pale, the red, and the 
yellow. The pale bark is least liable to 
offend the stomach, and is perhaps the best 
as a general tonic ; but for the treatment 
of fever and ague, the red and the yellow 
are both preferable to the pale, and the red 
is considered better than the yellow. 

Cinchona is tonic and antiperiodic, and 
is much used, and with great success, in 
all periodical diseases, as fever and ague, 
remittent fever, neuralgia and epidemic 
diseases ; also in chronic diseases attended 
with debility, as scrofula, dropsy, and affec- 
tions of the skin. Dose of the powdered 
bark as a tonic, from ten to fifty grains; 
as an antiperiodic, from twenty to seventy- 
five grains. 

Preparations. — Fluid extract, dose, half a dram to a dram ; com- 
pound fluid extract, dose, half a dram to a dram; tincture, four 
ounces to one pint diluted alcohol, dose, one to four drams ; infusion, 
dose, one to one and a half ounces. A good compound infusion of 
cinchona is made by combining one ounce fluid extract with half an 
ounce of fluid extract of snakeroot, two drams of fluid extract of 
orange-peel, one dram of fluid extract of cloves, one dram of carbon- 
ate of potassa and one pint of water. Dose, one to one and a half 
ounces. The following is a good nervine and tonic for persons of 
nervous temperaments : fluid extract of cinchona, one ounce ; fluid 
extract of valerian, one ounce ; essence of cardamom, two drams ; 
dose, one dram every three hours. 

Cinchon ia is a white crystalline substance obtained from the Peru- 
vian bark. It is sometimes used as a substitute for quinia, in doses 
of from one to three grains, three times a day. 

Sulphate of Quinia is snow white, and in satin-like crystals, 
having an exceedingly bitter taste. It is completely soluble in water 
or alcohol, by adding a few drops of sulphuric acid. It is the chief 
active principle of cinchona, and has similar properties, namely, feb- 
rifuge, tonic and antiperiodic ; it is, however, less apt to nauseate 




Pig. 226. Peruvian Bark. 




Parsley. 



Squill. 



Peppermint-. 



MEDICINES AND THEIR PREPARATIONS. 



863 



and oppress the stomach. In the treatment of intermittent fevers, it 
has almost entirely superseded the use of the bark. 

Valerianate of Quinia. — This is a combination of quinia and 
valerianic acid. It is tonic, febrifuge and sedative. It is used for 
headache of a periodic character, and for nervous irritability, wake- 
fulness, restlessness, etc. Dose, from half a grain to two grains. 

Petroleum or Rock=OiI is a dark brown or greenish liquid found 
abundantly in the upper strata of the earth in various parts of the 
world. Before the discovery of the deep deposits of the oil by arte- 
sian wells, the Indians of New York used to collect it where it 
oozed from the ground, and sold it as a family medicine under the 
name of " Seneca Oil." It has been used externally for chilblains, 
chronic rheumatism, diseases of the joints, and skin affections. 
Taken internally, it is stimulating, anti-spasmodic, and sudorific, and 
has been recommended for lung troubles. At present it is used in 
various modified forms. 

Phosphorus. — This is a semi-transparent solid, is flexible, and 
has a waxy lustre. It is extracted from bones by sulphuric acid. 
As a medicine in small doses, it acts as a powerful general stimulant ; 
in large doses, as a violent, irritant poison. When taken in sub- 
stance it causes irritation of the stomach, and should, therefore, 
always be administered in solution ; and even in this form it is ob- 
jectionable ; it is better to resort to the phosphates and the hypo- 
phosphites. Phosphorus, being an element in the composition of the 
brain, has been given with advantage in the various forms of ner- 
vous debility, as consumption, typhus fever, amaurosis, paralysis, and 
the general breakdown of the vital powers. Phosphorus burns when 
exposed to the air, and should therefore be kept covered with water. 

Pink=Root (Shigella Marilandica, Fig. 227). — This perennial 
herb grows in rich soils in the Middle and Southern 
States. The root is the medicinal part. It is a 
powerful anthelmintic, and is but little used except 
for expelling worms. 

Preparations. — Fluid extract, dose, half a dram 
to a dram ; compound fluid extract, dose, half a 
dram to two drams ; fluid extract of pink-root and 
senna, dose, half a dram to a dram : infusion, half 
an ounce to a pint of water, dose, two to six 
ounces. 

Pipsissewa ( Cliimaphila Umbellate Fig. 228 ). — 
This is a small evergreen plant, growing in the 
United States, and in Northern Europe and Asia. 
It is known by the name of princes' pine. The 
whole plant is tonic, diuretic and astringent, and 
has proved itself useful in dropsy, general debility, 
rheumatism, chronic disorders of the kidneys, bladder, urethra, etc. 




864 



MEDICINES AND THEIR PREPARATIONS. 



Preparations. — Fluid extract, dose, one dram; solid extract, dose, 
ten to fifteen grains; infusion, dose, two ounces. 

Plantain (Plantago Major). — This peren- 
nial herb grows both in Europe and America. 
A strong decoction of the tops and the roots is 
highly spoken of for syphilis and scrofula ; the 
dose being from two to four fluid ounces, two 
or three times a day. But the bruised leaves 
are most useful when applied to wounds, ulcers, 
bites of poisonous insects, erysipelas, etc. 

Pleurisy-Root (Asclepias Tuberosa, Fig. 
229). — This perennial plant is abundant in 
the Southern States. The root, which is the 
part used, is carminative, tonic, and diuretic ; 
used in pleurisy, bronchitis, inflammation of 
acute rheumatism and dysentery. The warm infusion 
promotes diaphoresis, without raising the temperature of the body. 
United with the warm infusion of wild-yam root, it is excellent for 
flatulency and w^ind colic. 

Preparations. — Fluid extract, dose, half a dram to two drams; 
tincture, four ounces to a pint of diluted alcohol, dose, three to five 
drams; infusion, dose, one to four ounces; asclepidin, dose, one to 
five grains. Ascelpidin and dioscorein, united in equal parts, make 
a valuable preparation for flatulent and bilious colic ; dose, two to 
three grains. 




Fig. 228. PlPSISSEWA. 



the 



lungs, 





Fig. 229. Pletjrist-Root. 



Fig. 230. Poison Hemlock. 



Poison Hemlock (Conium Maculatum, Fig. 230). — This biennial 
plant is a native of Europe and Asia, and is naturalized in this coun- 
try. The leaves and the seeds are used in medicine. Conium is 
narcotic, anodyne, antispasmodic and deobstruent ; used in neuralgia, 
asthma, syphilis, chronic rheumatism, and various other affections. 

Preparations. — Fluid extract, Mose, five to fifteen drops; solid 
extract, dose, half a grain to two grains ; tincture, three ounces to a 
pint of diluted alcohol, dose thirty drops to a dram ; infusion, half 



MEDICINES AND THEIR PREPARATIONS. 



865 



an ounce to a pint of water, mainly used as a wash for malignant 
ulcers, etc. Use with care. 

Poison Oak (Rhus Toxicodendron). — The leaves are the medicinal 
part of this creeping shrub, which is common in this country. The 
form of using this medicine is that of a saturated tincture, made 
from the fresh leaves, and to be kept in well-corked vials. It has 
been found useful in paralysis of the bladder and rectum, in diseases 
of the eyes and skin, and in chronic rheumatism. Dose of the tinc- 
ture, from five to seven drops, three times a day. Large doses should 
be avoided. 

Poke {Phytolacca Decandra, Fig. 231). — A perennial plant, 
growing in nearly all parts of the country, and 
called garget, pigeon-berry and scoke. The root 
is the part used. It is emetic, cathartic, altera- 
tive and slightly narcotic. It excites the whole 
glandular system, and is used in syphilis, scrof- 
ula, rheumatism and affections of the skin. 
The root, buried in hot ashes until soft, is 
then mashed and applied as a poultice for 
felons and various tumors. Dose of the pow- 
dered root as an emetic, twelve grains to half 
a dram; as an alterative, from two to five 
grains. 

Preparations. — Fluid extract, dose, ten to 
twenty drops ; solid extract, dose, one to 
three grains ; tincture, four ounces to a pint 
of diluted alcohol, dose, half a dram to a dram ; syrup, two ounces to 
fourteen ounces of simple syrup, dose, one to two drams ; phytolaccin, 
the active principle, dose, one quarter to one grain. For mercurial 
and syphilitic pains in the bones the following pill is useful: solid 
extract of poke, two drams ; solid extract of stillingia, one dram ; 
solid extract of stramonium, eight grains. Mix, and divide into sixty 
pills, of which one pill is to be taken every two or three hours. 

Potassa. — This is used in medicine under the name of caustic 
potassa. It is made by boiling a solution of potassa in a clean iron 
vessel until ebullition ceases, and the potassa melts, and then pouring 
it into cylindrical moulds ; when cold it is to be kept in well-stopped 
bottles. It is a very powerful escharotic, quickly destroying the flesh 
which it touches, and extending its action deep under the surface. It 
differs in this respect from nitrate of silver, which only acts upon the 
surface, and is not, properly speaking, a caustic. 

Caustic potassa is used for forming issues. The method of using 
it for this purpose is to cut in a piece of adhesive plaster a hole as 
large as the desired issue, and then, having stuck this upon the skin, 
to apply the end of the caustic, previously moistened, to the opening. 
This application is to be continued till the life of the part is destroyed. 




Fig. 231. Poke. 



366 MEDICINES AND THEIR PREPARATIONS. 

when the caustic must be neutralized by vinegar, or carefully washed 
off with a wet sponge. 

The following preparations of potassa are used in medicine : — 

Acetate of Potassa (Potassce Acetas). — This is made by the union 
of acetic acid and carbonate of potassa, and in consequence of its 
extreme deliquescence when exposed to the air it is kept in closely- 
stopped bottles. It is diuretic, deobstruent, and mildly cathartic. 
It is used in febrile diseases, several skin diseases, such as psoriasis, 
eczema, and lepra, and particularly in dropsical affections. Dose, as 
a diuretic, from ten to twenty grains ; as an aperient from one to two 
drams. 

Bicarbonate of Potassa (Potassa? Bica?*bonas). — This is a solu- 
tion of carbonate of potassa, saturated with carbonic acid. This acid is 
diuretic, antacid, and deobstruent ; used in dropsy, acidity of the 
stomach, and glandular obstructions. Dose, ten to twenty grains. 
Twenty grains dissolved in eight fluid ounces of water, and mixed 
with four fluid drains of lemon-juice, forms a good effervescing 
draught. 

Bitartrate of Potassa (Potassce Bitartras). — This salt is better 
known as cream of tartar, and supertartrate of potassa. It is formed 
from the matter deposited on the bottom and sides of casks, during 
the fermentation of sour wines. As a medicine it is diuretic, cathartic, 
and refrigerent. In small doses it acts as a cooling aperient, gently 
opening the bowels ; in large ones as a hydragogue cathartic, causing 
free, watery stools. This property, as well as its power of acting upon 
the kidneys, causes it to be much used in dropsical complaints. Dis- 
solved in boiling water, allowed to cool, and then sweetened with loaf 
sugar, it forms a cooling, pleasant, acid drink. This kind of solution, 
with a little fresh lemon-peel added to it, forms the drink called im- 
perial. Combined with sulphur, it is often used in skin diseases. 
Dose, as an aperient, a dram or two ; as a hydragogue cathartic, half 
an ounce to an ounce ; as a diuretic in dropsical complaints, a dram 
and a half to two drams several times a day. Cream of tartar, pow- 
dered rhatany, and myrrh, mixed in equal proportions, form a good 
preparation for cleansing the teeth. 

Carbonate of Potassa (Potassa? Carbona*). — Carbonate of potassa 
is purified pearlash, and is frequently called^// of tartar. Carbonate 
of potassa has the same medicinal properties with the bicarbonate, and 
is used for similar purposes. 

Chlorate of Potassa. — This is prepared by passing an excess of 
chlorine through carbonate of potassa. It is refrigerent and diuretic, 
and is given in scurvy, scarlet fever, etc., and as a wash in canker in 
the mouth, and various unhealthy ulcers, and as an injection in 
leucorrhoea and gleet. 



MEDICINES AND THEIR PREPARATIONS. 867 

Citrate of Potassa (Potassce Citras) . — A grateful, cooling diapho- 
retic, long and much used in fevers, chiefly in the forms of the neutral 
mixture, and effervescing draught. 

Solution of Citrate of Potassa (Liquor Potassce Citratis). — This 
is prepared by taking half a pint of lemon-juice, and adding bicarbonate 
of potassa gradually to it until it is saturated, then filtering*. This 
passes under the name of neutral mixture, saline mixture, and efferves- 
cing draught. It is a valuable refrigerent diaphoretic, well adapted 
to the hot stage of remittent and intermittent fevers, and indeed to 
almost all cases of fever, with a dry, hot skin. The dose is a table- 
spoonful, or half a fluid ounce, which should be well diluted when 
taken, and be repeated every two or three hours, according to the 
necessities of the case. 

Solution of Potassa (Liquor Potassce}.- — This is a transparent, 
caustic fluid, which requires to be kept in green bottles, tightly corked. 
ft is antacid, antilithic, and diuretic. It is used in some affections of 
the skin, and scrofula, but more particularly for scalding of the ure- 
thra, in gonorrhoea ; in this case, it is well to unite a few drops of 
laudanum with it. The dose is from fifteen to twenty-five drops, two 
or three times a day, in half a tumblerful of water. In dyspeptic 
cases, attended with acidity of the stomach, it may be associated with 
some simple bitters. 

Sulphate of Potassa (Potassa? Sulphas). — This is a mild purga- 
tive, operating without irritation or pain. As an aperient, it should 
be given in doses of from a scruple to a dram. Ten grains of rhubarb 
and one dram of carbonate of potassa, united, and divided into' six 
powders, is an excellent alterative cathartic for children having defec- 
tive digestion and nutrition, and a tumid state of the abdomen. One 
powder may be given at a time, as often as may be necessary to open 
the bowels gently. 

Tartrate of Potassa (Potassce Tartras). — This often passes under 
the name of soluble tartar. It is a mild, cooling purgative, operating, 
as most of the neutral salts do, without much pain, and producing 
watery stools. It is useful in fevers. Combining it with senna destroys 
its tendency to produce griping of the bowels. The dose varies from 
a dram to an ounce, according to the effect desired. 

Potassium. — This is a soft, bluish-white metal. Its union with 
oxygen, in the proportion of one equivalent of each, forms potassa or 
potash. The following preparations of it are used in medicine : — 

Bromide of Potassium (Potassii Bromiduni). — This is a perma- 
nent, colorless salt, having a pungent, saline taste, a little more acrid 
than common salt, yet similar to it. As a medicine it is alterative and 
resolvent, and is used occasionally for secondary syphilis, scrofula, and 
enlarged spleen. Dose, from three to five grains, three times a day, in 
pill or solution. One dram of the bromide of potassium, rubbed up 



868 



MEDICINES AND THEIR PREPARATIONS. 



with an ounce of lard, makes an ointment which has been used with 
some good effect in goitre and scrofulous affections. 

Cyanuret of Potassium (Potassii Cyanuretum). — This is emi- 
nently poisonous, acting both as a medicine and as a poison, like 
Irydrocyanic acid. It has therefore been recommended as a substitute 
for that acid. The dose is one-eighth of a grain, dissolved in half a 
fluid ounce of water. 

Sulphuret of Potassium (Potassii Sulphur etum). — This is called 
liver of sulphur, and hepar, being composed of sulphur and potassium. 
It has been used in chronic bronchitis, asthma, whooping-cough, and 
rheumatism. Half an ounce to an ounce of it, dissolved in several 
gallons of warm water, makes a valuable sulphur bath for several 
skin diseases, as itch, prurigo, etc. 

Prickly Ash (Xanthoxylum Fraxineum). — This shrub grows in 
various parts of the United States. The leaves and capsules have 
a pleasant, aromatic smell. Its medicinal properties 
are in the bark and berries. The bark is stimulant, 
tonic, alterative, and sialagogue. It is used to rouse 
and excite the system, when in a languid state, and for 
derangements of the liver, rheumatism, and chronic 
syphilis. It stimulates and strengthens mucous mem- 
branes, and is a valuable tonic in low typhoid fever. 
Applied externally, it improves indolent and malig- 
nant ulcers. Dose of the powdered bark, from ten to 
twenty grains, three times a day. 

Preparations. — Fluid extract, dose, fifteen to 
twenty-five drops ; tincture, four ounces to a pint of 
diluted alcohol, dose, half a dram to a dram ; infusion, 
half an ounce to a pint of water, dose, half an ounce 
to two ounces ; xanthoxylin, the active principle, dose, 
two to five grains. 
For chronic rheumatism the following is a good preparation : xan- 
thoxylin, one dram ; cimicifugin, one dram ; apocynin, one dram ; 
diluted alcohol, one pint; dose, three drams, three times a day. 

Prickly Ash Berries are carminative, antispasmodic, and stimulant, 
and have a special direction to mucous membranes. The tincture is 
excellent in nervous diseases, spasms of the bowels, flatulency, and 
diarrhoea ; and, combined with the tincture of poke-berries, is very 
serviceable in chronic rheumatism and syphilis. It is said to have 
been used with great success, in the West, in Asiatic cholera. Dose 
of the tincture, from ten drops to a fluid dram, in sweetened water. 
Dose of the oil of prickly-ash berries, from two to seven drops, on 
sugar. 

Prickly Elder (Aralia Spinosa). — This is a tree which grows in 
the Southern and Western States, and is called Southern prickly ash, 
and toothache tree. The bark is stimulant, alterative, and diaphoretic. 




fig. 232. 
Prickly ash. 



MEDICINES AND THEIR PREPARATIONS. 869 

The fresh bark, emetic and cathartic. The tincture is serviceable in 
skin diseases, syphilis, and chronic rheumatism. The bark is siala- 
gogue, and in small doses, powdered, is said to relieve the dry and 
parched condition. of the throat, in many diseases. 

Pumpkin=Seeds — The infusion of pumpkin-seeds, made by plac- 
ing them in water without bruising them, is mucilaginous and diu- 
retic, and is used in inflammation of the stomach and bowels, scald- 
ing of the urine, strangury, etc. But this infusion is more particularly 
valuable for its power of expelling the tape-worm. It may be drunk 
freely. The oil of pumpkin seeds, obtained by expression, has similar 
properties, and may be taken in doses of six to ten drops, several times 
a day. 

Quassia (Picroena Excelsa). — This is the wood of a tall tree grow- 
ing in Surinam and some of the West India Islands. It is an intensely 
bitter tonic, febrifuge, and anthelmintic, possessing in the highest de- 
gree the properties of the simple bitters. It invigorates the digestive 
organs, without producing much excitement of the circulation. It is 
well adapted to dyspepsia, and the debility of the stomach which suc- 
ceeds acute disease, and indeed all complaints where simple bitter is 
required. Its generic title perpetuates the name of the negro Quassi, 
of Surinam, who first discovered its medicinal virtues, about the mid- 
dle of the last century, and who became famous for treating malig- 
nant fevers with it, as a secret remedy. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, three to five grains ; tincture, dose, four to eight drams ; 
infusion, two drams to a pint of water, dose, two to three ounces. 

Queen of the Meadow (Eupatorium Purpureum). — This peren- 
nial herb grows in low, swampy places, in many parts of the country. 
It is called trumpet weed, and, from its fine medicinal effects in com- 
plaints of the urinary organs, gravel-root. It is an excellent diuretic, 
tonic, and stimulant. Used in gout, rheumatism, hematuria, chronic 
diseases of the urinary organs, strangury, gravel, and dropsical affec- 
tions. The decoction is the form in which it is most used ; the dose 
being two to three ounces, two or three times a day. 

A preparation called eupurpurin is also extracted from it, which, in 
three-grain doses, is a powerful diuretic, occasioning, in some cases, it 
is said, an enormous flow of urine. 

Queen's Root (Stillingia Sylvatica). — This perennial herb grows 
in sandy soils in the Southern States. The root is medicinal, being, 
in large doses, emetic and cathartic ; in small doses, an alterative of 
considerable value in skin diseases, rheumatism, syphilis, and scrofula, 
and in such other complaints as require alteratives. 

Preparations. — Fluid extract, dose, five to ten drops ; compound 
fluid extract, dose, half a dram to a dram ; tincture, two ounces to a 
pint of diluted alcohol, dose, one to three drams ; infusion, dose, one 
to one and one-half ounces. In chronic bronchitis and similar com- 



870 MEDICINES AND THEIK PREPARATIONS. 

plaints, the following syrup is well recommended: fluid extract of 
stillingia, two ounces; fluid extract of bloodroot, two ounces; fluid 
extract of cherry bark, two ounces: balsam of tolu, one ounce and a 
half: syrup, two and a half pints. Dose, one to two drams. 

Red Chickweed (Anagallis Arvensis).- — An annual plant, com- 
mon in Europe and this country. It has small scarlet flowers in June 
and July. It has been used in nervous diseases, as mania, delirium, 
epilepsy, and particularly hydrophobia. Old and ill-conditioned ul- 
cers are improved by its use, in the form of poultice. 

Red Root ( Ceanothus Americanus). — This shrubby plant has the 

names of New Jersey tea and wild snowball, and is found in all parts 
of the United States. The bark is antispasmodic, sedative, astringent. 
and expectorant, and tastes and smells like the peach-leaf. A decoc- 
tion is useful in dysentery, diarrhoea, whooping-cough, and chronic 
bronchitis, in doses of a tablespoonful three times a day. It makes, 
likewise, a very good injection in leucorrhcea and gleet, and gargle 
for ulcerations of the mouth and throat. 

Red Clover (Trifolium Pratense). — The blossoms of this very 
common biennial plant are medicinal, and are highly recommended 
in deep, ragged, and cancerous ulcers, as well as in badly condi- 
tioned burns. They are soothing and detergent, and promote health- 
ful granulation. Taken in large doses for a year or so, it is said to 
be good for cancer. 

Preparation. — Solid extract, to be used as an external applica- 
tion, chiefly in the form of ointment, made by uniting four ounces of 
it with half a pound of lard. 

Red Rose (Bosa Gallica). — The petals of the rose are slightly 
tonic and astringent, and are considerably employed in chronic in- 
flammations of the eye. Rose-water, distilled from the petals, is 
used for similar purposes. 

Red Saunders (Pterocarpus Santalinus). — This is a large tree 
growing in Ceylon, the wood of which imparts a red color to alcohol, 
ether, and alkaline solutions, but not to water. It is almost solely 
used for imparting color to tinctures, etc., having little or no medi- 
cinal properties. 

Rosin. — This is the solid resinous matter which remains after 
the distillation of turpentine. It is much used as an ingredient in 
ointments and plasters, but is never taken internally. The vapor 
which arises from heating it upon some hot surface is sometimes in- 
haled with great advantage in chronic bronchitis, and other chronic 
affections of the air-tubes. 

Rhatany (Kramerla Triandra). — This is a native of Peru, grow- 
ing in dry. sandy places. It is a powerful astringent, and a gentle 
tonic. It is given with advantage in excessive menstruation, vom- 



MEDICINES AND THEIR PREPARATIONS. 871 

iting of blood, chronic diarrhoea, leucorrhcea, and inability to retain 
the urine ; likewise, as a local application in falling of the bowel. 
It is valuable also for nosebleed, and bleeding gums. Dose of the 
powder, for internal use, from ten to twenty-five grains. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, five to fifteen grains ; tincture, three ounces to a pint 
of diluted alcohol, dose, three to five drams ; infusion, two ounces to 
a pint of water, dose, half an ounce. 

Rhubarb {Rheum Palmatum). — This root is derived from several 
species of rheum, and passes under the various names of European, 
Russian, Chinese, East India, and Turkey rhubarb. The variety 
called Russian or Turkey rhubarb (for they are the same) is consid- 
ered the best. Rhubarb is cathartic, astringent, and tonic. It is 
much used in mild cases of diarrhoea and cholera infantum ; likewise, 
as a stomachic and gentle tonic in dyspepsia, accompanied with a 
debilitated state of the digestive organs. It is a valuable remedy in 
the complaints of children, and is deservedly much used in treating 
them. It acts upon the muscular coat of the bowels, producing thick 
rather than watery stools. It is therefore not adapted to the treatment 
of dropsical complaints. Its astringency may be increased by roasting 
it, or diminished by combination with an alkali. 

Preparations. — Fluid extract, dose, half a dram to a dram ; aro- 
matic fluid extract, dose, half a dram to a dram ; fluid extract of 
rhubarb and senna, dose, half a dram to a dram ; solid extract, dose, 
two to eight grains ; tincture, an ounce and a half of fluid extract, 
and half an ounce of essence of cardamom, to a pint of diluted alcohol, 
dose, half an ounce to an ounce and a half ; infusion, one ounce fluid 
extract and two ounces spirit of cinnamon to a pint of water, dose, 
one to three ounces ; syrup, three ounces of fluid extract to fourteen 
of syrup, dose, two to five drams. 

Rosemary (Rosemarinus Officinalis).— This evergreen shrub grows 
on the borders of the Mediterranean, and is cultivated in Europe and 
this country. It is stimulant, antispasmodic, and emmenagogue. It 
is not used in this country, however, except to perfume ointments, 
tinctures, and syrups. 

Round=Leaved Pyrola (Pyrola Rotund ifoli a). — This perennial 
shrub grows in various parts of our country, and bears white flowers 
in June. It is called canker-lettuce, pear-leaf wintergreen, etc. Its 
medicinal properties are those of a tonic, astringent, antispasmodic, 
and diuretic. Used in decoction for epilepsy and other nervous dis- 
orders ; also for gravel, and other diseases of the bladder and kid- 
neys. The decoction may be used, too, as a wash for ulcerations of 
the mouth, indolent ulcers, and chronic ophthalmia. The decoction 
may likewise be used in making poultices for painful swellings, boils, 
and carbuncles. It may be taken in doses of from one to four 
ounces. 



872 MEDICINES AND THEIR PREPARATIONS. 

Rue (Ruta Graveolens). — Rue has the medicinal virtues of the 
antispasmodics, anthelmintics, and emmenagogues. In large doses 
it is poisonous. It is useful in wind-colic, worms, hysterics, epilepsy, 
etc. Dose of the leaves, from ten to fifteen grains ; of the infusion, 
from one to two ounces. Use with care. 

Saffron [Crocus Sativus). — This is a native of Greece and Asia 
Minor ; it is also cultivated in France, England, and America, as 
well as in other countries. It has been thought to be stimulant and 
antispasmodic in small doses, relieving pain, and producing sleep ; in 
large doses, giving rise to headache, and producing stupor. In the 
general judgment of the profession it is now considered, however, as 
having very little activity. It is accordingly not much used, except 
in domestic practice, where it has some reputation among nurses for 
its power to bring out measles, and other eruptions. It is also thought 
to be beneficial in amenorrhcea, dysmenorrhoea, chlorosis, and hys- 
teria. It is chiefly used at present to impart flavor and color to 
tinctures. 

Preparations. — Fluid extract, dose, twenty to forty drops ; tinc- 
ture, dose, half a dram to a dram ; infusion, one dram to a pint of 
water, dose, one to two ounces. 

Sage (Salvia Officinalis). — The tops and leaves of this well known 
garden plant are aromatic, astringent, diaphoretic, and slightly tonic. 
The infusion is useful in debilitated conditions of the stomach, at- 
tended with flatulence : it frequently relieves nausea ; the cold infu- 
sion checks and sometimes entirely removes the night-sweats of 
hectic. The infusion is useful as a gargle in inflammation of the 
throat, particularly if united with a little honey and alum. Dose of 
the infusion, from one to three fluid ounces. 

Sarsaparilla (Smilax Officinalis). — Grows in swamps and hedges 
in the Middle and Southern States. The root has long been held in 
esteem as an alterative, diuretic, and demulcent, being used in scrof- 
ula, chronic rheumatism, and affections of the skin ; but its most ex- 
tensive and useful application has been found to be in the treatment 
of secondary and tertiary syphilis ; and especially in the broken con- 
dition of the system which follows the use of mercury in these 
affections. 

Preparations. — Fluid extract, dose, one dram ; fluid extract of sar- 
saparilla and dandelion, dose, one dram ; solid extract, dose, five to 
twenty grains ; infusion, dose, two to three ounces. 

Sassafras (Laurus Sassafras'). — This tree is common in theUnited 
States. The bark of the root, which is the medicinal part, is altera- 
tive diuretic, diaphoretic, and a warm aromatic stimulant. It is 
mainly used to improve the flavor of other medicines, and also as a 
constituent of those compounds which are recommended in chronic 



MEDICINES AND THEIR PREPARATIONS. 



873 



rheumatism, syphiloid affections, eruptions of the skin, and 
scurvy. 

Preparations. — Fluid extract, dose, one to two drams ; tincture, 
six ounces to a pint of alcohol, dose, half an ounce to an ounce ; in- 
fusion, two ounces to a pint of water, to be drunk as desired. 

Savin (Juniperus Sabina). — An evergreen shrub, growing in 
Europe and North America. The tops and leaves are diuretic, dia- 
phoretic, emmenagogue, and anthelmintic. The warm infusion pro- 
motes menstruation, and destroys worms. Care should be taken never 
to administer this medicine during pregnancy, its effects being violent 
and dangerous. 

Preparations. — Fluid extract, dose, ten to twenty drops; solid 
extract, dose, one to three grains ; tincture, four ounces to a pint of 
diluted alcohol, dose, half a dram to a dram and a half ; infusion, half 
an ounce to a pint of water, dose, half an ounce to an ounce. The 
following mixture is useful in amenorrhcea : fluid extract of savin, 
half a dram ; fluid extract of ginger, one dram ; sulphate of potassa, 
two drams. Mix. Dose, half a dram twice a day. The oil of savin 
has properties similar to those of the leaves. Dose, from two to five 
drops, on sugar. 

Scammony (Convolvulus Scammonia) . — This plant is a native of 
Syria and the neighboring countries. The medicinal part is the har- 
dened juice of the fresh root. It is an energetic cathartic, producing 
griping, and sometimes operating with decided harshness, on which 
account it is generally combined with other medicines which lessen 
the severity of its action. The dose is from five to fifteen grains. 

Scullcap (Scutellaria Lateriflora, Fig. 233). — An indigenous plant, 
flowering in July and August. The whole herb is used. It is a valuable 
nervine, tonic, and antispasmodic; while it 
gives support to the nerves, it imparts both 
quietness and strength to the whole system, 
and does not, like other nervines, leave the 
patient excited and irritable. It finds its use 
in the treatment of neuralgia, chorea, con- 
vulsions, lockjaw, and most other diseases of 
the nervous system. 

, Preparations. — Fluid extract, dose, half a 
dram to a dram ; compound fluid extract, dose, 
half a dram to a dram ; tincture, four ounces to 
a pint of diluted alcohol, dose, one to two 
drams ; infusion, dose, a wineglassful three 
times a day ; scutellarin, the active principle, 
dose, two to five grains. 

Senega). — An indigenous plant, commonly 
in medicine. It is a stim- 




Fig. 233. Scullcap. 



Seneka (Poly gala 
called snakeroot, the root of which is used 



874 MEDICINES AND THEIE PREPARATIONS. 

ulatiug diuretic and expectorant, and in large doses an emetic and 
cathartic. It excites all the secretions. It is useful in chronic 
bronchitis, and in other chronic affections of the breathing-tubes. 

Preparations. — Fluid extract, dose, twenty to twenty-five drops; 
infusion, dose, one ounce to an ounce and a half; syrup, four ounces 
of fluid extract to twelve ounces simple syrup, dose, half a dram to 
a dram. The following is a very good expectorant cough prepara- 
tion : fluid extract of seneka, three drams ; fluid extract of squill, 
half a dram ; syrup of tolu, two drams ; paregoric, two drams ; car- 
bonate of ammonia, twenty grains ; water, four and a half ounces. 
Mix. Dose, one dram. 

Senna (Cassia Ac uti folia.'). — Grows abundantly in Upper Egypt. 
The leaves are the medicinal part. It is a mild, active, and certain 
cathartic, and is much used in combination with other medicines, 
particularly epsom salts. The addition of cloves, ginger, cinnamon, 
and other aromatics, removes all its tendency to griping, and makes 
it a safe and gentle yet active purgative, calling for an evacuation 
of the bowels. 

Preparations. — Fluid extract, dose, one to two drams; fluid extract 
of senna and jalap, dose, half a dram to a dram ; solid extract, dose, 
three to five grains ; tincture, three ounces to thirteen ounces of 
diluted alcohol, dose, half an ounce to an ounce ; infusion, two ounces 
to a pint of water, dose, half an ounce to an ounce. 

Shrubby Trefoil (Ptelea Trifoliata). — This shrub, which grows 
in the West, is called wafer-ash and wingseed. Its bark and root 
have tonic properties, and are used in intermittent and remittent 
fevers, and wherever nature needs a lift in getting up from exhaust- 
ing complaints. The medicine, like other tonics, improves the ap- 
petite and digestion. Dose of the solid extract, from three to five 
grains, three or four times a day ; of the cold infusion, a tablespoon- 
ful every two or three hours. 

The oleo-resinous principle of the crude bark is called ptelein, and 
is a powerful tonic. Dose, one or two grains three or four times a 
day. 

Skunk=Cabbage (Symplocarpus Fcetidus, Fig. 234). — A peren- 
nial plant, growing in moist places throughout the United States ; 
sometimes called meadow-cabbage. The root is stimulant, expectorant, 
antispasmodic, and slightly narcotic. It is given for pulmonary and 
bronchial affections, epilepsy, hysterics, asthma, whooping-cough, 
and irritable nerves. 

Preparations. — Fluid extract, dose, twenty to fifty drops ; tinc- 
ture, three ounces to a pint of alcohol, dose, half a dram to a dram ; 
infusion, dose, one to one and a half ounces ; syrup, two ounces of 
fluid extract to eight ounces of simple syrup, dose, two to three drams. 
For asthma and cough, and to promote expectoration and remove 



MEDICINES AND THEIK PREPARATIONS 



875 



tightness across the chest, the following is a very good compound 
preparation: one ounce each of the fluid extract of skunk-cabbage, 
lobelia, bloodroot, pleurisy-root, and ginger, one pint of water, and 
three pints of alcohol. Dose, two to three drams. 





Fig. 234. Skunk-Cabbage. 



Fig. 235. Slippery Elm. 



Slippery Elm (Ulmus Fulva, Fig 235). — The inner bark of 
this well-known tree is nutritive, demulcent, emollient, and slightly 
expectorant and diuretic. It is valuable as a demulcent drink in in- 
flammations of the lungs, stomach, bowels, bladder, and kidneys ; 
also for coughs, strangury, dysentery, and the summer complaints of 
infants. It makes a valuable poultice for various purposes. 

Small Spikenard (Aralia Nudicaulis). — This plant grows 
throughout the United States, from Canada to the Carolinas, in 
rocky woods. It is called false sarsaparilla and wild sarsaparilla. 
The root is a gentle stimulant, diaphoretic and alterative. It is used 
in domestic practice, and by some physicians, in rheumatism, syph- 
ilis, and cutaneous diseases. The American spikenard, Aralia race- 
mosa, resembles the small spikenard in medicinal properties. Either 
of these roots is valuable in chronic affections of the lungs and air- 
tubes. 

Soap (Sapo). — Soap is laxative, antacid, and antilithic, and is 
much used in combination with cathartics, to lessen the severity of 
their action. In mesenteric fever, advantage is derived from rubbing 
the tumid belly of children with a strong lather of soap, morning and 
evening ; and few things are more effectual in removing hardened 
feces from the rectum in cases of obstinate costiveness than an injec- 
tion of soap-suds. Soap is now made out of so many kinds of fat 
that care should be taken to use as medicine only the best Castile. 

Sodium. — This is a soft white metal. .United with oxygen in 
the proportion of one equivalent each, it forms the alkali, soda. The 
following are the principal preparations of soda used in medicine:- 



876 MEDICINES AND THEIR PREPARATION*. 

Bicarbonate of Soda (Sodce Bicarbonm) . — This is a white, inodor- 
ous powder, sometimes called superearbonate of soda. It is antacid, 
antilithic, and slightly diuretic. It is chiefly used in preparing what 
are called soda-powders, and in various preparations of medicine, when 
an antacid is required. It is also taken simply dissolved in water, 
for acidity of the stomach. 

Borate of Soda (Sodce Boras) . — This is everywhere known by the 
name of borax. It exists naturally formed in various parts of the 
world, and is likewise manufactured. It is a mild refrigerent and 
diuretic ; also emmenagogue, promoting menstruation, facilitating par- 
turition, and favoring the expulsion of the after-birth by its specific 
influence upon the womb. It has considerable reputation in the treats 
ment of urinary diseases, particularly those connected with an excess 
of uric acid. The dose is from twenty to twenty-five grains in solu- 
tion. Combined with rose-water, honey, and various other things, 
according to circumstances, borax makes a valuable wash for inflam- 
matory affections of the mouth and throat, skin-diseases, etc. 

Chloride of Sodium ([Sodii Chloriduni). — This is the chemical 
name of muriate of soda or common salt. In small doses, it is tonic, 
alterative and anthelmintic. It checks bleeding from the lungs, when 
taken in teaspoonful doses. The dose as an alterative is from ten to 
sixty grains. As moderately used in food by most civilized people, 
it promotes digestion and improves the general health. 

Sulphate of Soda (Sodce Sulphas). — This has a very pretty 
name, but it will not sound half as well to thousands of young per- 
sons, when they are told that it is the well-known Glaubers salts. 
From half an ounce to an ounce of it dissolved in half a tumblerful 
of water acts as a cathartic ; a smaller dose, as a laxative and diu- 
retic. Its nauseous and bitter taste may be somewhat concealed by 
a little cream of tartar or lemon-juice. 

Sulphite of Soda (Sodce Sulphis). — This preparation is in the 
form of transparent crystals, and is very soluble in water. In doses 
of sixty grains, this is said to have been used with success in frothy 
vomitings ; it is also well spoken of as a remedy in acute rheuma- 
tism, and as a wash in thrush and some diseases of the skin. 

Tartrate of Potassa and Soda (Sodce et Potasses Tartras). — This 
is one of the mildest and most cooling purgatives among the salts. 
It is known as Rochelle salt, and generally agrees well with irritable 
and delicate stomachs. Dose, from four drams to two ounces, in a 
tumblerful of water. The gentle physic called Seidlitz powders is 
composed of two drams of rochelle salt and two scruples of bicarbon- 
ate of soda in a blue paper, and thirty-five grains of tartaric acid in a 
white paper. The contents of each paper is dissolved in half a tum- 
bler of water by itself ; one solution is then poured into the other, 
and the whole is drunk during the effervescence. 



MEDICINES AND THEIK PREPARATIONS. 877 

Solomon's Seal (Convalaria Multiflora). — This is one of our own 
perennial plants, and is found in various parts of the country. The 
root is tonic, mucilaginous and astringent. It acts especially upon 
mucous tissues, and has therefore found its use in chronic dysentery 
and piles, and in chronic inflammation of the stomach and bowels. 
Dose of the decoction, or infusion, from one to four fluid ounces, 
three or four times a day. Large doses purge and vomit. The de- 
coction applied locally, relieves the inflammation caused by the poison 
ivy. 

Solution of Arsenite of Potassa (Liquor Potassm Arsenitis). — 
This is known under the names of arsenical solution and Fowler's 
solution. It is a transparent liquid, having the color, taste and 
smell of spirits of lavender. It has the general action upon the 
human body of the arsenical preparations. It is the preparation 
generally resorted to where arsenic is given internally, and is used 
with considerable success in intermittent fever, leprosy and several 
other skin diseases, St. Vitus's dance, periodical headache, and some 
other complaints. The dose is from three to five drops, three times 
a day, given in water ; generally, it is better not to go beyond five 
drops. Sometimes it disturbs the stomach and binds the bowels, 
producing headache, dizziness and confusion of mind. When such 
effects follow its use, it must be laid aside and a purgative given. 
After an interval of two weeks, it may be resumed in smaller doses. 
It often requires to be used for several months. 

Spanish Flies (Cantharis Vesieatorid). — These insects are of a 
beautiful, shining, golden-green color. They attach themselves to 
such trees, in France, Spain and Italy, as the white poplar, elder, 
privet and lilac, upon the leaves of which they feed. They make 
their appearance in swarms upon these trees in May and June, and 
are shaken off in the morning while torpid with the cold. Internally 
administered, they are a powerful stimulant, exercising a peculiar 
influence over the urinary and genital organs. In large doses, they 
excite violent inflammation of the alimentary canal and urinary or- 
gans, strangury, irritation of the sexual organs, headache, delirium, 
and convulsions ; also painful priapism, vomiting, bloody stools, sali- 
vation, fetid breath, hurried breathing, and difficulty of swallowing. 
They are given internally for chronic gonorrhoea, leucorrhcea, seminal 
weakness, and paralysis of the bladder. Dose of the powder, from 
half a grain to a grain ; of the tincture, from twenty to fifty drops. 
Solution of potassa given every hour, in thirty-drop doses, is a 
remedy for strangury produced by cantharides. Spanish flies are 
used externally, in the form of blistering plaster ; also in the form of 
tincture, mixed with various solutions, to produce irritation and red- 
ness of the skin. 

Spearmint (Mentha Viridis). — This has carminative, diuretic 
and antispasmodic virtues. The warm infusion of it is much em- 



878 MEDICINES AND THEIR PREPARATIONS. 

ployed in domestic practice to produce perspiration after taking cold, 
and while suffering from feverish symptoms from various causes. 
The oil of spearmint has similar properties with the herb, and may 
be taken in five- to eight-drop doses, on sugar. One ounce of the oil 
of spearmint dissolved in a pint of alcohol, constitutes the essence of 
spearmint. 

Spermaceti (Cetaceum). — This is a white crystalline substance 
obtained from the head of the spermaceti whale. In househeld prac- 
tice, it is considerably used for the coughs and colds of children, 
being generally simmered with molasses or white sugar. It forms a 
part of several cerates and ointments. 

Spider's Web {Tela Araneoe). — The web of the black or brown 
spider, gathered in barns, cellars, etc., is sometimes given in five- or 
six-grain doses, in pill form, and it is said with good effect, in peri- 
odical headache, hysterics. St. Vitus's dance, asthma, and fever and 
ague. It is likewise applied externally to check bleeding. Care 
should be taken to have it clean and free from dust. 

Spirit of Nitric Ether (Spiritus jEtheris Nitrici). — The general 
reader will know this article better under the name of siveet spirits of 
nitre. It is diuretic, diaphoretic, antispasmodic and stimulant, and 
in large doses, a narcotic poison. It is much used in diseases of the 
urinary organs, either alone or combined with sedatives, and other 
diuretics. Dose, from twenty to thirty drops, to be taken in water, 
three or four times a day. 

Sponge (Spongia) . — When burned, this is used as an alterative in 
scrofula, scrofulous tumors, goitre, and obstinate diseases of the skin. 
It is much employed by homoeopathic physicians, though it has much 
less remedial power than iodine. Dose, one to two drams, mixed 
with honey or syrup. 

Spurred Rye (Secale Gornutuiix). — This is a diseased product of 
rye, known by the name of ergot. This article has a peculiar effect upon 
the womb, causing it to contract with great energy, when given in full 
doses. It should never be given, however, continuously, for a great 
length of time, as it has been known, when so used, to produce dry 
gangrene, typhus fever, and nervous disorders connected with con- 
vulsions. Such were its effects in certain provinces of France, in 
consequence of the use of rye bread contaminated with it. It is use- 
ful in excessive uterine hemorrhage, which it arrests by causing the 
womb to contract, and thus to condense its tissue and close up its 
bleeding vessels. It has also been successful in bleeding from the 
lungs. 

Preparations. — Fluid extract, dose, half a dram to a dram : tinc- 
ture, four ounees to a pint of diluted alcohol, dose, two and a half to 
five diams; infusion, dose, one to two ounces: wine, five ounces of 



MEDICINES AND THEIR PREPARATIONS. 879 

fluid extract to a pint of sherry wine, dose, two to three drams, in 
cases of labor ; for other purposes, one to two drams. 

Squill (Scilla Maritima). — A perennial plant growing in coun- 
tries on the Mediterranean. In large doses it is emetic and purga- 
tive ; in small doses expectorant and diuretic. It is used in pulmonary 
affections to increase expectoration, and in dropsical complaints to 
augment the secretions of the kidneys. Dose of the dried root, one to 
five grains, generally to be united with nitre or ipecac. 

Preparations. — Fluid extract, dose, as an expectorant and diuretic, 
two to six drops ; as an emetic, twelve to twenty drops ; compound 
fluid extract, dose, ten to twenty drops ; tincture, two ounces to a 
pint of diluted alcohol, dose, twenty to thirty drops ; syrup, dose, 
a quarter to half a dram. 

StarsGrass (Aletris Farinosa, Fig. 236). — This plant is found in 
dry soils throughout most parts of the United 
States, and called unicorn-root, ague-root, and 
croiv-corn. The root is an intensely bitter tonic, 
and is used to improve the tone of the stomach, 
and for flatulent colic and hysterics. It is said 
also to give tone to the female generative organs, 
affording a protection against miscarriage. The 
Eclectics call it one of their best agents in chlo- 
rosis, suppressed menstruation, engorgement and 
falling of the womb, and painful menstruation. 
Dose of the powdered root, from five to ten 
grains, three times a day. 

Preparations. — Fluid extract, dose, ten to 
twenty drops ; tincture, two ounces to a pint of FlG - m - Star-Grass. 
diluted alcohol, dose, half a dram to a dram ; infusion, two drams to 
a pint of water, dose, one or two ounces ; syrup, dose, one to two 
drams ; aletridin, the active principle, dose, one to three grains. 

St. Ignatius' Bean (Fdba Sancti Ignatii). — The seeds are the 
part used, and are the product of the Ignatia Amara, — a tree of 
middle size, growing in the Philippine Islands, and is a species of the 
strychnos. These seeds possess a large amount of strychnine, and 
consequently, in medicinal doses, are a powerful nervine tonic, and 
are used for improving the digestive functions, and for rousing and 
strengthening the whole system when prostrated by nervous com- 
plaints. 

Preparatiofis. — Fluid extract, dose, five to ten drops ; solid ex- 
tract, dose, half a grain to a grain and a half. 

Storax (Styrax Officinale). — This is the hardened juice of the 
storax, a native of the countries along the Mediterranean. It is a 
stimulant and expectorant, and is used for chronic bronchitis, laryn- 
gitis, and cough. The liquid storax is sometimes employed instead 





880 MEDICINES AND THEIR PREPARATIONS. 

of copaiba in gonorrhoea and gleet. The dose is from ten to fifteen 
grains. Storax is a constituent in the compound tincture of benzoin. 

Stramonium {Datura Stramonium, Fig. 237).— This annual 
plant is most known in this country by the 
name of Jamestown tveed ; in England by that 
of thornapple. The leaves and seeds are med- 
icinal. Stramonium is a powerful narcotic ; it 
is also antispasmodic, anodyne, and sedative. 
It is used in various nervous affections, as 
chorea, epilepsy, palsy, tetanus, and mania. 
It is much used for relieving acute ^>ains, etc. 
Taken in large doses, it is a powerful poison. 
Preparations. — Fluid extract, dose, five to 
fig. 237. stramonium. fifteen drops ; solid extract, dose, half a grain 
to a grain ; tincture, two ounces to a pint of alcohol, dose, half a 
dram to a dram, and to be gradually increased. Use with care. 

Sulphur. — This is considerably used in medicine, being laxative, 
diaphoretic, and resolvent. It is chiefly used for piles, chronic rheu- 
matism, gout, asthma, and those affections of the breathing organs 
not attended with acute inflammation. Externally and internally, 
it is much employed in skin-diseases, particularly for itch, for which 
it is a specific. In these affections, it is frequently applied in the 
form of sulphur baths. The dose of sulphur is from one to three 
drams, mixed with syrup, molasses, or milk. When sublimed, 
this article is vdlledt flowers of sulphur, which is the form in which 
it is chiefly used in medicine. 

Sumach (Rhus Grlabrum). — Found in almost all parts of the 
United States in old, neglected fields, and by the side of fences. The 
bark and berries are astringent, tonic, antiseptic, and diuretic, and 
are used in diarrhoea, dysentery, gonorrhoea, whites, hectic fever, 
and scrofula. The berries make a valuable gargle in quinsy and 
ulcerations of the mouth and throat, and also a useful wash for 
ringworm, tetter, and ulcers. The excrescences which grow upon 
the leaves have nearly as much astringency as galls, and when pul- 
verized and mixed with lard, have a similarly soothing effect upon 
piles. 

Preparations. — Fluid extract, dose, one to two drams ; tincture, 
four ounces to thirteen ounces of diluted alcohol, dose, half an ounce 
to an ounce. 

Sunflower (Helianthus Annivus). — The seeds and leaves of this 
plant are expectorant and diuretic, and are useful in several 
pulmonary affections. The seeds yield a fixed oil, in which their 
medicinal virtues are chiefly found. In doses of ten or fifteen drops, 
this oil acts favorably upon inflamed mucous surfaces, and in doses 
twice as large it greatly augments the flow of urine. 



MEDICINES AND THEIR PREPARATIONS. 881 

Swamp Dogwood {Cornus Sericed). — This is found in damp 
places, and along the banks of rivers, in various parts of our country, 
and is known as red osier, red willow and rose willow. The bark is 
tonic, stimulant and astringent, and has been used for similar pur- 
poses with dogwood-bark ; it is well spoken of, also, for dyspepsia, 
diarrhoea, malignant fevers, and as an external application to foul 
and ill-conditioned ulcers. Dose of the powdered bark, from 
twenty to fifty grains ; of the infusion, from two to three fluid 
ounces. 

Swamp Milkweed (Asclepias Incarnata). — This is a native of 
the United States, and bears red flowers from June to August. It 
has the name of white Indian hemp. The root is emetic, cathartic, 
and diuretic, and is useful in asthma, bronchitis, rheumatism, syphilis, 
and worms. 

Preparations. — Fluid extract, dose, twenty to thirty drops ; 
solid extract, dose, three to five grains ; tincture, two ounces to a 
pint of diluted alcohol, dose, one and a half to three drams ; infu- 
sion, dose, three to five drams; syrup, four ounces fluid extract to 
twelve ounces simple syrup, dose, half a dram to a dram. 

Sweet Fern QComptonia Asplenifolia) . — This shrub, growing in 
stony pastures in New England and Virginia, is tonic, astringent, 
alterative and aromatic, and is used in diarrhoea, dysentery, cholera- 
infantum, rheumatism, and debility after fevers. Dose of the decoc- 
tion, from one to three fluid ounces, three or four times a day. 

Sweet Flag (Acorus Calamus). — Found in damp places, in most 
parts of the world. The root is stimulant, tonic, and aromatic; 
useful in wind colic, weakened conditions of the stomach, and dys- 
pepsia. Dose of the root, from twenty to sixty grains ; of the infu- 
sion, from two to three fluid ounces. 

Sweet Gum (Liquidamber Styraciflud). — This tree grows in the 
Middle and Southern States. Being wounded, it yields a yellowish- 
white, honey-like balsam, which hardens into a gum. This, melted 
with equal parts of lard or tallow, forms an ointment which is used 
in some parts of the country for piles, ringworm of the scalp, fever- 
sores, and other complaints. Used internally, it has very nearly 
the same effects as storax. 

Tag Alder (Alnus Rubra). — This shrub grows in swamps and 
other damp places, in northern United States. The bark is altera- 
tive, emetic, and astringent. It is used in scrofula, secondary 
syphilis, herpes, impetigo, and other skin-diseases. 

Preparations. — Fluid extract, dose, one to two drams ; infusion, 
two ounces to a pint of water, dose, one to one and a half ounces ; 
alnuin, the active principle, dose, one to two grains. 

Tansy (Tanacetum Vulgare). — Tansy is a perennial herb, haying 
tonic, emmenagogue, and diaphoretic properties ; the cold infusion 



882 



MEDICINES AND THEIR PREPARATIONS. 



being tonic, and useful in dyspepsia, wind in the stomach, jaundice, 
and worms ; the warm infusion, diaphoretic and emmenagogue. 
Dose of the infusion, from one to three fluid ounces, two or three 
times a day. 

Tar (Pix Liquida). — The medicinal qualities of tar are like those 
of turpentine, and it is sometimes used in old chronic coughs and 
bronchitis. The vapor of boiling tar was once thought to be very 
serviceable in bronchial diseases, when inhaled. Doubtless it is 
useful in some cases, but its virtues have been extolled above their 
merits. In the form of ointment it has real efficacy in scald head 
and tetter. 

Thimbleweed (Budbeckia Laciniata). — The whole of this herb 
is balsamic, diuretic, and tonic, and in the form of decoction, used 
freely, is said to have been found useful in some urinary complaints, 
as Bright's disease, strangury, etc. 

Tobacco (JSFicotiana Tabacum). — The leaves of tobacco are acrid, 
narcotic, and poisonous, and are chiefly used in the form of oint- 
ment, in skin diseases, etc. Its poisonous qualities, however, render 
it dangerous when much used, even externally. Nervous people 
should not smoke. Chewing is not only an unhealthy, but a dis- 
gusting habit. 

Trailing Arbutus (Epigiaia Repens). — This grows in sandy 
woods and rocky soils, its flowers appearing in early spring, and ex- 
haling a spicy fragrance. The leaves are diuretic and astringent, 
and are very useful in gravel, and most diseases of the urinary 
organs, being regarded in some cases superior to uva-ursi and buchu. 

Preparations — Fluid extract, dose, one to two drams ; infusion, 
dose, two to three ounces. 

Tapioca (Janipha Manihot, Fig. 238). — This plant grows in the 
West Indies and Brazil. It is cultivated 
chiefly on account of the root, which is large- 
ly used as an article of food, particularly for 
the sick, or rather for those recovering from 
sickness. The starch which it contains is 
separated by washing, scraping, grating, and 
grinding, and is in the form of hard, white, 
rough grains. It is prepared for use by boil- 
ing; and, in debility and low forms of disease, 
may have the addition of wine, nutmeg, or 
other aromatics. 

Tulip Tree {Liriodendron Tulipifera) . — 
This is a large and elegant tree growing in 
many parts of the country, and called poplar and white poplar. 
The bark of the root is aromatic, stimulant, and tonic, and in warm 
infusion, diaphoretic. It is used in fever and ague, chronic rheuma- 




Fig. 238. Tapioca. 



MEDICINES AND THEIR PREPARATIONS. 883 

tism, and chronic diseases of the stomach and bowels. Dose of the 
powdered bark, from a scruple to two drams ; of the infusion, from 
one to two fluid ounces. 

Turkey Corn (Corydalis Formosa). — This perennial plant is 
called wild-turkey pea and stagger-weed, and grows in rich soils in 
the Southern and Western States. The tuber, which is the medicinal 
part, should only be collected when the plant is in flower. It is tonic, 
diuretic, and alterative. It is much valued as a remedy in syphilis 
and scrofula. 

Preparations. — Fluid extract, dose, ten to thirty drops ; tincture, 
three ounces to a pint of diluted alcohol, dose, half a dram to two 
drams : corydalin, the active principle, dose, half a grain to a grain. 
A valuable alterative for syphilis is made by uniting eight grains of 
corydalin with ten grains of hydrastin, and dividing into twelve 
powders. Dose, one powder three or four times a day. 

Turmeric (Curcuma Longa). — This is a native of the East Indies 
and Cochin China. The root is a stimulant aromatic and tonic, 
somewhat like ginger, employed in debilitated states of the stom- 
ach, etc. 

Preparations. — Fluid extract, dose, two or three drams ; tincture, 
two ounces to twelve ounces of diluted alcohol, dose, one and a half 
to two ounces ; infusion, dose, two to four ounces. 

Valerian (Valeriana Officinalis). — This is a European plant, 
flowering in June or July. The root is tonic, nervine, and antispas- 
modic, and is much used in cases of irregular nervous action, partic- 
ularly morbid nervous vigilance, or hypochondria, epilepsy, lowness 
of spirits, and nervous headache. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, three to eight grains ; tincture, four ounces to a pint 
of diluted alcohol, dose, two to three drams ; infusion, half an ounce 
to a pint of water, dose, two to three ounces ; syrup, four ounces of 
fluid extract to a pint of simple syrup, dose, two to three drams. 

Vervain (Verbena Hastata). — A perennial plant, common in the 
United States. The root is tonic, emetic, expectorant, and sudorific. 
It is used in intermittent fevers, colds, and obstructed menstruation, 
in the form of warm infusion. The cold infusion is a good tonic in 
loss of appetite, debility, etc. Dose of the powdered root, one or two 
scruples ; of the infusion, from two to three ounces, three or four 
times a day. 

Vinegar (Acetum). — This is refrigerant, diuretic, astringent, and 
tonic ; used in fevers and inflammatory complaints, likewise in scurvy 
and typhus, as an antiseptic. It has been found useful in dysentery 
and scarlet fever, saturated with common salt. Externally, it is ap- 
plied to bruises, inflammations, sprains, and swellings. It sometimes 
has a good effect as a gargle in putrid sore throat, etc., and as a 
cooling wash in headache during fevers. 



884 



MEDICINES AND THEIK PREPARATIONS. 



Virginia Snake-root (Aristolochia Serpentaria, Fig. 239). — This 
is a perennial herb of the Middle and Southern States. The root is 
stimulant, tonic, and diaphoretic. It is used in typhoid fevers, when 
the system needs support, but cannot bear active stimulation. Com- 
bined with Peruvian bark, it is also used in intermittent fevers. The 
cold infusion is employed in some forms of dyspepsia ; likewise as a 
gargle in malignant sore throat. 

Preparations. — Fluid extract, dose, one-quarter to half a dram ; 
tincture, three ounces to a pint of diluted alcohol, dose, one to two 
drams ; infusion, half an ounce to a pint of water, dose, one to two 
ounces, in low forms of fever. The following is a good compound 
tincture : half an ounce each of fluid extract of snake-root, fluid ex- 
tract of ipecac, fluid extract of saffron, fluid extract of ladies' slipper, 
together with half an ounce of camphor, and one and a half pints of 
diluted alcohol ; dose, a dram to a dram and a half. 




*V 



Fig. 239. Virginia Snake "Root. 



Fig. 240. Water-Horehound. 



Water=Horehound (Fig. 240). — This article has been described 
under Bugle-Weed (Lycopus Virginicus). See Bugle-Weed. 

Water=Pepper {Polygonum Punctaturri). — This annual plant is 
called smart-weed, and grows throughout our country, in low grounds, 
and along ditches and brooks. It has a pungent, biting taste, and is 
stimulant, diuretic, emmenagogue, antiseptic, and vesicant. It is 
used in coughs, colds, gravel, and womb-complaints. 

Preparations. — Fluid extract, dose, ten to forty drops ; solid 
extract, dose, two to three grains ; tincture, four ounces to a pint of 
diluted alcohol, dose, half a dram to two drams ; infusion, half an 
ounce to a pint of water, dose, half an ounce to an ounce. 

Wahoo (Uuonymus Atropurpureus) . — A small shrub growing 
in woods in many parts of the United States. The bark of the root 
is a bitter tonic, laxative, alterative, diuretic, and expectorant, and is 
advantageously used in pulmonary affections, dropsy, constipation, 
torpidity of the liver, dyspepsia, and intermittent fevers. 



MEDICINES AND THEIR PREPARATIONS. 885 

Preparations. — Fluid extract, dose, one to two drams ; tincture, 
four ounces to twelve ounces of diluted alcohol, dose, half an ounce 
to an ounce. 

Wax. — The yellow and white wax are chiefly used as ingredients 
of plasters and ointments. 

White Hellebore ( Veratrum Album) . — This is a European 
perennial plant, the root of which is a violent emetic and purgative, 
and in large doses is poisonous ; not often used, except externally, 
in the form of ointment or decoction, for the cure of itch and some 
other skin-diseases. 

White Oak (Quercus Alba). — The inner bark of the white oak 
is astringent, tonic, and antiseptic, and has been used in intermit- 
tent fever, chronic diarrhoea, chronic mucous discharges, and passive 
hemorrhages. As a wash applied externally it sometimes arrests 
night-sweats, and as an astringent gargle and injection its use is com- 
mon for relaxed palate, spongy gums, leucorrhcea falling of the 
bowel, etc. 

Preparations. — Fluid extract, dose half a dram to a dram ; solid 
extract, dose, ten to fifteen grains ; tincture, two ounces to a pint of 
diluted alcohol, dose, half an ounce to an ounce. 

White Pond=Lily QNymphma Odorata). — This grows in ponds 
and marshes in many parts of our country. The root is demulcent, 
anodyne, astringent, and alterative ; used in dysentery, diarrhoea, 
gonorrhoea, whites, and scrofula. An infusion is sometimes used as 
a gargle in ulcers of the mouth and throat, and as an injection in 
leucorrhcea. Dose of the infusion, from two to three fluid ounces. 

Wild Cherry (PrunusVirginiana~). — This tree grows extensively 
in the American forests, flourishing where the soil is fertile and the 
climate temperate. The inner bark is tonic and stimulant to the 
digestive organs, and -sedative to the nerves and the circulation. It 
is much used in consumption, scrofula, and dyspepsia. 

Preparations. — Fluid extract, dose, two to three drams, compound 
fluid extract, dose, half a dram to a dram ; infusion, half an ounce 
to a pint of water, dose, one ounce ; syrup, three ounces of fluid 
extract to thirteen ounces of simple syrup, dose, two drams to an 
ounce. 

Wild Cucumber (MomordicaElaterium). — 'This, sometimes called 
squirting cucumber, is a native of the south of Europe, and is culti- 
vated in Great Britain. It is a powerful hydragogue cathartic, and 
in large doses causes nausea and vomiting. On account of the 
watery stools it produces it is much used in dropsical complaints, 
though the severity of its action forbids its being used alone. Dose. 
a quarter to half a grain, repeated every hour till it operates : of 
elaterin, from a sixteenth to a twentieth of a grain, given in solution. 




Fig. 241. Wild Ixdigo. 



886 MEDICINES AND THEIR PREPARATIONS. 

Wild Ginger (Asarum Canadense). — This is known by the names 
of coltsfoot and Canada snake-root, and Is common in all parts of the 
country. The root is tonic, stimulant, aromatic, expectorant, and 
diaphoretic. It is used in pains of the stomach, colic, etc. Dose of 
the powder, half a dram ; of the tincture, half a dram to two drams. 

Wild Indigo (Baptist a Tinctoria, Fig. 241). — This perennial 
shrub is found in most parts of the country. 
The bark of the root is purgative, emetic, stimu- 
lant, astringent, and antiseptic. It is chiefly 
used for its antiseptic properties. For external 
use it is valuable as a wash or gargle for various 
ulcers, mercurial sore mouth, and scrofulous 
and syphilitic ophthalmia. 

Preparation*. — Fluid extract, dose, a quarter 
to half a dram ; tincture, two ounces to a pint of 
diluted alcohol, dose, two to four drams : infu- 
sion, dose, half an ounce; baptisin, the active 
principle, a quarter to half a grain : gargle, four 

ounces of fluid extract to twelve ounces of water, to be used as 

occasion requires. 

Wild Yam {Dioscorea Villosa). — A perennial vine, found mostly 
at the South. The root is antispasmodic, and is successfully used in 
bilious colic. It is said to bring relief in the most violent cases of 
this complaint. It allays nausea and spasms during pregnancy. It 
is given in the form of decoction, two or three fluid ounces every 
thirty or forty minutes. Dose of the tincture, from a quarter of a 
dram to a dram : of dioscorein, the active principle, one to three 
grains. 

Willow (Sali.r Alba). — The willow is common in Europe and 
America. Its bark is tonic and astringent, and is used, occasionally. 
as a substitute for Peruvian bark in intermittent fever. It is also 
employed in the treatment of chronic diarrhoea and dysentery. 
Dose of the powdered bark, one dram ; of the decoction, one to two 
fluid ounces. Salicin, the active principle, is given, sometimes, in 
place of quinine ; dose, from two to eight grains. 

Wintergreen (Gaultheria Procumbent). — This evergreen grows 
in mountainous, barren regions, throughout our country. The leaves 
are an agreeable stimulant, aromatic and astringent. Used for 
chronic diarrhoea, and as an emmenagogue. The oil and essence are 
useful in flatulent colic ; dose of the oil, from five to eight drops, on 
sugar ; of the essence, twenty to thirty drops. Much used to flavor 
other medicines. 

Witch-Hazel (Hamamelis Virginica, Fig. 242). — This derives its 
name from its having fruit and flowers together on the same tree. 
It is found in most parts of our country. The bark and leaves are 



MEDICINES AND THEIR PREPARATIONS. 



887 



tonic, astringent and sedative. It is used in bleeding from the lungs 
and stomach, and in diarrhoea, dysentery, 
and excessive mucous discharges. It is 
also used in incipient consumption, and 
for sore mouth, etc. 

Preparations. — Fluid extract, dose, one 
to two drams ; infusion, dose, three drams ; 
syrup, four ounces of fluid extract to twelve 
ounces of simple syrup, dose, one to two 
drams. 

Wolfsbane (Aconitum Napellus, Fig. 
243). — This has already been described 
under its other common name, which is 
monkshood. See " Monkshood " for its 
description. 

Wormseed (Chenopodium Anthelminticum) . — This perennial is 
called Jerusalem oak, and is found in waste places all over the United 
States. An oil is extracted from the seeds, which, in doses of from 
three to five drops, morning and evening, for a child, destroys worms. 
A strong infusion of the tops has a similar effect. The remedy 
should be used four or five days, and be followed by a purge. 




Fig. 242. Witch-Hazel. 





Fig. 243. Wolfsbane. 



Fig. 244. Wormwood. 



Wormwood {Artemisia Absinthium, Fig. 244). — The tops and 
leaves of this perennial are tonic and anthelmintic ; used in inter- 
mittent fever, jaundice, and worms. It restores the appetite in a 
weakened state of the digestive organs, and is also useful in amen- 
orrhea. It is excellent applied as a tincture, or in the form of fo- 
mentation, to bruises, sprains, and local inflammations. 

Preparations. — Fluid extract, dose, one-third to two-thirds of a 
dram ; solid extract, dose, three to five grains ; tincture, two ounces 
to fourteen ounces of diluted alcohol, dose, two to three drams ; 



MEDICINES AND THEIR PREPARATIONS. 

syrup, two ounces fluid extract to six ounces of simple syrup, dose, 
one to two drams. 

Yarrow (Achillea Millefolium). — A perennial herb, common to 
the Old World and New, and growing in old fields and along fences. 
It is tonic, astringent, and alterative, and has been used in intermit- 
tent fever, bleeding from the lungs, excessive menstruation, wind 
colic, and chronic dysentery. Dose of the infusion, a wineglassful 
three or four times a day. 

Yeast (Cerevisice Fermentum). — Yeast is slightly tonic and stim- 
ulating, and has been used with advantage in typhoid fever ; also in 
scarlet fever, and in all diseases where there is a disposition to 
putridity. The dose is from one to two fluid ounces every two or 
three hours. It makes an excellent antiseptic poultice for unhealthy 
and fetid ulcers, especially if combined with powdered slippery-elm 
bark and charcoal. 

Yellow Dock (Rumex Crispus, Fig. 245). — The root of this 
perennial plant is alterative, tonic, diuretic, and deter- 
gent, and is regarded as very valuable in the treat- 
ment of scrofula, syphilis, leprosy, scurvy, and other 
skin diseases. 

Preparations. — Fluid extract, dose, one to two 
drams ; solid extract, dose, four to five grains ; syrup, 
four ounces of fluid extract to twelve ounces of simple 
syrup, dose, half an ounce to an ounce ; rumin, the 
active principle, dose, two to three grains. 

Yellow Jessamine (G-eheminum Sempervirens). — 
This abounds in the Southern States, where it is cul- 
tivated as an ornamental vine. The root is a power- 
ful febrifuge, narcotic and relaxant, controlling and 
yellow dock, subduing fever, quieting nervous irritability and ex- 
citement, equalizing the circulation, promoting perspiration, and recti- 
fying the secretions. It is much used by the Eclectics of the West- 
ern States, but the general judgment of the profession is that it is 
too powerful a remedy to be safe. My own opinion is, that the 
American hellebore is equally effective with the yellow jessamine, 
and that its general use involves far less danger. 

Preparations. — Fluid extract, dose, two to ten drops ; tincture, 
four ounces to a pint of alcohol, dose, fifteen to thirty drops, and in- 
crease ; gelseminin, the active principle, dose, half a grain to a grain 

and a half. 

■ 
Yellow Ladies' Slipper ( Cypripedium Pubescens). — This perennial 
plant is called American valerian, nerve-root, etc. The fibrous roots 
are tonic, nervine, antispasmodic and diaphoretic, and are used in 
nervous headache, nervous excitability, hysterics, neuralgia, and St. 
Vitus's dance. Dose of the powder, from ten to twenty grains. 




MEDICINES AND THEIR PREPARATIONS. 889 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, five to ten grains ; tincture, two ounces to a pint of 
diluted alcohol, dose, half an ounce to an ounce ; syrup, four ounces 
of fluid extract to fourteen ounces of simple syrup, dose, two to three 
drams ; cypripedin, the active principle, dose, two to three grains. 

Yellow Parilla (Menispermum Canadense). — This is a perennial 
plant, growing in woods and near streams, throughout the country. 
The root has the properties of a tonic, laxative, alterative, and diu- 
retic. It is valued in the treatment of scrofula, syphilis, skin dis- 
eases, gout, rheumatism, dyspepsia, general debility and chronic 
inflammation of the stomach and bowels. Dose of the decoction, 
from two to three fluid ounces, three times a day; of the solid ex- 
tract, from two to three grains. 

Zinc. — Several preparations of this metal are used in medicine, 
as follows : — 

Acetate of Zinc (Zinci Acetas). — This is used as an external 
remedy only, generally as an astringent wash for inflammations of the 
eye, and as an injection in gonorrhoea, but only after the acute stage 
of these diseases has past. The strength of these solutions gen- 
erally should be one or two grains to a fluid ounce of soft water. 

Chloride of Zinc (Zinci Chloridurn) . — This is a powerful escharo- 
tic, and is employed as an external application to cancers and obsti- 
nate ulcers. A weak solution of it is occasionally employed in old 
chronic gleet, also in whites and purulent discharge from the neck 
of the womb. 

Iodide of Zinc (Zinci Iodidum). — This is in the form of white 
needles, and is tonic and astringent. It is not much used, except 
externally, being applied in a solution of twenty grains to a fluid 
ounce of water, to enlarged tonsils, by means of a camel's-hair pencil 
or a piece of sponge tied to the end of a stick. 

Oxide of Zinc (Zinci Oxiduni). — This is an inodorous white 
powder, insoluble in water and alcohol. It is tonic and anti- 
spasmodic, and is given in chorea, epilepsy, whooping-cough, and 
other similar diseases ; but it is more especially employed to arrest 
the night-sweats of consumption, for which purpose we have at 
present no other article of equal efficacy. It is sprinkled externally 
upon excoriated surfaces, and is used in ointments. Dose, from two 
to five grains, in the form of pill. 

Precipitated Carbonate of Zinc (Zinci Carbonas ProBcipitas.') — 
This is employed for the same purpose as prepared calamine, being 
adapted only to external use. 

Prepared Calamine (Calamina Prceparata). — This is in the 
form of a pinkish or flesh-colored powder, of an earthy appearance. 
It is employed only as an external application, being dusted on ex- 



890 MEDICINES AND THEIR PREPARATIONS. 

conations and superficial ulcerations, as a mild astringent. It should 
be a very fine powder. 

Sulphate of Zinc (Zinci /Sulphas). — This is a colorless, transpar- 
ent salt, crystallizing usually in small four-sided prisms. It is tonic 
and astringent, and in large doses, a prompt emetic. Used as a tonic 
in cases of debility attended with irritation. In obstinate intermit- 
Lents, it is sometimes conjoined with sulphate of quinia ; it is chiefly 
employed, however, in such spasmodic diseases as epilepsy, chorea 
and whooping-cough. As an astringent, it is used externally, being 
applied in solution to bleeding surfaces, as a wash in ophthalmia, 
and as an injection in whites and chronic gonorrhoea. 

Valerianate of Zinc (Zinci Valeriana*). — This is in white, 
pearly scales, with a faint odor of valerianic acid. It is tonic and 
antispasmodic, and is used in the various nervous affections which 
accompany chlorosis. Dose, one or two grains, several times a day, 
in the form of a pill. 

Vaseline (Petrolatum). — This is a transparent, fat-like substance, 
obtained in the distillation of crude petroleum. It is very exten- 
sively used in the domestic materia medica, in the treatment of colds 
and many other ailments. Its efficacy has been, however, much 
overrated, its chief utility being that of a neutral, simple unguent, 
and as a vehicle for the application of more active remedies, for 
which purpose it is preferable to the animal fats generally employed. 



PREPARATIONS-PHARMACY. 



The preparation of medicines for use constitutes the art of phar- 
macy. It is the peculiar business of the apothecary. It will not be 
necessary in these pages to describe his art, in all particulars, but 
merely as many of the preparations which it is his duty to prepare 
as are really needed in the treatment of disease. In doing this, I 
shall classify the preparations alphabetically, and begin with 

Cerates. 

These substances have a degree of hardness midway between 
ointments and plasters. They may be spread upon leather or linen, 
without the use of heat, and they do not melt and run when applied 
to the skin. They are made of wax, or spermaceti, combined with 
lard or oil. The articles are melted together by a very gentle heat, 
and during the process of cooling the whole should be well stirred. 

Calamine Cerate. — Prepared calamine and yellow wax, each 
three ounces ; lard, one pound. Melt the lard and wax together. 
When the mixture begins to thicken, on cooling, gradually stir in the 
calamine. 

This is called Turner's Cerate, and is useful for burns, excoriations, 
superficial ulcers, and sores. 

Goulard's Cerate. — Take of solution of subacetate of lead, two 
fluid ounces and a half ; white wax, four ounces ; olive oil, nine fluid 
ounces; camphor, half a dram. Mix the wax, previously melted, 
with eight fluid ounces of the oil ; remove from the fire, and when 
the mixture begins to thicken, gradually pour in the solution of 
subacetate of lead, stirring constantly, with a wooden spatula, till it 
becomes cool. Then add the camphor, dissolved in the remainder of 
the oil. 

This is the cerate of subacetate of lead, and is used for excoriations, 
inflamed burns, scalds and chilblains, and for eruptions of the skin. 
Excellent for blistered surfaces, indisposed to heal. 

Half an ounce of this preparation united with half an ounce of 
simple cerate, and one dram each of calomel and powdered opium, 
makes a very valuable remedy for various eruptions of the skin, of a 
local nature. 



892 MEDICINES AND THEIR PREPARATIONS. 

Resin Cerate. — Take of resin, five ounces; lard, eight ounces; 
yellow wax, two ounces. Melt together with a gentle heat, and stir 
till cool. 

This is known as basilicon ointment, and is used as a gentle stimu- 
lant to blistered surfaces, indolent ulcers, burns, scalds and chilblains. 

Compound Resin Cerate. — Take of resin, suet, and yellow wax, 
each a pound ; turpentine, half a pound ; flax-seed oil, half a pint. 
Melt together, strain through linen, and stir till cool. 

This, under the name of Deshler's salve, is popularly used for sim- 
ilar purposes with the resin cerate. 

Savin Cerate. — Take powdered savin, two ounces; resin ce- 
rate, a pound. Mix the savin with the cerate, previously softened. 
Used as a dressing for perpetual blisters. 

Simple Cerate. — Lard, eight ounces; white wax, four ounces. 
Melt together and stir till cool. 

Used for dressing blisters, wounds, etc., where it is desirable sim- 
ply to preserve the moisture of the part, and to exclude the air. 

Spanish Flies Cerate, known as blistering plaster. Take finely 
powdered Spanish flies, a pound ; yellow wax and resin, each seven 
ounces; lard, ten ounces. To the wax, resin and lard, previously 
melted together and strained, add the Spanish flies, and, by means 
of the most gentle heat, keep the mixture in a fluid state for half an 
hour, stirring occasionally, then remove the heat and stir till cool. 

This can be easily spread without the aid of heat, and is used for 
the purpose of drawing blisters. It is now, however, superseded in 
a great degree by various preparations, composed for the most part 
of cantharidin, either dissolved in oil, and applied to the skin by 
means of a piece of paper saturated with it, or incorporated with wax 
and spread in a very thin layer upon fine waxed cloth, silk, or paper, 
constituting the blistering cloth, blistering paper, etc. 

Confections, Conserves and Electuaries. 

These are soft solids, in which medicinal articles are incorporated 
with sugar, syrup, honey, or some other saccharine matter, for the 
purpose both of preserving the mass, and of rendering the medicine 
more palatable and convenient for use. 

Aromatic Confection. — Take of aromatic powder, five and a half 
ounces ; powdered saffron, half an ounce ; syrup of orange-peel, six 
ounces ; clarified honey, two ounces. Rub the aromatic powder with 
the saffron ; then add the syrup and honey, and beat the whole to- 
gether in a mortar till they are thoroughly mixed. 

Given in debilitated states of the stomach, as a vehicle for other 
medicines. Dose, ten grains. 



MEDICINES AND THEIR PREPARATIONS. 893 

Compound Confection of Catechu. — Take of compound powder 
of catechu, five ounces ; simple syrup, five fluid ounces. Add the 
syrup gradually to the powder, and mix them well. 

To be given in diarrhoea and chronic dysentery, in the dose of half 
a dram to a dram. 

Confection of Senna, otherwise called lenitive electuary. Take of 
senna, eight ounces ; coriander seeds, four ounces ; bruised liquorice- 
root, three ounces; figs, a pound; pulp of prunes, pulp of tamarinds, 
pulp of purging cassia, each, half a pound ; refined sugar, two pounds 
and a half ; water, four pints. Rub the senna and coriander together 
and separate ten ounces of the powder with a sieve. Boil the residue 
with the liquorice-root and figs, in the water, to one half ; then press 
out the liquor and strain. Evaporate the strained liquor, by the 
most gentle heat, to a pint and a half ; then add the sugar and form 
a syrup. Lastly, rub the pulps with the syrup, added gradually, and, 
having thrown in the sifted powder, beat all together till well mixed. 

This is a pleasant and admirable laxative, being well adapted to 
the habitual costiveness of pregnant women, and those affected with 
piles ; for this latter purpose, it is still better combined with cream 
of tartar and sulphur, as described in No. 6 of the prescriptions. 

Decoctions. 

These are solutions of vegetable medicines, obtained by boiling 
them in water. They differ from infusions, in being subjected to a 
greater degree of heat, the water during their preparation being kept 
up to the boiling point. The process should be conducted in a 
covered vessel, and the boiling must not be continued for a very long 
time. Medicines whose active principle is volatile are not proper 
for decoctions, the active principle being driven of! by heat and lost. 

The usual proportion of vegetable substances used in making de- 
coctions is one ounce to a pint of water, and the dose of the decoction, 
from one to three ounces. 

Essences. 

These are generally prepared by dissolving one ounce of the 
essentia] oils of plants in one pint of alcohol. The oils of lemon, 
peppermint, sassafras, etc., are made in this way, and their properties, 
of course, are similar to the oils from which they are prepared. They 
are generally taken in a little sweetened water, in doses of ten drops 
to a teaspoonful. 

Extracts. 

These are soft solids, obtained by evaporating the tinctures, or 
solutions, of vegetable substances. The active principles of dried 
vegetables can only be extracted by some liquid ; this, for preparing 



894 MEDICINES AND THEIR PREPARATIONS. 

extracts, is either water or alcohol, or a mixture of the two. Those 
obtained by the use of water are called aqueous, or watery extracts ; 
those by means of alcohol, alcoholic extracts; and those by both 
alcohol and water, hydro-alcoholic extracts. 

Fluid Extracts. 

These are concentrations, into a small bulk, in liquid form, of 
the active principles of medicinal substances. They are a valuable 
class of remedies, being in some cases preferable to tinctures, having 
less alcohol ; and better than extracts or decoctions, because not so 
often injured by heat in their preparation, and not requiring to be 
taken in large doses. Great skill is required in their preparation, 
and they should always be obtained from those who have the repu- 
tation of making reliable articles. 

Fomentations. 

Fomentation is a sort of partial or local hot bath, and consists 
either in the application of cloths dipped in hot water, or some hot 
medicated decoction, and applied to the affected part, or of bitter or 
anodyne herbs steeped in vinegar or water, and then, while hot, en- 
closed in a muslin bag, and laid upon the diseased place. In either 
case, whether the cloths wet in a decoction of the herbs, or the herbs 
themselves, slightly steeped, be applied in a bag, the application 
should be as hot as can be borne, and not so moist as to wet the bed 
or clothes of the patient. 

Fomentations act by their warmth and moisture chiefly: and 
slightly, in some cases, by their medicinal virtues. Their object is 
to lessen pain and inflammation, by relaxing the parts, and relieving 
tension and spasm. They may be prepared from equal parts of hops, 
tansy, and wormwood, or from equal parts of hops, lobelia, and stra- 
monium, etc., etc. 

Infusions. 

Those made of one article only are sufficiently referred to in pre- 
vious pages. It will only be necessary here to insert such compound 
infusions as are deemed important. 

Compound Infusion of Catechu. — Take of powdered catechu 
half an ounce, bruised cinnamon a dram : boiling water a pint ; mace- 
rate for an hour in a covered vessel, and strain. An elegant mode 
of administering catechu. Dose, from one to two fluid ounces three 
or four times a day. 

Compound Infusion of Gentian. — Take of bruised gentian half 
an ounce : dried orange-peel and coriander-seeds, bruised, each a dram ; 
diluted alcohol, four fluid ounces ; cold water, twelve fluid ounces. 



MEDICINES AND THEIR PREPARATIONS. 895 

First pour on the diluted alcohol, then, three hours afterward, the 
water. Let the whole stand twelve hours, and strain. An excel- 
lent form for using gentian. Dose, one fluid ounce three or four 
times a day. 

Compound Infusion of Geranium. — Take of geranium root, 
sweet bugle-leaves, golden- seal root, witch-hazel bark, each, in coarse 
powder, one ounce ; boiling water, four pints. Mix, and allow all 
to stand in a covered vessel two hours, applying a gentle heat; 
then strain. Two drams of alum may or may not be added. 

Used in chronic diarrhoea and dysentery, in one or two tablespoon- 
ful doses, every two or three hours ; also as an injection in gleet, 
whites, falling of the bowel, etc. ; and as a gargle in ulcerations of 
the mouth and throat. 

Compound Infusion of Parsley. — Take of parsley roots and 
seeds and subcarbonate of iron, each two ounces ; horseradish-root, 
one ounce ; squill, juniper-berries, white mustard-seed, mandrake 
root, and queen of the meadow root, each half an ounce ; coarsely 
bruise these articles, and place them in boiling cider, and expose 
them for twenty-four hours to a very gentle heat, in a covered earthen 
vessel. The cider should be sparkling and tart. Let the articles 
stand in the cider. 

Useful in dropsy. Dose, one or two fluid ounces three or four 
times a day. 

Compound Infusion of Senna. — Take of senna and manna, each 
one ounce ; jalap, cream of tartar, and caraway seeds, bruised, 
each two drams ; boiling water, one pint. Add all the ingredients 
to the water, in a covered vessel, and let them stand twelve hours. 
Then add four ounces of elixir salutis. 

This is a valuable, and not disagreeable, gentle physic for various 
purposes. Dose, from one to three ounces. 

Compound Infusion of Trailing Arbutus. — Take of queen of 
the meadow root, dwarf-elder bark, marshmallow root, and trailing 
arbutus, each, coarsely bruised, half an ounce ; add to them one pint 
of boiling water and one pint of Holland gin, and steep by the fire 
four hours, in a closely covered vessel. Strain, and sweeten with 
honey. 

Excellent for gravel, suppression of urine, scalding of urine, and 
various other disorders of the urinary organs. Dose, from an ounce 
to a wineglassful, with more or less frequency, according to the ur- 
gency of the case. 

Injections. — Clysters. 

These are preparations to be introduced into the lower bowel by 
means of a syringe. A sufficient number of them are given among 
the recipes. It is not necessary to repeat them here. 



896 MEDICINES AND THEIR PREPARATIONS. 

Liniments. 

These are liquid preparations, generally a little thicker than water, 
and thinner than oils, intended only to be applied to inflamed, pain- 
ful, or swelled parts. They are designed to soothe, or quiet, or 
stimulate, or make red the part to which they are applied ; and are 
rubbed on with the hand, or a piece of flannel or cotton, and fre- 
quently in connection with heat, by sitting or standing before a 
fire. 

A large number of liniments are given under the head of recipes. 
To those I add a few valuable ones here. 

Camphor Liniment. — Take six drams of camphor, and dissolve it 
in one fluid ounce of chloroform, and add to this one fluid ounce of 
olive oil. 

For sprains, neuralgia, rheumatism, etc. 

Compound Camphor Liniment. — Take two ounces and a half 
of camphor, a fluid dram of oil of lavender, seventeen fluid ounces 
of alcohol, and three fluid ounces of strong solution of ammonia, 
dissolve the camphor and oil in the alcohol ; then add the ammonia, 
and shake till they are mixed. 

To be used as a rubefacient and anodyne for local pains, particu- 
larly rheumatism. 

Compound Liniment of Ammonia. — Take five fluid ounces of 
strong water of ammonia, two fluid ounces of tincture of camphor, 
and one fluid ounce of spirit of rosemary. Mix them well together. 

This is used as a prompt and powerful rubefacient, or even vesi- 
catory, in neuralgia, rheumatism, gout, spasms, and inflammations. 

Croton Oil Liniment. — Take one fluid ounce of croton oil and 
seven fluid ounces of oil of turpentine. Mix, and shake them well 
together. 

A good rubefacient and pustulating preparation to apply to the 
chest and other parts. 

Liniment of Opium. — Take six ounces of Castile soap, an ounce 
and a half of opium, three ounces of camphor, six fluid drams of oil 
of rosemary, and two pints of alcohol. Macerate the soap and opium 
in the spirit for three days ; then filter, and add the oil and camphor, 
and shake briskly. 

This is a useful anodyne and rubefacient liniment for bruises, 
sprains and pains of a rheumatic and gouty nature. 

Liniment of Spanish Flies. — Take an ounce of powdered Span- 
ish flies, and half a pint of oil of turpentine. Mix, and apply gentle 
heat to them, in a covered vessel, for three hours. Then strain. 

Employed with advantage externally in the sinking stage of ty- 
phoid fevers. If so powerful as to cause blistering, it may be weak- 
ened by adding flax-seed or olive oil. 



MEDICINES AND THEIR PREPARATIONS. 897 

Liniment of Turpentine. — Take half a pint of oil of turpentine, 
and a pound of resin cerate. Melt the cerate, and add the oil to it, 
mixing them well. 

This is a valuable remedy for scalds and burns, and should be 
applied soon after the accident, and be discontinued when the inflam- 
mation excited by the fire is removed. The burned or scalded sur- 
face should be covered with lint wet with the liniment. 

Opodeldoc. — Take three ounces of white bar soap, sliced, an 
ounce of camphor, a fluid dram each of oil of rosemary and oil of 
origanum, and a pint of alcohol. Digest the soap in the alcohol by 
means of a gentle heat until it is dissolved ; then add the camphor 
and oils, and when they are dissolved pour the whole into broad- 
mouthed vials. 

This is the camphorated soap liniment, and is used as an anodyne 
application to sprains, bruises, painful tumors, etc. 

Medicated Waters. 

Those preparations consisting of water impregnated with some 
medicinal substance are called medicated waters. They are pre- 
pared from volatile oils by triturating in a mortar a dram of the oil, 
more or less, with a small quantity of carbonate of magnesia, and 
then very gradually pouring on one quart of water, while the tritura- 
tion is continued. At last the preparation is filtered through paper. 
The quantity of oil, magnesia, and water, used for each preparation, 
is as follows : 

Oil of bitter almonds, sixteen minims ; carbonate of magnesia, a 
dram ; water, one quart. 

Oil of cinnamon, half a fluid dram ; carbonate of magnesia, a 
dram ; water, one quart. 

Twenty minims of oil of roses, a dram of carbonate of magnesia, 
and one quart of water. 

Oil of fennel, half a fluid dram ; carbonate of magnesia, a dram ; 
water, a quart. 

Peppermint-water, spearmint-water, and pen nyroyal- water, are 
all prepared from the same quantities of their several oils as cinna- 
mon-water. 

The dose of these waters is half a fluid ounce to two fluid ounces, 
except the bitter almond water, which is one or two fluid drams. 

Camphor Water — Take two drams of camphor, forty minims of 
alcohol, four drams of carbonate of magnesia, and one quart of 
water. Rub the camphor first with the alcohol, afterwards with the 
carbonate of magnesia, and lastly with the water, gradually added. 
Then filter through paper. 



898 MEDICINES AND THEIR PREPARATIONS. 

Medicated Wines. 

Wines are used in making certain preparations, because the alco- 
hol they contain will extract from plants, etc., some medicinal prop- 
erties which water will not, and at the same time is less stimulating 
than the tinctures, etc., made from alcoholic spirits. 

Compound Wine of Comfrey {Restorative Wine Bitters). — Take 
one ounce each, bruised, of comfrey, Solomon's seal, and spikenard ; 
and half an ounce each, bruised, of chamomile flowers, Colombo, and 
gentian. Cover these with boiling water, and let them stand twenty- 
four hours in a covered vessel. Then add two quarts of sherry wine. 
Macerate fourteen days, express and strain. 

Valuable in leucorrhoea and other female complaints. Dose, from 
half a fluid ounce to two fluid ounces, three or four times a da}-. 

Compound Wine of Golden Seal. — Take one dram each, bruised, 
of golden seal root, tulip-tree bark, and bitter-root, half a dram of 
pulverized cayenne, and two quarts of sherry wine. Macerate for 
fourteen days, with occasional shaking ; then express and strain. 

This is a pleasant bitter tonic in dyspepsia, etc. Dose, from half 
a fluid ounce to two fluid ounces, three times a day. 

Wine of Ipecacuanha. — Take two ounces of bruised ipecac, and 
one quart of sherry wine. Macerate fourteen days, with occasional 
shaking. Then express, and filter through paper. 

This is a valuable emetic preparation, — especially for children. 
Dose, as an emetic, for an adult, one fluid ounce ; as an expectorant, 
from ten to thirty minims ; for a child two years old, as an emetic, 
one fluid dram, repeated every fifteen minutes till it operates. 

Mixtures. 

These are preparations in which medicinal substances which 
cannot be dissolved in water are suspended in it by means of 
some viscid matter, like sugar or gum-arabic. Their object is to 
conceal the taste, prevent the sickening effect, and make it more easy 
to take disagreeable medicines. To make a perfect mixture requires 
skill. Generally, the medicines to be suspended should be tritur- 
ated in a mortar with the sugar, gum-arabic, etc., before the water is 
added. 

Almond Mixture. — Take half an ounce of sweet almonds, half a 
dram of powdered gum-arabic, two drams of sugar, and eight fluid 
ounces of water. ' Soak the almonds in the water, and, having re- 
moved their external coat, beat them with the gum-arabic and sugar 
in a mortar, till they are thoroughly mixed : then rub the mixture, 
gradually adding the water, and lastly, strain. 

This is an agreeable, nutritive demulcent, in bronchial, dysenteric, 
an 1 urinary affections. It must be used freely, the dose being from 
two to live fluid ounces. 



MEDICINES AND THEIR PREPARATIONS. 899 

Chalk Mixture. — Take half an ounce of prepared chalk, two 
drams each of refined sugar and powdered gum-arabic, and four 
liuid ounces each of cinnamon-water and water. Rub them together 
till they are thoroughly mixed. 

This is much used in looseness of the bowels, accompanied with 
acidity, particularly among children. If an increase of its astrin- 
gency be required, add laudanum, or kino, or catechu. 

Compound Mixture of Iron. — Take a dram of myrrh, twenty-five 
grains of carbonate of potassa, one scruple of powdered sulphate of 
iron, half a fluid ounce of spirit of lavender, one dram of refined 
sugar, and seven and a half fluid ounces of rose-water. Rub the 
myrrh in a mortar, gradually adding the rose-water, then mix with 
these the spirit of lavender, sugar, and carbonate of potassa, and 
lastly, the sulphate of iron. Pour the whole into a glass bottle, and 
keep it well stopped. 

This is considerably used in chlorosis, and other affections requir- 
ing the use of iron. 

Brandy Mixture. — Take four fluid ounces each of brandy and 
cinnamon water, the yolks ' of two eggs, half an ounce of refined 
sugar, and three drops of oil of cinnamon. Mix them. 

A useful stimulant and nutritive draught, to be used in the sink- 
ing stage of low forms of fever. 

Extract of Rhubarb and Potassa (Neutralizing Extract). — Take 
two pounds of the best rhubarb, one pound each of cinnamon and 
golden seal. Grind or coarsely bruise the articles, and mix them ; 
macerate them for two days in one gallon of the best fourth proof 
brandy. Then express the tincture with strong pressure, and add 
to it one fluid dram of oil of peppermint, previously dissolved in a 
little alcohol. Break up the compressed residue from the press, and 
place it in a percolator, and gradually run warm water through it 
until the strength is exhausted. Evaporate this solution to four 
pints, and while the liquor is still hot, dissolve in it two pounds of 
bicarbonate of potassa, and three pounds of refined sugar. Continue 
the evaporation, if necessary, until, when added to the tincture first 
obtained, it will make a gallon and a half, then mix the two solu- 
tions together. 

This is a useful preparation for diarrhoea, dysentery, cholera morbus, 
summer complaints of children, acidity of the stomach, heartburn, 
etc. Dose, one fluid dram. 

Metauer's Aperient. — Take one ounce and a half of pulverized 
aloes, four ounces of bicarbonate of soda, two fluid ounces of com- 
pound spirits of lavender and two quarts of water. Place the whole 
in a jar or jug, and let them stand fourteen days, shaking well once 
a day. Then pour off from the dregs. It improves b}^ age. 



900 MEDICINES AND THEIR PREPARATIONS. 

This preparation is one of the best-known aperients for costive- 
ness, — particularly when connected with bilious dyspepsia. For 
that class of bilious persons who overeat, and have acid stomachs, it 
has great value. In bilious cases, the nitro-muriatic acid, taken 
before meals (the aperient after meals) may be usefully associated 
with it. In the constipation of hysteria and hypochondriasis, the 
fluid extract of valerian may be added to it. Dose, from two drams 
to an ounce. 

Saline Mixture ( White Liquid Physic). — Take half a pound of 
sulphate of soda, and one and a half pints of water. Mix, and dis- 
solve the soda ; then add two fluid ounces of nitro-muriatic acid, and 
one dram and eight grains of powdered alum. 

Used to allay nausea and vomiting, and as a cooling purgative; 
also for colic, diseases of the liver, diarrhoea, dysentery, intermittent 
fevers, etc. 

This is one of the remedies of the Eclectic school of physicians, 
and is held by them in high esteem. Dose, a tablespoonful in a gill 
of water, to be repeated every hour or two until it causes one or two 
evacuations from the bowels. 

Ointments. 

Ointments are composed of fatty substances, about the consistence 
of butter, impregnated with medicine. All gritty matter should be 
excluded from them. To prevent the rancidity to which they are 
liable, a little glycerin is now frequently added. 

Ointment of Acetate of Lead. — Take two ounces of white wax 
and four ounces of lard ; melt them together, and add two and a half 
drams of finely-powdered acetate of lead ; stir constantly till cold. 
This is useful for burns, scalds, ulcers and excoriations. 

Ointment of Bayberry. — Take half a pound each of tallow, 
white turpentine and bayberry, and four ounces of olive-oil ; melt 
together and strain. 

Good for scrofulous and indolent ulcers. 

Ointment of Belladonna. — Take a dram of extract of belladonna 
and an ounce of lard ; mix them. 

A useful anodyne application for painful tumors, neuralgia, etc. 

Ointment of Creosote. — Take half a fluid dram of creosote and 
an ounce of lard ; mix them. 

A useful application for syphilitic, scrofulous and cancerous ulcers. 

Compound Ointment of Galls. — Take six drams of finely-pow- 
dered galls, six ounces of lard, and a dram and a half of pulverized 
opium ; rub them together. 

A valuable preparation in irritable piles. 



MEDICINES AND THEIR PREPARATIONS. , 901 

Ointment of Red Iodide of Mercury. — Take one dram of red 
iodide of mercury, and seven drams of ointment of white wax ; in- 
corporate them thoroughly together by trituration in a mortar. 

Used as a dressing for indolent scrofulous ulcers. 

Ointment of Nitrate of Mercury. — > Take one ounce of mercury, 
eleven fluid ounces of nitric acid, nine fluid ounces of fresh neats- 
foot oil, three ounces of lard. Dissolve the mercury in the acid, then 
heat the oil and lard together in an earthen vessel to 200° F. ; then 
add the mercurial solution, and stir with a wooden spatula, constantly, 
as long as effervescence continues, and afterward occasionally till the 
ointment stiffens. 

Milder Ointment of Nitrate of Mercury. — Take an ounce of oint- 
ment of nitrate of mercury, and seven ounces of lard ; rub them 
together. 

The first of the above two preparations is the citrine ointment, and 
is much and advantageously employed as an external application in 
porrigo, impetigo, psoriasis and pityriasis. It is nearly a specific for 
inflammation of the eyelids connected with the formation of scaly 
matter about the lashes. The second of these two preparations is 
merely a dilution of the first. 

Ointment of Oxide of Zinc. — Take half an ounce of oxide of 
zinc and three ounces of lard ; rub them together. 

This is a mild astringent application in chronic ophthalmia, erup- 
tions of the skin, sore nipples, and other excoriations. 

Ointment of Poison Hemlock. — Take one dram of extract of 
poison hemlock and one ounce of lard ; rub them together. 

An anodyne application for painful swellings, ulcers and piles. 

Ointment of Poke. — Take a dram of the extract of poke and one 
ounce of lard ; mix them. 

For malignant ulcers, scaldhead, itch, etc. 

Ointment of Stramonium. — Take one dram of the extract of 
stramonium leaves, and one ounce of lard ; rub the extract with a 
little water till it is uniformly soft, and then with the lard. 

Used as an external application in irritable ulcers, painful piles and 
skin eruptions. 

Simple Ointment. — Take a pound of white wax, and four pounds 
of lard ; melt them together with a gentle heat, and stir constantly 
till cold. 

Ointment of Rose- Water. — Take a fluid ounce of rose-water, two 
fluid ounces of oil of almonds, half an ounce of spermaceti, one dram 
of white wax; melt together, by means of a water-bath, the oil, sper- 
maceti, and wax ; then add the rose-water, and stir the mixture con- 
stantly till cold. 



902 MEDICINES AND THEIR PREPARATIONS. 

This is the well-known preparation called cold cream, and is used 
with much advantage for chapped lips and hands, excoriations, etc. 

Spermaceti Ointment. — Take five ounces of spermaceti, fourteen 
of white wax, and a pint of olive-oil ; melt them together over a slow 
fire and stir constantly till cold. 

A mild dressing for blisters, wounds and excoriated surfaces. 

Tar Ointment. — Take a pound each of tar and suet; melt the 
suet with a gentle heat, and add the tar to it ; then stir constantly 
till they are cold. 

A useful stimulating application to various scaly and scabby erup- 
tions, particularly leprosy and scaldhead. 

Ointment of White Hellebore. — Take one ounce of powdered 
white hellebore root, four ounces of lard, and twelve drops of oil of 
lemons ; rub them thoroughly together. 

A useful ointment for the cure of itch. 

Ointment of Wild Indigo. — Take one pound of powdered wild- 
indigo root, moisten it thoroughly with alcohol and let it stand 
twenty-four hours; then put it in a percolator and add alcohol as 
long as the liquid which passes contains the taste of the root. Distil 
the alcohol from this filtered tincture until half a gallon of tincture 
is obtained. Melt one pound of fresh butter, without salt, add the 
above tincture, and carefully evaporate the rest of the alcohol ; stir 
constantly till cold, after the alcohol has nearly passed off. 

This is one of the preparations of the Eclectics, and is a cleansing, 
detergent, antiseptic and discutient ointment, useful in scrofulous, 
erysipelatous and malignant ulcers, eruptions of the skin, etc. 

Pile Ointment. — Take three handfuls each of witch-hazel bark, 
white-oak bark and sweet-apple tree bark ; bruise or grind them, and 
add to them three pints of water ; boil down to one pint and strain ; 
add to this liquid half a pound of lard, and simmer till the water all 
disappears, stirring continually both before and after removing from 
the fire till it cools. 

This forms a brick-colored anodyne, astringent ointment, admirably 
adapted to the cure of pile-tumors. 

Compound Lead Ointment. — Take two and a half pounds of 
olive-oil, four ounces each of beeswax and unsalted butter, and half 
a pound of white turpentine; melt them together, strain, and then 
heat to nearly the boiling point ; then gradually add one pound of 
red lead, stirring constantly till the mixture becomes black or brown ; 
then remove from the fire, and when it is partly cool, add to it a 
mixture of twelve ounces of honey and half a pound of powdered 
camphor. 

This is a very healing ointment, and is much used for ulcers, burns, 
wounds, and skin-diseases. 



MEDICINES AND THEIR PREPARATIONS. 903 

Compound SuIphurOintment. — Take one ounce of sulphur, one 
dram each of ammoniated mercury and benzoic acid, one fluid dram 
each of sulphuric acid and oil of bergamot, two drams of nitrate of 
potassa and half a pound of lard. First melt the lard with a gentle 
heat, then add the other ingredients, stirring constantly till they are 
cold. 

A sovereign remedy for itch. 

Pills. 

Pills are small masses of medicinal substances in globular shape, 
and of a size convenient for swallowing. Each pill generally weighs 
from four to five grains. Those medicines which cannot be dissolved 
in water, and are particularly unpleasant to the taste, are usually given 
in the form of pill. Sugar, or gelatine coated, as now very exten- 
sively used for every important medicine, and in a great variety of 
combinations, they are a very popular form of taking medicine. Phy- 
sicians 'cannot do better than to use the pills when made by a reliable 
firm. 

The method of making pills is as follows : If the substance to be 
worked into pills be a solid extract, add a few drops of water to it, 
and rub it to the right consistence ; if it be a resin, add to it a few 
drops of alcohol ; if it be a soft or liquid substance, rub up with it 
some inert substance, or crumb of bread, or wheat flour, or starch, or 
pulverized gum-arabic ; if it be a powder, mix it with some soft sub- 
stance, as confection, or syrup, molasses, honey, or mucilage of gum- 
arabic. The materials must be well mixed and rubbed into a uniform 
mass, which should be rolled with a spatula or knife into a cy- 
linder of just the same size throughout. This is to be divided 
equally into the number of pills required, each of which is rolled 
into a spherical form between the thumb and finger, or upon the palm. 

So many valuable pills are prescribed among the " Recipes," that 
it is not necessary here to add to their number. 

Plasters. 

Plasters are composed of wax, resins, gums, fats and oils, and 
sometimes medicinal substances, and are spread upon linen, muslin, 
or leather. When cold they are hard ; but when brought to the 
warmth of the human body, they so far soften as to adhere firmly to 
the skin, but do not "run" so as to spread outward and soil the 
under-clothes. They are intended generally to excite and irritate 
the skin; sometimes as mechanical supporters, and sometimes to 
affect the system by having their medicinal matters absorbed. 

Belladonna Plaster. — Take three ounces of resin plaster, and an 
ounce and a half of extract of belladonna, add the extract to the 
plaster previously melted by a gentle heat, and mix. 



904 MEDICINES AND THEIR PREPARATIONS. 

A useful anodyne application in neuralgia, rheumatic pains, and 
dysmenorrhea. 

Compound Capsicum Plaster. — Melt together half a pound of 
resin and two ounces of beeswax ; to this add one pint of spirit in which 
two ounces of powdered cayenne, enclosed loosely in a linen bag, has 
been digested one hour by a gentle heat ; evaporate the spirit by a 
moderate heat, and add one ounce of powdered camphor and one 
fluid dram and a half of oil of sassafras ; stir constantly till cold. 

This may be used whenever a stimulating plaster is required. 

Compound Galbanum Plaster. — Take two ounces of galbanum, 
three ounces of burgundy pitch, half an ounce of resin, half an ounce of 
yellow wax, and four ounces of lead plaster ; melt them all together 
over a gentle fire. 

This is a valuable strengthening plaster, and may be used for 
weakness of various parts, as well as for scrofulous enlargement of 
glands and joints. 

Compound Lead Plaster. — Take one pound of lead plaster; melt 
it by a moderate heat, and then add two fluid ounces each of linseed 
oil and tincture of opium, six fluid ounces of oil of turpentine, and 
two-thirds of a pound of oil of origanum ; stir together till cold. 

Used for burns, scalds, chilblains, etc. 

Compound Resin Plaster. — Take three pounds of resin, four ounces 
each of beeswax and hemlock gum ; melt the articles together, then 
remove from the fire, and, whsn nearly cold, add gradually one fluid 
ounce each of oil of hemlock, oil of sassafras, and olive oil, with half 
an ounce of camphor, dissolved in them, and half a fluid ounce of oil 
of turpentine. Pour the whole into cold water, and work in the 
hands till cold, forming it into rolls. 

This is an excellent strengthening plaster, useful for rheumatism, 
enlarged joints, glands, and wherever a weakened part needs gentle 
stimulation and support. 

Spiced Plaster. — Take one ounce each of powdered ginger, cloves, 
cinnamon and black pepper ; one dram of pulverized cayenne ; half 
a fluid ounce of tincture of ginger, and a sufficient quantity of honey. 
Mix the powders, and then add the tincture and honey to form a stiff 
poultice. 

This is applied with great advantage over the stomach in cases of 
nausea and vomiting. 

Compound Tar Plaster. — Boil three pounds of tar half an hour, 
then add one pound and a half of burgundy pitch, one pound of white 
gum turpentine (after having melted them together and strained). 
Stir together, then remove from the fire and add ten ounces each of 
finely-powdered mandrake-root, blood root, poke-root and Indian tur- 
nip ; mix thoroughly together. 



MEDICINES AND THEIR PREPARATIONS. 905 

This is an irritant, rubefacient, suppurative plaster, and is con- 
siderably used by the Eclectics to produce counter-irritation and re- 
vulsion in neuralgia, rheumatism and other painful affections, as well 
as in chronic inflammation of internal organs. To be spread thinly 
on soft leather, and renewed daily on the same leather. Four days 
are required to produce suppuration. If it produce great pain or 
inflammation, remove it, and apply mutton-tallow or elm-poultice. 

Lead Plaster. — Take one pound and a quarter of very finely pow- 
dered semi vitrified oxide of lead, one quart of olive oil and half a 
pint of water. Boil together over a gentle fire, stirring constantly 
till the oil and litharge unite and form a plaster. If the water nearly 
all evaporates before the process is completed, add a little boiling 
water. 

A useful plaster for ulcers, burns, excoriated surfaces, etc. 

Red Oxide of Lead Plaster. — Melt together one quart of olive-oil 
and one ounce each of beeswax and resin ; heat to the boiling point, and 
then add gradually three-quarters of a pound of powdered red-lead. 
Stir constantly, and when the oil has taken up the lead, the mixture 
will be brown or shining black ; then remove from the fire, and when 
nearly cold add four scruples of powdered camphor, and stir together. 
It should not be removed from the fire until it has acquired a proper 
consistence for spreading, which may be easily ascertained by allow- 
ing a portion of it to cool on a knife. 

This is a valuable plaster for scrofulous and syphilitic ulcers, also 
for burns, scalds, and several skin-diseases. 

Poultices. — Cataplasms. 

Bread-and- Water Poultice. — Put the needed quantity of boiling 
water in a basin ; throw in crumbled white bread, or cracker, and 
cover with a plate. When the bread or cracker has soaked up all it 
will, drain off the remaining water. Spread one-third of an inch 
thick, and apply. 

Flaxseed Poultice. — Put boiling water in a basin, and stir in 
flaxseed meal to make a thick paste. Spread on linen and apply. 

Yeast Poultice. — Mix half a pint of yeast with one pound of 
flaxseed-meal. Stir carefully while heating. 

Carrot Poultice. — Boil the proper quantity of carrots till they are 
quite soft. Strain off the water, mash them to a pulp, and add a 
little lard or sweet oil to prevent them from getting hard, then 
spread. A good application for malignant and offensive sores. 

Oatmeal Poultice Place hot water in a basin, and stir in oat- 
meal slowly, while it boils, till the poultice is of the right thickness ; 
that is, till it will not run on the rag on which it is spread. 



906 MEDICINES AND THEIR PREPARATIONS. 

Indian-Meal Poultice.— Made the same as oatmeal poultice . 

Arrow-Root Poultice Mix two or more tablespoonfuls of arrow- 
root with a little cold water, in a basin, till it is all united with the 
water. Then add boiling water, and stir till the whole becomes a 
thick paste. 

Slippery Elm Poultice Stir ground slippery-elm bark into hot 

water, and let it swell. This is a very soothing poultice for irritable 
sores. 

Onion Poultice. — Made in the same way as the carrot poultice. 
This is quite stimulating, and induces indolent sores to maturate 
more freely. It is excellent for slow boils. 

Charcoal Poultice Take either the bread-and-milk, or the In- 
dian-meal poultice, and stir into it one-quarter its bulk of finely pul- 
verized charcoal. Excellent for thoroughly cleansing a foul sore or 
ulcer. 

Anodyne Poultice. — Take half an ounce of the extract either of 
foxglove, or henbane, or stramonium, or conium, or belladonna, and 
mix it with half a pint of tepid water. Then stir in as much flax- 
seed meal as will make a poultice of the right thickness. Always 
be careful not to apply this poultice where there is much skin off, 
lest the extract used be so much absorbed as to produce poisonous 
effects. These poultices allay the pain of cancerous and other sores. 

Lobelia Poultice. — Powdered lobelia and ground slippery-elm 
bark, each, one ounce. Stir these into hot weak lye, to make a poul- 
tice. For wounds, fistula, whitlow, boils, erysipelas and stings of 
insects. 

Poke=Root Poultice Roast a sufficient quantity of fresh poke- 
root in hot ashes. When it is quite soft, pound it, and make a poul- 
tice. To be applied to tumors to scatter them, or hasten their suppu- 
ration. To be removed every four hours. 

Mustard Poultice Stir up a tablespoonful of ground mustard 

with a little water, to the consistence of paste. Spread upon linen 
or brown paper, and cover with thin muslin, that the mustard may 
not stick to the skin when the poultice is removed. They can now 
be bought all prepared, either on paper or cloth, of several different 
degrees of strength, and are much better than the home-made. 

Powders. 

A single substance used as a powder is called a simple powder ; 
two or more united, a compound powder. Under the above head, I 
shall describe only compound powders. In preparing compound 
powders, the substances, if of different degrees of hardness, should 



MEDICINES AND THEIR PREPARATIONS. 907 

generally be pulverized separately. Many powders require to be ex- 
cluded from the light, which may be done by covering the bottles in 
which they are kept with black varnish. 

Aromatic Powder Take two ounces each of cinnamon and gin- 
ger, and an ounce each of cardamom deprived of the capsules, and 
grated nutmeg. Rub them together into a very tine powder, and 
keep in well-stopped bottles. 

The powder is stimulant and carminative, and in cases of weak- 
ened digestion, may be given in ten to thirty-grain doses. 

Compound Powder of Aloes and Canella — Take a pound of aloes 
and three ounces of canella. Rub them separately to a fine powder, 
and mix them. 

This is the preparation known as hiera picra, or simply picra. It 
may be used for amenorrhcea, or generally as a bitter to correct cos- 
tiveness, and improve the appetite. 

Compound Powder of Catechu — Take two ounces each of catechu 
and kino, and half an ounce each of cinnamon and nutmeg. Reduce 
all to a fine powder, mix and pass them through a fine sieve. 

For chronic diarrhoea, dysentery, etc. Dose, from fifteen to thirty 
grains. 

Compound Powder of Chalk Take half a pound of prepared 

chalk, four ounces of cinnamon, three ounces each of tormentil and 
gum-arabic, and half an ounce of long pepper. Rub them separately 
into a very fine powder, and mix. 

This powder is warm, stimulant, astringent and antacid, and is 
well fitted for diarrhoea not connected with inflammation. 

Compound Powder of Chalk with Opium. — Take six ounces and 
a half of compound powder of chalk, and four scruples of powdered 
opium. Mix them. 

The opium in this preparation increases the efficacy of the com- 
pound powder of chalk in diarrhoea. Dose for an adult, ten to fif- 
teen grains, and repeated after each discharge. 

Compound Powder of Golden Seal. — Take two drams each of 
powdered golden seal, blue cohosh and helonias, and mix them. 

Useful in dyspepsia, chronic inflammation of the mucous mem- 
brane of the stomach, etc. Dose, half a teaspoonful to a teaspoonful, 
three or four times a day. 

Compound Powder of Hydrastin Take half a dram each, in 

powder, of hydrastin, leptandrin, rhubarb and myricin. Mix thor- 
oughly, and divide into thirty-two powders. 

This is tonic and laxative, and is useful in dyspepsia, jaundice, 
chronic inflammation of the bowels, and during recovery from ex- 
hausting complaints. One powder may be taken often enough to 
produce one movement of the bowels a day. 



908 MEDICINES AND THEIR PREPARATIONS. 

Inhaling Powder. — Take one dram of crystals of nitrate of silver, 
and two and a half drams of lycopodium. Work the lycopodium 
into a very stiff paste, with a little warm water, in which the nitrate 
is dissolved. Spread this thin in a shallow dish, cover it so as to shut 
out the light, and set it where it will dry ; when thoroughly dry, pul- 
verize. 

I have used this powder with great advantage in many cases of 
bronchitis, by directing three to four grains of it to be inhaled once 
a day, in an instrument constructed for that purpose. This is the 
only really valuable catarrh snuff ever used. A pinch of it taken 
once a day (never oftener) for nasal catarrh, will often do excellent 
service. 

Compound Powder of Ipecacuanha. — Take a dram each of pow- 
dered ipecacuanha and opium, and one ounce of sulphate of potassa. 
Rub them together into a fine powder. 

This is the well known Dover's powder. It is an admirahle ano- 
dyne and diaphoretic, and is much used in inflammatory complaints, 
particularly rheumatism and pneumonia, complicated with low ty- 
phoid symptoms. Dose, from five to ten grains. 

Compound Powder of Jalap. — Take half an ounce of pulverized 
jalap and senna, one ounce of pulverized bitartrate of potassa, half a 
dram of pulverized ginger, and ten grains of pulverized cayenne. 
Mix thoroughly. 

This is a valuable purgative medicine, and may be used in most 
cases where a simple cathartic is required. Dose, half a teaspoonful 
to a tablespoonful. 

Compound Powder of Kino. — Take fifteen drams of kino, half an 
ounce of cinnamon, and a dram of dried opium. Rub them sepa- 
rately to a very fine powder, and mix them. 

This is anodyne and astringent, and is useful in diarrhoea, etc. 

Compound Powder of Rhubarb. — Take four ounces of powdered 
rhubarb, one pound of magnesia, and two ounces of finely powdered 
ginger. Mix thoroughly, and preserve in well stopped bottles. 

An excellent laxative and antacid, and well adapted to the bowel- 
complaints of children. 

Compound Powder of Rhubarb and Potassa (Neutralizing Pow- 
der). — Take half an ounce each of powdered rhubarb, bicarbonate 
of potassa and peppermint leaves. Mix thoroughly. 

Valuable in diarrhoea, cholera morbus, dysentery, summer com- 
plaint of children, sour stomach, heartburn, etc. 

Worm Powder. — Take one ounce each of powdered white Indian- 
hemp root (Asclepias incarnatd), mandrake, pink-root, and bitter-root ; 
two ounces of powdered balmony, and four scruples of powdered 
aloes. Mix thoroughly. 



MEDICINES AND THEIR PREPARATIONS. 909 

A very good remedy for all kinds of worms. A teaspoonful of 
the powder may be mixed with a gill of molasses, and a teaspoonful 
of this given to a child every hour or two till it operates. After 
this, give a teaspoonful three times a day, for a few days. 

Syrups. 

A STRONG solution of sugar and water is a simple syrup. When 
the water is first charged with some medicinal substance, and sugar 
is added to this, we have a medicated syrup. Refined sugar should 
always be preferred in preparing medicated syrups. 

Simple Syrup. — Take two and a half pounds of refined sugar, and 
a pint of water ; dissolve the sugar in the water by heat, remove any 
scum that may arise, and strain while hot. 

Syrup of Almonds. — Take a pound of sweet almonds, four ounces 
of bitter almonds, three pints of water, and six pounds of refined 
sugar. Blanch the almonds, then rub them in a mortar to very fine 
paste, and add, during the trituration, three fluid ounces of the water, 
and one pound of the sugar. Mix the paste thoroughly with the 
remainder of the water. Strain with strong expression, add the 
remainder of the sugar to the strained liquor, and dissolve by a 
gentle heat. Strain through fine linen, and after it is cool, put it 
into bottles, thoroughly stopped, and keep in a cool place. 

This is demulcent, nutritive and sedative, and is sometimes added 
to cough mixtures, etc. 

Syrup of Citric Acid Take two drams of powdered citric acid, 

four minims of oil of lemons, and two pints of syrup. With one 
fluid ounce of the syrup, rub the citric acid and oil of lemons, then 
add the remainder of the syrup, and dissolve by a gentle heat. 

This is much employed as an agreeable and cooling addition to 
drinks, especially to carbonic-acid water. Tartaric acid, being cheaper 
than citric acid, is often substituted for it, and the preparation thus 
made is much sold under the name of lemon syrup. 

Syrup of Garlic. — Take six ounces of fresh garlic, sliced and 
bruised, one pint of diluted acetic acid, and two pounds of refined 
sugar. "Macerate the garlic in ten fluid ounces of the diluted acetic 
acid in a glass vessel, four days, and express the liquor. Then mix 
the rest with what remains of the acid, and again express, till sufficient 
has passed to make the whole when filtered measure a pint. Then 
pour the filtered liquor on the sugar in a bottle, and shake till it is 
dissolved. 

Excellent in the bronchial affections of children. Dose, a tea- 
spoonful, for a child a year old". 

Syrup of Ginger. — Add two fluid ounces of tincture of ginger to 
a quart of simple syrup; evaporate the alcohol by a gentle heat. 



910 MEDICINES AND THEIR PREPARATIONS. 

This is carminative and stimulant, and gives tone to the debilitated 
stomach, removing wind, etc. It is added to other medicines to im- 
prove their flavor. 

Compound Syrup of Hypophosphites. — Take 256 grains of hypo- 
phosphite of lime, 192 grains of hypophosphite of soda, 128 grains 
of hypophosphite of potassa, 96 grains of recently precipitated hypo- 
phosphite of iron, 240 grains of hypophosphorous acid solution, 12 
ounces of white sugar, half an ounce of extract of vanilla, and a 
sufficient quantity of water. Dissolve the salts of lime, soda and 
potassa, in six ounces of water ; put the iron salt into a mortar and 
gradually add solution of hypophosphorous acid till it is dissolved ; to 
this add the solution of the other salts, after it has been rendered 
slightly acidulous with the same acid, and then water, till the whole 
measures nine fluid ounces. Dissolve this in sugar, with heat, and 
flavor with the vanilla. Without flavoring, this syrup is not unpleasant, 
being slightly saline, and not at all ferruginous. Any other flavor- 
ing may be used, as orange-peel, orange-flower or ginger. It is also 
suggested to physicians that glycerine may be used, wholly or par- 
tially, in place of sugar, when indicated, six ounces and a half of 
glycerine being substituted for twelve ounces of sugar. Dose, a tea- 
spoonful, three times a day before meals. 

Syrup of Ipecacuanha. — Take one ounce of ipecacuanha, in 
coarse powder, one pint of diluted alcohol, two pounds and a half of 
sugar, and one pint of water. Macerate the ipecacuanha in the alco- 
hol, fourteen days, and filter ; evaporate the filtered liquor to six fluid 
ounces, filter again, and add water to make the liquor measure a pint ; 
then add the sugar, and proceed as directed for syrup. 

This is chiefly used in complaints of children. Dose, as an emetic, 
for an adult, two fluid ounces ; for a child a year or two old, one or 
two fluid drams. As an expectorant, for an adult, two fluid drams ; 
for a child, five to twenty minims. 

Syrup of Lemons. — Take a pint of strained lemon-juice, two 
pounds and a half of refined sugar, and two and a half fluid ounces 
of rectified spirit ; boil the juice ten minutes, and strain ; then add 
the sugar, and dissolve. After the syrup has cooled, mix the spirit 
with it. 

A cooling and grateful addition to drinks in fevers, and serves to 
cover the taste of salts and other purgatives. 

Aromatic Syrup of Rhubarb. — Take two ounces and a half of 
bruised rhubarb, half an ounce each of bruised cloves and cinnamon, 
two drams of bruised nutmeg, two pints of diluted alcohol, and six 
pints of syrup. Macerate the rhubarb and aromatics in the alcohol 
for fourteen days, and strain ; then, by a gentle heat, evaporate the 
liquor to a pint, and, while hot, mix it with the syrup previously 
heated. 



MEDICINES AND THEIR PREPARATIONS. 911 

This is a warm cordial laxative, admirably fitted for the bowel 
complaints of infants. Dose, a fluid dram, repeated every two hours 
till it operates. 

Syrup of Seneka. — Take four ounces of fluid extract of seneka, 
and one pint of water ; mix, and dissolve in the liquid one pound of 
refined sugar, and proceed as directed for syrup. 

This is a stimulating expectorant, used in colds, coughs, etc., after 
inflammatory symptoms have subsided. Dose, for an adult, one or 
two teaspoonfuls, as often as necessary. 

Syrup of Squill. — To one pint of vinegar of squill, add two 
pounds of refined sugar, and proceed as directed for syrup. 

It is a useful expectorant for coughs and bronchial affections of 
infants and children. Dose, half a dram to a dram. 

Syrup of Tolu. — Take two fluid ounces of tincture of tolu, and 
one pint of simple syrup ; mix, and gently heat the mixture to evapo- 
rate the alcohol. 

This is chiefly used to flavor other preparations. 

Syrup of Wild=Cherry Bark. — Place two pounds and a half of 
coarsely powdered wild-cherry bark in a percolator, and pass through 
it one gallon of water. Strain this and dissolve in it by heat sixteen 
pounds of refined sugar. 

This makes an elegant tonic and sedative preparation, and is mixed 
with various other articles in prescribing for dyspepsia, consumption, 
etc. 

Compound Syrup of Partridge Berry. — Take half a pound of 
partridge berry, and two ounces each of helonias, blue cohosh, and 
high cranberry bark ; add to them one quart of brandy, and macerate 
four days. Press out the brandy ; and place the herbs in three quarts 
of boiling water, and boil down to two and a half pints. Strain, add 
one pound of sugar, and evaporate to two and a half pints. Remove 
from the fire, and when nearly cold, add the brandy previously pressed 
out. 

This is considerably used by the Eclectic physicians, under the 
name of mother 's cordial, and may be usefully employed by all 
physicians in suppression of the menses, painful menstruation, pro- 
fuse menstruation and habitual abortions. Dose, from one to two 
ounces, two or three times a day. 

Compound Syrup of Phosphates {Chemical Food). — Take ten 
drams of protosulphate of iron, twelve drams of phosphate of soda, 
twelve drams of phosphate of lime, twenty drams of phosphoric 
acid (glacial), two scruples of carbonate of soda, one dram of car- 
bonate of potassa, sufficient quantity of muriatic acid, sufficient 
quantity of water of ammonia, two drams of powdered cochineal, 
sufficient water to make twenty fluid ounces, three pounds of sugar. 



912 MEDICINES AND THEIR PREPARATIONS. 

and fifteen drops of oil of orange. Dissolve the sulphate of iron in 
two fluid ounces of boiling water, and the phosphate of soda in four 
fluid ounces of boiling water. Mix the solutions, and wash the pre- 
cipitated phosphate of iron till the washings are tasteless. 

Dissolve the phosphate of lime in four fluid ounces of boiling- 
water, with sufficient muriatic acid to make a clear solution, precipi- 
tate it with water of ammonia, and wash the precipitate. 

To the freshly precipitated phosphates, as thus prepared, add the 
phosphoric acid, previously dissolved in the water. When clear, add 
the carbonates of soda and potassa, and afterwards sufficient muriatic 
acid to dissolve the precipitate. 

Now add the cochineal mixed with the sugar, apply heat, and when 
the syrup is formed, strain and flavor it. 

This is an elegant syrup, agreeable both to the eye and taste, and 
has been extensively sold and used as a nutritive tonic, in chronic 
debility, in cases of broken down constitution, wasting of the flesh, 
etc. 

Compound Syrup of Rhubarb and Potassa (Neutralizing Cor- 
dial). — Take half a pound each of powdered rhubarb and bicarbonate 
potassa, and four ounces each of cinnamon and golden seal ; macerate 
for four days in one gallon of best fourth proof brandy. Express 
the tincture with strong pressure, and add to it two fluid drams of 
oil of peppermint, previously dissolved in a little alcohol. Break up 
the cake from the press, place it in a percolator, and gradually pass 
through it warm water till the strength is exhausted. Evaporate 
tins solution to four quarts, and while the liquor is still hot, dissolve 
in it six pounds of refined sugar. Continue the evaporation, if neces- 
sary, till the addition of the tincture first obtained will make three 
gallons. Then add the tincture. 

A valuable antacid and laxative in diarrhoea, dysentery, cholera 
morbus, and summer complaint of children. Dose, for an adult, a 
tablespoonful, to be taken as circumstances require. 

Compound Syrup of Sarsaparilla. — Take a pound each of sarsa- 
parilla, yellow parilla, and pipsissewa; an ounce and a half of guaia- 
cum ; one ounce each of red roses, senna, and liquorice root ; and 
three minims each of oil of sassafras, anise, and partridge berry ; di- 
luted alcohol, five pints, and four pounds of refined sugar. Grind 
and mix the sarsaparilla, yellow parilla, pipsissewa, guaiacum, roses, 
senna, and liquorice, and add to them the alcohol. Let the whole 
stand fourteen days, then express and filter. Evaporate by a water- 
bath to one quart, and add the sugar. Lastly, rub the oils in a mor- 
tar with a little of the syrup, and thoroughly mix with the remainder. 

This is a valuable alterative syrup, and is used for syphilis, scrofula, 
diseases of the skin, etc. ■ It is much improved by adding half an 
ounce of the iodide of potassium to each pint of the syrup. Dose, a 
tablespoonful. 



MEDICINES AND THEIR PREPARATIONS. 913 

Compound Aromatic Syrup of Senna. — Take four ounces of 
senna, one ounce and a half of jalap root, half an ounce of rhubarb, 
one dram of cinnamon, one dram of cloves, and half a dram of nut- 
meg. Reduce these articles to a coarse powder ; add one quart of 
diluted alcohol. Let the whole stand two days and percolate. Filter, 
dissolve in it one pound of refined sugar, and add one dram of oil of 
lemons. 

An excellent cordial physic. 

Compound Syrup of Stillingia. — Take a pound each of queen's 
root and turkey corn ; half a pound each of pipsissewa leaves and 
elder flowers ; and four ounces each of prickly-ash berries and carda- 
mom seeds. Grind all the articles, mix, and place them in a jar, and 
moisten them well with alcohol. Let them stand two days ; then 
place them in a percolator, and gradually add hot water till two pints 
are obtained, which must be strained and set aside. Then continue 
the percolation so long as there is a sensible taste of the spirit. Re- 
serve this also. Then continue the percolation till what is obtained 
is almost tasteless. Boil down this last till the addition of the two 
reserved tinctures will make two gallons of the whole. Now add 
twelve pounds of refined sugar, and make a syrup. 

This is one of the Eclectic medicines ; and is quite an effective 
alterative for syphilis, scrofula, etc. Improved by adding iodide of 
potassium. Dose, from a teaspoonful to a tablespoonful. 

Compound Syrup of Yellow Dock. — Take two pounds of yellow- 
dock root, one pound of the bark of the root of false bittersweet, and 
half a pound each of American ivy and figwort. Make a syrup 
according to the directions for compound syrup of stillingia, using 
sixteen pounds of sugar, and making two gallons of syrup. 

A valuable preparation for scrofula. Improved by iodide of potas- 
sium. Dose, a tablespoonful, three or four times a day. 

Tinctures. 

An ethereal tincture is one which is made with ether as the solvent 
instead of alcohol, and an ammoniated tincture, one made with water 
of ammonia as the solvent. 

Simple tinctures, in which only one medicinal article is used, are 
made thus: 

Tincture of Aconite. — Take eight ounces of powdered aconite- 
root, and one pint of alcohol. Mix, and let them stand for two weeks, 
frequently stirring. Then express, and filter through paper. 

Given in fevers and inflammatory diseases. Dose, three drops 
every hour or two in a little water. - 

In the above manner all simple tinctures are made. Some medi- 
cines require alcohol to extract their active principle ; some only 
diluted alcohol. 



914 MEDICINES AND THEIR PREPARATIONS. 

One Ounce to the Pint of Alcohol. — In preparing simple tinctures 
from the following articles, alcohol is used, and one ounce only of the 
medicine is employed to the pint, namely : 

Castor, Saffron, Leptandria. 

One Ounce to the Pint of Diluted Alcohol. — In making tinctures 
from the following articles, one ounce is used to the pint of diluted 
alcohol : 

Iodine, Quassia. 

Two Ounces to a Pint of Alcohol : 

Assafcetida, Camphor, Oil of Peppermint, Oil of Spearmint, Ben- 
zoin, Colchicum seeds, Lupulin. 

Two Ounces to a Pint of Diluted Alcohol : 

Cardamom, Cotton-Bark, Cochineal, Colombo, Colchicum, Ergot, 
Galls, Hemlock, Cubebs, Foxglove, Black Hellebore, Henbane, Lactu- 
carium, Lobelia, Poke, Shrubby Trefoil, Bloodroot, Squill, Valerian, 
Bittersweet, Belladonna. 

Three Ounces to a Pint of Diluted Alcohol : 

Peruvian Bark, Rhatany, Poison Hemlock, Sheep Laurel, Stramo- 
nium, White Hellebore, Yarrow, Prickly Elder, Jalap. 

Four Ounces to a Pint of Alcohol : 

Nux Vomica, Ginger, Guaiacum, Black Cohosh. 

Four Ounces to a Pint of Diluted Alcohol : 

Yellow Jessamine, Prickly-ash Berries, Ergot, Matico. 

The following tinctures embrace those which vary from the above 
proportions among the simple tinctures, and also the compound 
tinctures : 

Tincture of Orange=Peel. — Take three and a half ounces of dried 
orange-peel and one quart of diluted alcohol. Macerate for seven 
days, express and filter. 

Tincture of Buchu. — Take five ounces of buchu, and one quart 
of diluted alcohol. Digest seven days ; pour off the clear liquor, and 
filter. 

Tincture of Indian Hemp. — Take of extract of Indian Hemp 
(Cannabis Indica) one ounce, and one pint of alcohol. Dissolve the 
extract in the spirit. Dose, from twenty to thirty drops. 

Tincture of Cantharides. — * Take an ounce of bruised Spanish 
flies, and two pints of diluted alcohol. Macerate for fourteen days, 
express and filter through paper. 

Dose, from twenty drops to a dram, three or four times a day. 



MEDICINES AND THEIR PREPARATIONS. 915 

Tincture of Cayenne Pepper. — Take an ounce of pulverized 
cayenne, and two pints of diluted alcohol. Macerate fourteen days, 
and filter through paper. 

Tincture of Catechu. — Take an ounce and a half of catechu, an 
ounce of bruised cinnamon, and one pint of diluted alcohol. Let 
them stand together two weeks, frequently shaking ; then express 
and filter. 

Dose, from thirty drops to a tablespoonful. 

Tincture of Cinnamon. — Take an ounce and a half of powdered 
cinnamon, and one pint of diluted alcohol. Let them stand together 
for two weeks ; express and filter. 

Dose, from one to three teaspoonfuls in sweetened water. 

Elixir Vitriol. — Take half a pint of alcohol; drop into it seven 
fluid drams of sulphuric acid, and let the mixture stand three days 
in a close vessel ; then add two drams of powdered ginger, and three 
drams of powdered cinnamon. Macerate seven days^ and filter. 

Useful in diarrhoea, dysentery, etc. Dose, from five to fifteen 
drops. To avoid injury to the teeth, it should be taken through a 
quill, or glass tube, or else the mouth should be rinsed immediately 
after swallowing it. Use with care. 

Tincture of Lobelia. — Take four ounces of lobelia, and one pint 
each of distilled vinegar and alcohol. Macerate two weeks, express 
and filter. 

Dose, as a nauseant or expectorant, from thirty to forty drops. 

Tincture of Opium. (Laudanum) . — Take two and a half ounces 
of opium, and two pints of diluted alcohol. Macerate fourteen days, 
express, and filter through paper. Dose, from ten to twenty drops. 

Tincture of Tolu — Dissolve one ounce of balsam of tolu in one 
pint of alcohol, and filter. 

Tincture of Rhubarb. — Take three ounces of bruised rhubarb, 
half an ounce of bruised cardamom, and a quart of diluted alcohol. 
Macerate two webks, express, and filter through paper. 

Tincture of Virginia Snake=Root. — Take three ounces of bruised 
Virginia snake-root, and one quart of diluted alcohol. Macerate two 
weeks, express, and filter through paper. 

This is advantageously added to the infusion of Peruvian bark, in 
low states of the system. Dose one to two fluid drams. 

Compound Tincture of Aloes. — Take three ounces of powdered 
aloes, one ounce of saffron, and two pints of tincture of myrrh. 
Macerate fourteen days, and filter. 

This is the well-known elixir proprietatis, or more commonly, elixir 
pro. It is considerably used in female disorders, connected with sup- 
pressed, retained, or deficient menstruation. Dose, one to two fluid 
drams. 



916 MEDICINES AND THEIR PREPARATIONS. 

Compound Tincture of Assafoetida. — Take half an ounce each 
of lupulin, assafoetida, in small pieces, bruised stramonium seeds, 
powdered valerian root, and one pint and a half of alcohol ; macerate 
two weeks, shaking frequently, then express and filter. 

This is anodyne and antispasmodic, and is used in epilepsy, St. 
Vitus's dance, and hysterics. Dose, a teaspoonful. 

Compound Tincture of Benzoin. — Take three ounces of benzoin, 
two ounces of purified storax, one ounce of balsam of tolu, half an 
ounce of powdered aloes, and two pints of alcohol. Macerate two 
weeks and filter. 

This is used in chronic diseases of the air-passages. Dose, from 
thirty to fifty drops. 

Compound Tincture of Cardamom. — Take six drams of bruised 
cardamom, two ounces of bruised caraway, five drams of bruised cin- 
namon, five ounces of seeded raisins, one dram of bruised cochineal, 
and two pints and a half of diluted alcohol. Macerate two weeks, 
and filter. 

This is a very agreeable aromatic ; used as a carminative, and to 
improve other preparations. Dose, one or two fluid drams. 

Compound Tincture of Catechu. — Take three ounces of catechu, 
two ounces of bruised cinnamon, and two pints of diluted alcohol. 
Macerate fourteen days, express and filter. 

This is frequently added to chalk preparations for diarrhoea, etc. 
Dose, from one to three fluid drams. 

Compound Tincture of Cinnamon. — Take one ounce of bruised 
cinnamon, half an ounce of bruised cardamom seeds, three drams of 
bruised ginger, and two pints of proof spirits. Macerate fourteen 
days, express, and filter. 

This is a warm, aromatic tincture, useful in spasms and debility 
of the stomach. Dose, one to two fluid drams. 

Compound Tincture of Black Cohosh. — Take one fluid ounce 
of tincture of black cohosh, half a fluid ounce of tincture of blood- 
root, and two fluid drams of tincture of poke-root. ' Mix. 

This is used in diseases of the lungs, liver, and stomach. Dose, 
from twenty to fifty drops, three or four times a day. 

Compound Tincture of Blue Cohosh. — Take one ounce of pow- 
dered blue-cohosh root, half an ounce each of bruised water-pepper 
and ergot, two fluid drams of oil of savin, and twelve fluid ounces of 
alcohol ; mix, macerate for a fortnight, and filter. 

A uterine tonic, used for suppressed and painful menstruation, etc. 
Dose, a teaspoonful, two or three times a day. 

Compound Tincture of Colchicum. — Mix one fluid ounce each 
of tincture of black cohosh and tincture of colchicum-seed. 

Used for inflammatory rheumatism and gout. Dose, ten to fifty 
drops. 



MEDICINES AND THEIR PREPARATIONS. 917 

Compound Tincture of Gentian. — Take two ounces of bruised 
gentian, one ounce of orange-peel, half an ounce of bruised carda- 
mom seeds, and two pints of diluted alcohol. Macerate fourteen 
days, express, and filter. 

An elegant bitter, much used in dyspepsia, and as an addition to 
tonic mixtures for a weakened state of the stomach. Dose, one or 
two fluid drams. 

Compound Tincture of Golden Seal. — Take one ounce each of 
powdered lobelia-seed and golden seal, and one pint of diluted alco- 
hol. Macerate two weeks, express, and filter. 

This is used as a local application to diseased mucous membranes, 
in leucorrhoea, gleet, etc. 

Ammoniated Tincture of Guaiac. — Take four ounces of pow- 
dered guaiac, and a pint and a half of aromatic spirits of ammonia. 
Macerate for two weeks, and filter. 

This tincture has considerable reputation in the treatment of 
chronic rheumatism. Dose, one or two fluid drams. 

Compound Tincture of Hemlock QG-olden Tincture). — Take one 
ounce each of powdered balsam of tolu, guaiacum, gum hemlock, and 
gum myrrh, one ounce and a half of oil of hemlock, one ounce of oil 
of wintergreen, and four pints of alcohol. Mix, let them stand four- 
teen days, shaking frequently, then filter. 

This is used by the Eclectics for rheumatism, wind colic, water- 
brash, soreness of the chest, etc. Dose, a teaspoonful in a wineglass- 
ful of water. 

Compound Tincture of High Cranberry. — Take one ounce of 
high cranberry bark, powdered, half an ounce each of powdered 
lobelia-seed and bruised skunk-cabbage seed, two drams each of 
bruised stramonium-seed, powdered bloodroot and capsicum, and two 
pints of alcohol. Macerate two weeks, express, and filter. 

This is an Eclectic remedy, and is useful in nervous and spasmodic 
complaints, particularly hysterics, etc. Dose, from twenty drops to 
a teaspoonful. 

Compound Tincture of Lavender. — Take three fluid drams of 
oil of lavender, one dram and a half of oil of anise, one ounce of 
powdered cloves, three drams of mace, one ounce of raisins, two 
ounces of red saunders, and one gallon of Jamaica rum. Mix, and 
macerate fourteen days, then express and filter. 

This is often used for flatulence, hysterics, and faintness. Dose, 
from one to three teaspoonfuls, in water. 

Compound Tincture of Lobelia. — Take one ounce each of 
coarsely powdered lobelia, bloodroot, skunk-cabbage, wild ginger, 
and pleurisy root. Place them in a vessel, and pour over them one 
pint of boiling water or vinegar, and cover tightly. When cold, add 
three pints of alcohol. Macerate two weeks, then express and filter. 



918 MEDICINES AND THEIR PREPARATIONS. 

A valuable emetic for infants and children, in croup, whooping- 
cough, bronchitis, and convulsions. Used also as an expectorant, in 
coughs, pleurisy, etc. Dose, as an emetic for a child, half a teaspoon- 
ful and upwards. 

Compound Tincture of Lobelia and Capsicum. — Take one ounce 
each of powdered lobelia, capsicum, and skunk-cabbage, and one pint 
of diluted alcohol. Mix, macerate fourteen days, and filter. 

A prompt antispasmodic in cramps, spasms, lock-jaw, etc. Dose, 
half a dram to a dram. 

Compound Tincture of Myrrh (Hot Drops). — Take four ounces 
of bruised myrrh, two ounces of capsicum, and four pints of alcohol. 
Mix, macerate a fortnight, and filter. 

Applied externally, and occasionally given internally for distress 
of stomach, flatulence, etc. 

Camphorated Tincture of Opium. — Take one dram each of pow- 
dered opium and benzoic acid, one fluid dram of oil of anise, two 
ounces of clarified honey, two scruples of camphor, and two pints of 
diluted alcohol. Macerate fourteen days, and filter. 

This is known to all the world as paregoric elixir. It is an agree- 
able anodyne and antispasmodic, and a good deal used among chil- 
dren to allay cough, and to relieve pains, diarrhoea, etc. 

Compound Tincture of Peruvian Bark. — Take two ounces of 
red bark, powdered, one ounce and a half of bruised orange-peel, 
three drams of bruised Virginia snake-root, one dram each of saffron, 
cut, and red saunders, rasped, and twenty fluid ounces of diluted 
alcohol. Macerate two weeks, express, and filter. 

This is Huxhams tincture. It is an excellent stomach cordial, and 
is used with advantage in low forms of fever, etc. Dose, from one 
to three fluid drams. 

Compound Tincture of Rhubarb (Sweet Tincture of Rhubarb). — 
Take two ounces and a half of bruised rhubarb, six drams of bruised 
liquorice root, three drams each of bruised ginger and saffron, two 
ounces of refined sugar, and one quart of diluted alcohol. Macerate 
one week, express, and filter. 

A warm, gentle aperient, well fitted for debilitated states of the 
stomach. Dose, from a dram or two to an ounce. 

Tincture of Senna and Jalap (Elixir Salutis). — Take three 
ounces of senna, one ounce of powdered jalap, half an ounce each of 
bruised coriander and caraway seeds, two drams of bruised cardamom 
seeds, four ounces of sugar, and three pints of diluted alcohol. Mace- 
rate two weeks, express, and filter. 

This is a warm cordial purgative, useful in costiveness, and gout 
attended with debility. Dose, two fluid drams to an ounce. 

Compound Tincture of Tamarac (Bone's Bitters). — Take three 
ounces each of tamarac-bark and juniper-berries, two ounces of 



MEDICINES AND THEIR PREPARATIONS. 919 

prickly-ash bark, one ounce and a half each of wild-cherry bark and 
seneca snake-root, and half an ounce of tansy ; powder coarsely, and 
mix ; then add one pint and a half of whiskey, and let them stand 
twenty-four hours ; then place the whole in a vapor displacement 
apparatus, and force through the mixture the vapor of another pint 
of whiskey, after which steam from water enough to make the tinc- 
ture equal to six quarts. To this add twelve ounces of molasses, and 
six ounces of thoroughly dissolved alcoholic extract of mandrake. 

This is tonic, diuretic, and aperient. Useful in dyspepsia, etc. 
Dose, a tablespoonful three times a day. 

Ammoniated Tincture of Valerian. — Take four ounces of 
bruised valerian, and one quart of aromatic spirit of ammonia. Mace- 
rate two weeks, express, and filter. 

This is used as an antispasmodic in hysterics and other nervous 
diseases. Dose, one or two fluid drams, in sweetened water. 

Compound Tincture of Virginia Snake=root {Sudorific Tincture). 
— Take eight scruples each, in coarse powder, of Virginia snake- 
root, ipecacuanha, saffron, opium, and camphor, and one pint of Hol- 
land gin or proof spirit. Mix, macerate two weeks, express, and 
filter. 

This tincture tends powerfully to induce perspiration, and is used 
for such purpose when it is desirable to procure sleep, etc. Dose, 
from ten drops to a teaspoonful, every hour or two, in catnip or 
balm tea. 

Vinegars. 

Vinegar of Lobelia. — Take two ounces of powdered lobelia-seed, 
and one pint of distilled vinegar. Macerate in a close vessel one 
week ; then express and filter, and add one fluid ounce of alcohol. 
This is useful as an emetic and expectorant ; externally, it is valua- 
ble in skin diseases. Dose, one to four teaspoonfuls, as often as 
necessary. 

Vinegar of Squill. — Take two ounces of sliced squill, and one 
pint of distilled vinegar ; macerate in a close glass vessel one week ; 
then express, strain, and add one fluid ounce of alcohol. 

This is expectorant and diuretic, and is sometimes used for coughs 
and diseases of the chest. 



PRESCRIPTIONS. — RECIPES. 



These prescriptions are numbered, and referred to by correspond- 
ing numbers in the treatment of the various diseases. This arrange- 
ment saves the trouble of writing out each prescription every time it 
is wanted under the several disorders. When there are several 
recipes, each of which is suitable in a certain stage of a complaint, 
this plan affords the means of referring to them all in a little space, 
by simply giving their numbers. The doses named are always for 
grown persons, unless it is otherwise stated. For young people, from 
15 to 21, give f of dose. For children, from 7 to 15, i of dose. 
In administering medicines of all kinds, the strength and condition 
of the patient should be taken into consideration. 

Great pains have been taken in preparing these prescriptions. A 
considerable portion of them are the favorite recipes of the most dis- 
tinguished physicians, the world over. They have been thoroughly 
revised, newly discovered remedies added, and those which time has 
proved not as valuable have been omitted. 

The classification of these recipes under separate heads is necessa- 
rily very imperfect, and has been attempted only to make it more 
easy for me to refer to them while writing the book. The classifica- 
tion could only be applied to a part of them, however ; the rest are 
indiscriminately mixed. 

Emetics. 

1. Ipecac powder, in 30-grain doses, taken in lukewarm water and 
repeated every 20 minutes if needed. Wine or syrup of ipecac is a 
more useful and palatable emetic for infants and children : it may be 
given in 1 to 2 teaspoonfuls as a dose. Useful in poisoning, overloaded 
stomach, croup, etc. 

2. Mustard flour is a very prompt emetic and always on hand for an 
emergency. Dose, 1 dessertspoonful in ^ pint of warm water; repeated in 
10 minutes if needed. 

3. Sulphate zinc is a very prompt emetic producing little irritation; 30 
grains, with thirty of Ipecac, generally suffice, but the dose may be re- 
peated. 

920 






MEDICINES AND THEIR PREPARATIONS. 921 

4. Apomorphia, when injected under the skin in doses of J grain, 
produces vomiting in 3 to 10 minutes. It may also be given by the mouth 
in doses of J of a grain. 

Purges. Cathartics. 

5. Precipitated sulphur, 15 grains ; magnesia, 1 scruple. Mix. To be 
taken each night at bedtime, for costiveness and bleeding piles. 

6. Confection of senna, 2 ozs. ; bream of tartar, 1 oz. ; sulphur, 1 oz.; 
syrup of ginger enough to make a stiff paste. Mix. A piece as large as 
a nutmeg is to be taken as often as necessary to keep the bowels open. 
One of the very best remedies for piles. 

7. Rochelle salts, 2 drams; bicarbonate of soda, 2 scruples; water, -J 
pint. Mix. To this mixture add 35 grains of tartaric acid, and take the 
whole foaming. This is the recipe for Seidlitz powders. 

8. Calcined magnesia, 1 dram; water, 2 ozs. Mix. To be taken at a 
draught. Husband's magnesia, in powder form, taken in teaspoonful 
doses every 2 hours till bowels move, is a excellent mild saline. 

9. Sulphate of magnesia (epsom salts), 2 drams ; freshly roasted coffee 
in coarse powder, 2 scruples ; hot water, 4 ozs. Mix and boil for three 
minutes, and strain. This may be sweetened, and taken every morning 
for habitual costiveness, or repeated once in three hours, if an immediate 
effect is desired. 

10. Castor-oil, 1 oz. ; the yolk of one egg; put together, and add 
simple syrup, ^ oz. ; peppermint water, 2 ozs. Mix. To be taken at a 
draught, after being well stirred or shaken. Equally palatable is a table- 
spoonful or two of castor-oil between 2 layers of lemon juice. 

11. Sulphur, 1 dram; cream of tartar, 2 drams. Mix. To be taken 
in syrup or molasses. 

12. Rbubarb, 10 grains; calcined magnesia, \ dram. Mix. To be 
taken in syrup or molasses. 

13. Powdered senna, \ dram; powdered jalap, 10 grains; powdered 
cloves, 10 grains. Mix. To be taken in sweetened water. 

14. Compound licorice powder, or so-called German powder, is a 
thorough physic in heaping teaspoonful doses. It is a physic very com- 
monly used. Best taken in milk, but not bad in water. 

15. Garfield tea, bought in packages and steeped per directions, is also 
a simple carthartic, and may be continued for a while each night. No 
physic proper should be so used for any great length of time. 

16. Castor-oil, 1 dessert spoonful to 2 tablespoonfuls. 

17. Castoria is a proprietary medicine, yet one which children and in- 
fants take readily and without any deleterious effect. 

18. Sulphate of magnesia, 1 oz.; cream of tartar, 1 oz. ; pure water, 
1 pint. Mix. A wine-glassful occasionally. 

19. Compound extract of colocynth, \ dram ; aloin, 2 grains; extract 
of belladonna, 2 grains. Mix, and divide into 8 pills. One as required 



922 MEDICINES AND THEIK PREPARATIONS. 

20. The solution of citrate of magnesia, which all druggists keep in 
stock in pint bottles, is the most palatable, the simplest, and most effeca- 
cious saline we have. The ordinary dose is J bottle ; this may be repeated 
in 4 hours. 

21. Syrup of figs is another proprietary medicine of some value ; it con- 
tains senna. Dose, 2 to 4 teaspoonfuls. Is agreeable to children. 

22. Aloin, strychnia and belladonna, in pill form, is sold everywhere 
by druggists, and is a suitable mild cathartic. The pill is put up in vary- 
ing strengths, but that which contains aloin, -J grain, is a moderate strength 
pill. 

23. Sulphur, 1 teaspoonful ; cream of tartar, 10 grains; saltpetre, 5 
grains. Mix. To be taken at a dose. 

24. Manna, 2 drams ; fennel water, 1 oz. Mix. One dessert spoon- 
ful, as a cathartic for an infant. 

25. Castoria (See No. 17) and aromatic syrup of rhubarb are good laxa- 
tives for children. 

26. Cascara sagrada is an herb which has become extremely popular 
and useful in constipation, as it is a tonic laxative. It is given in various 
forms, of which the best are the aromatic preparations of cascara, in tea- 
spoonful doses at night, the solid extract in pill form, in doses of J to J 
grain, 1 to 3 three times daily, or Maltine with cascara, in 1 to 4 teaspoon- 
ful doses at bedtime. These preparations may be contined for long inter- 
vals if need be. 

27. Epsom salts, 2 drams; dissolve in pure water, 1 oz. Then add 
sweet spirits of nitre, 2 drams; laudanum, 10 drops. Dose, a tea- 
spoonful, to be repeated according to circumstances. 

28. Aromatic syrup of rhubarb, in teaspoonful doses to a young child, 
or in tablespoonful doses to an older child, is a good corrective. 

29. Compound extract of colocynth, \ dram ; extract of jalap, 15 grains. 
Mix. Make 12 pills. Two or three pills will produce active operation of 
the bowels. Add ext. belladonna, 2 grs., to prevent gripes. 

30. Solution of the citrate of magnesia, in wineglass doses, every two 
hours, till it operates, or in \ bottle dose for a single dose. 

31. Pulverized gamboge, 12 grs. ; pulv. scammony, 12 grs. ; elate- 
rium, 2 grs. ; croton oil, 8 drops ; ext. of stramonium, 3 grs. Mix. Make 
12 pills. One pill is a dose, repeated every hour until it operates. 

32. Compound cathartic pills, improved, in doses of two to three pills, 
produce in four hours one or two complete and full operations. 

33. See Nos. 17, 20, 21, and 25. 

34. Leptandrin, \ grain; podophyllin, y 1 ^ gr. ; euonymin, \ grain; in- 
spissated ox-gall, 2 grains, is an admirable liver-pill, taken one to three 
times daily. 

35. Pulverized rhubarb, 2 scruples; bicarbonate of potassa, 1 scruple; 
ext. of nux vomica, 5 grs. Mix. Make 20 pills. One pill twice a day. 

36. Leptandrin, \ grain; ext. nux vomica, \ grain; euonymin, \ grain; 
iridin, \ grain ; ext. cascara sagrada, J grain, makes also a very good bil- 
ious pill ; it may be taken as often as three times a day, if needed. 



MEDICINES AND THEIR PREPARATIONS. 923 

37. Sweet tinct. of rhubarb, 4 ozs. ; bicarbonate of soda, 2 drams. Mix. 
From a teaspoonful to a tablespoonful, as occasion may require. 

38. Pulverized rhubarb, 2 ozs. ; bicarbonate of potassa, 1 oz. Mix. Of 
this take enough to produce one movement of the bowels per day. 

39. Leptandrin, 30 grs. ; podophyllin, 5 grs. ; pulv. cayenne, 10 grs. ; 
ext. nux vomica, 6 grs. ; quinine, 12 grs. Mix. Make 24 pills. One, 
two or three times a day. 

40. Podophyllin, 2 grs. ; leptandrin, 10 grains ; cream of tartar, 5 scru- 
ples. Mix. Divide into 10 powders. One is a dose. 

41. Comp. powder of jalap, 1 oz. ; cream of tartar, 1 oz. Mix. One 
teaspoonful is a dose, to be taken in sweetened water. 

42. Pulverized charcoal, 1J drams ; pulv. rhubarb, 2 scruples ; pulv. 
ipecac, 6 grains; extract of hyoscyamus, 12 grs. Mix. Divide into 12 
portions. Give one every three or four hours. 

43. Pulverized blood-root, 1 dram ; pulv. rhubarb, 1 dram ; castile soap, 
2 scruples. Mix, and divide into 32 pills. Take one morning and night. 
Excellent for costiveness. 

44. Rochelle, 14 drams; magnesia, 11 drams; powdered charcoal, 8 
drams. Mix. Dose, a heaping teaspoonful, in dyspepsia and costive- 
ness, with foul breath, etc. 

45. Pulverized rhubarb, 8 grs. ; pulv. guaiacum, 8 grs. ; galbanum, 2 
grs. ; pulv. ipecac, 2 grs. Mix. Make 8 pills. Take one or two pills 
night and morning. For a weak stomach and a bilious condition. 

Tonic and Cathartic. 

46. Podophyllin, 4 grs. ; leptandrin, 8 grs. ; quinine, 8 grs. ; ext. nux 
vomica, 2 grs. Mix. Make 16 pills. One, two, or three pills at bedtime, 
according to the requirements of the case. 

47. Sulphate of iron, 1 scruple; ext. cascara, 7 grains. Mix and make 
into 20 pills. One pill twice a day. An excellent remedy in chlorosis, 
when the bowels are confined. 

48. Carbonate of iron, 1 dram ; pulverized rhubarb, \ dram ; aloin, 6 
grains; extract of hops, -J- dram. Mix. Make 30 pills. One pill three 
times a day. 

49. Fluid extract of senna, 1 dram; compound fluid extract of gentian, 
\ dram ; fluid extract of ginger, \ dram ; aromatic spirits of ammonia, 
\ dram. Mix. To be taken in a wineglassful of sweetened water. 

50. Aromatic syrup of rhubarb, 1 oz. ; tincture of Colombo, 1 oz. Mix. 
Dose, two teaspoonfuls three times a day. 

51. Compound infusion of gentian, 6 ozs. ; epsom salts, 4 drams; di- 
luted sulphuric acid, 16 drops. Mix. A tablespoonful every six hours. 

52. Tr. aloes, \ oz. ; pulv. gum-arabic, 5 grs.; magnesia, 1 dram; 
white sugar, 5 grs. ; comp. infusion of gentian, \\ ozs. ; water, 1^ ozs. : 
tinct. of ginger, 1^ ozs. Mix. From a teaspoonful to a tablespoonful to 
be taken night and morning. 



924 MEDICINES AND THEIR PREPARATIONS. 

53. Pulverized Peruvian bark, 1 oz. ; pulv. rhubarb, ^ dram ; pulv. mu- 
riate of ammonia, 1 dram. Mix. Divide into eight powders. Take one 
three times a day. 

54. Oxide of zinc, 2 drams; magnesia, \ oz. ; quinine, 1 scruple. Mix. 
Divide into 32 powders. Take one four times a day. 

55. Sprudel salts, 1 teaspoonful in \ glass warm water on arising; crab- 
orchard water, 1 tablespoonful in \ glass water on arising ; Hunyadi 
Janos, J glass or more in water; 1 teaspoonful phosphate of sodium in a 
glass of hot water on arising; are all good saline remedies for biliousness. 

Carminatives. 

56. Manna, 1 oz. ; aniseed, bruised, 1 dram; ooiling water, \ pint. 
Mix. Let the mixture stand for half an hour, then strain, and add three 
drams of carbonate of magnesia, so as to make a perfect mixture. Take 
a wineglass full every two or three hours till it operates. For the drum- 
head state of the bowels. 

57. Thoroughwort, 2 ozs. ; ginger and cloves, each, J oz. ; ext. dan- 
delion, 4 ozs. ; water, 1^ pints. Boil to one- third, and add sugar, 1-| 
pounds, and brandy, \ pint. An excellent cordial cathartic to act upon 
the liver. 

Tonics. 

58. Chamomile flowers, \ oz. ; cold water, 1 pint. Macerate for one 
hour and strain. A wineglassful to be taken several times a day. 

59. Sulphate of quinine, 15 grains; diluted sulphuric acid, 15 drops; 
compound tincture of cardamom, 3 drams ; tincture of hops, 3 drams ; com- 
pound infusion of roses, 6 ozs. Mix. A teaspoonful two or three times a 
day, in chlorosis. 

60. Diluted sulphuric acid, 2 drams ; syrup of orange-peel, 2 ozs. ; cin- 
namon-water, 1 oz. Mix. A teaspoonful or two in a wineglass of water 
two or three times a day. 

61. Bland's iron pill, 3 grains, three times daily. This pill is often 
united with strychnia, -^ grain, and arsenious acid, -Jq grain, which adds 
to its efficiency. If constipation exists, there may also be added ext. cas- 
cara, \ grain, in chlorosis, anaemia, and conditions requiring iron. 

62. Sulphate of quinine, 12 grains; aromatic sulphuric acid, 24 drops; 
syrup, 1 oz. ; peppermint water, 1 oz. Mix. In intermittent fever, take 
one tablespoonful once in three hours. Ordinarily, one teaspoonful is a 
sufficient dose. Or quinine, 10 grains, four hours before the expected chill. 

63. Compound infusion of gentian, 8 ozs. ; nitro-muriatic acid, 30 
drops. Mix. Take one tablespoonful three times a day. 

64. Bicarbonate of soda, \ oz. ; compound infusion of gentian, 4 ozs. ; 
tincture of Colombo, 1 oz. ; syrup of orange-peel, \ oz. Mix. Take a 
tablespoonful three times a day. 

65. Sulphate of quinine, 1 scruple; alcohol, 4 ozs.; sulphuric acid, 5 
drops ; Madeira wine, 1 quart. Mix. Two wineglassfuls a day. 

66. Tinct. gentian compound, teaspoonful in wineglass water before 
eating. 



MEDICINES AND THEIR PREPARATIONS. 925 

67. Quinine, 1 scruple ; alcohol, 4 ozs. ; sulphuric acid, 5 drops. Mix. 
Take a teaspoonful three times a day, or quinine pills, 2 grs. each, one 
three times a day. 

68. Arseniate of iron, 3 grains; extract of gentian, 2 drams; pulver- 
ized licorice, 1 dram. Mix. Make 20 pills. Take one pill three times 
a day. If the eyelids become inflamed, discontinue for a few days, and 
then begin again. 

69. Soft water, 3 ozs.; quinine, 10 grains; diluted sulphuric acid, 10 
drops; simple syrup, 1 oz. Mix. A teaspoonful every two or three 
hours. 

70. Quinine, 10 grains; diluted sulphuric acid, 10 drops; white sugar, 
4 drams ; cinnamon water, 4 ozs. ; tincture of kino, 2 drams. Mix. One 
teaspoonful every three hours. 

71. Tartrate of iron, 40 grains; soft water, 2 ozs.; syrup of ginger, 
J oz. Mix. 20 to 40 drops every three hours. 

72. Potassio-tartrate iron, 4 scruples ; quinine, 4 scruples ; alcoholic ext. 
of black cohosh, 4 scruples. Mix. Make 48 pills. 

73. Pill, citrate of iron, quinine, and strychnia, 2 grains. One pill three 
times daily. 

74. Precipitated carbonate of iron, 30 drams ; ext. of conium, 15 drams ; 
syrup of balsam of tolu, 6 ozs. ; oil of cinnamon, 12 drops ; oil of lemon, 
12 drops; alcohol, 2 ozs.; water, 1 pint; brandy, J pint; loaf-sugar, 
4 ozs. Mix. Give from one to three tablespoonfuls three or four times a 
day, in insanity. 

75. Citrate of iron, 1 dram ; sulphate of quinine, 1 scruple ; ext. of nux 
vomica, 8 grs. Mix. Make 32 pills. One pill three times a day. 

76. Nitric acid, 1 dram; hydrochloric acid, \ dram; comp. infusion of 
gentian, \\ ozs. Mix. One teaspoonful in water is a dose. 

77. Sulph. quinine, 1 dram ; tartaric acid, 6 grs. ; water, 1 drop. Mix. 
Make 30 pills. Dose, one pill, to be repeated as often as needed. 

- 78. Diluted nitric acid, 4 drams ; diluted muriatic acid, 4 drams; syrup 
of orange-peel, 1 dram ; water, \\ ozs. Mix. One teaspoonful in a wine- 
glass of water, taken before meals. 

General and Nerve Tonics. 

79. Valerianate of iron, quinine and zinc, of each 1 grain in pill form, 
taken three times daily, is an excellent nervine ; or pill sumbul comp. , one 
three times daily. 

80. Iron by hydrogren, 48 grs. ; arsenious acid, 1 gr. ; ext. of nux 
vomica, 5 grs. Mix. Make 24 pills. For an adult, one pill three times 
a day. 

81. Valerinate quinine, 1 grain; extract valerian, 1 grain; extract of hy- 
oscyamus, \ grain. One pill every two or three hours till quiet, then one 
every four or six hours. 

82. "White vitriol, 1 dram; ext. of nux vomica, 8 grs. Mix. Make 32 
pills. One pill three times a day. 



926 MEDICINES AND THEIR PREPARATIONS. 

83. Strychnia, 2 grs. ; ext. of aconite, 16 grs. ; ext. of hvoscyainus, 16- 
grs. ; quinine, \ dram. Mix. Make 32 pills. One pill three times a day. 

84. Citrate of iron, 1 dram; trisnitrate of bismuth, 1 dram; sulphate of 
quinia, 1 scruple ; ext. of nux vomica, 6 grs. Mix. Make 32 pills. Take 
one pill three times a day. 

Nerve-Tonics and Antispasmodics. 

85. Strychnine, 2 grs. ; ext. belladonna, f) grs. ; alcoholic extract of 
black cohosh, 2 scruples. Mix. Make 40 pills. One pill four times 
a day. 

86. Strychnine, 2 grs. ; diluted phosphoric acid, 1 oz. ; peppermint 
water, 3 pints. Dissolve the strychnine in the acid ; then add the pepper- 
mint water. A tablespoonful to be taken three times a day, in palsy, dys- 
pepsia, neuralgia, and in most states of the nervous system requiring tone. 
Also in fever and ague. 

87. High-cranberry bark, 1 oz. ; skunk-cabbage root, ^ oz. ; scullcap, 
^ oz. ; cardamom seeds, 2 drams; pulv. cayenne, 2 drams. Put these to 
a pint of wine; shake well every day for three or four days. A table- 
spoonful four times a day. 

88. Aconitia, ¥ £q grain; antifebrin, 2 grains; quinine. 1 grain; ar- 
senic chlorophos., T J^ grain; strychnia, T | - grain. One pill. Take one 
such pill every two to four hours, according to pain. Used in neuralgia. 

89. Extract of valerian, 12 grs. : extract of hyoscyamus, 12 grs. : 
oxide of zinc, 24 grs. Mix. Make 12 pills. One pill twice a day. 

90. Extract of hyoscyamus, 48 grs. ; extract of valerian, 24 grs. ; 
camphor, 24 grs. Divide into 24 pills. Take one every four hours. 

91. Extract of hyoscyamus, £ dram: aconitia, I gr. ; strychnine, 2 
grs. ; pulverized cayenne, J dram ; phosphide of zinc, 5 grs. Make 30 
pills. Take one four times a day. Excellent in neuralgia. 

92. Antikamnia, 60 grs. ; caffein, 24 grs. : divide into 12 capsules. 
Take one every two hours for neuralgia of face. See also 88. 

93. Valerianate of iron, valerianate of zinc, valerianate of quinine ; of 
each, 30 grs., to be divided into 30 pills or capsules. Take one three 
times a day for the neuralgic condition. 

94. Tincture of veratruin viride, 2 drams: bromide of soda, 4 drams: 
elixir of anise, 1 oz. : syrup of orange, 2 ozs. Take a teaspoonful in 
wineglass of water every two to four hours according to nervousness. 

95. Strychnine, 1 gr. ; arsenious acid, 1 gr. : quinine, 20 grs. ; reduced 
iron, 20 grs. ; extract cannabis indica, 5 grs. Divide into 30 pills or 
capsules. Take one three times daily. 

96. Simple syrup, 1 oz. : prussic acid, 1 drop. Mix. A teaspoonful 
morning and evening. If no dizziness or sickness is produced within 
forty-eight hours, repeat the dose three times a day. This is for a child 
six months old : add one drop more of the acid for each additional year of 
the child's age. 

97. Phosphide of zinc, 5 grs. : extract of nux vomica, 7 grs. ; extract 
of cannabis indica, 5 grs. Divide into 30 pills or capsules, and take one 
three times dailv as a nerve tonic. 



MEDICINES AND THEIR PREPARATIONS. 927 

98. Quinine, 12 grs. ; reduced iron, 10 grs. ; arsenious acid, J gr. ; 
phosphide of zinc, 2 grs. Divide into 24 pills. Take one three times 
daily for a child from 8 to 12 years of age. For St. Vitus's dance. Or, 
Fowler's solution, 1 oz. Give 3 drops to a child of 8 to 12 years in a 
little water three times daily, and increase dose by one drop every third 
day till eyes become puffy or nose waters. Then stop for three days and 
begin again. Give also pepto-mangan, 1 bottle; a teaspoonful three 
times daily. This latter is an elegant form of mild iron, and does not 
stain the teeth or constipate. 

99. Phenacetin, 50 grs.; divide into 6 powders; give one every two 
hours till pain ceases. Or chlorodyne, one dram ; aromatic spirits of 
ammonia, one dram ; elixir simplex, 1 oz. Mix. One teaspoonful in a 
tablespoonful of hot water every 20 minutes till relieved. 

100. Extract of high cranberry bark, 1 scr. ; euonymin, J scr. ; iridin, 
J scr. ; pulverized cayenne, 1 scr. Mix. Make 20 pills. Take one pill 
an hour after each meal. Simpler yet is a tablespoonful of crab-orchard 
water in J glass plain water once or twice a day. 

101. Iodide of potash, peppermint water ; of each 2 ozs. Give 10 to 30 
drops in ^ glass water three times daily on a full stomach ; for secondary 
and tertiary syphilis and similar complaints. For a child give 5 to 10 
drops. 

102. Elixir of the three iodides, 6" ozs. ; one teaspoonful in water three 
times daily. 

103. Syrup of iodide of iron, 1 oz. Thirty drops three times a day, in 
water. An excellent remedy in chlorosis, and all other low states of the 
blood connected with scrofula. Or, a pill of iodide of iron, 1 gr., three 
times daily. 

Expectorants and Cough Preparations. 

104. Apomorphia, 1 gr. ; chloroform, 10 drops; elixir verba santa, 
2 ozs. Take one teaspoonful every two hours. 

105. Infusion of senega, 4 ozs. ; syrup of ipecac, 1 dram; syrup of 
squills, 3 drams ; tartar emetic, 1 J grs. Mix. A teaspoonful every 
ten minutes. 

106. Wine of ipecac, 1J drams; chloroform, 5 drops; syrup of tolu 
sufficient to make 1 oz. Give J teaspoonful every two hours for a child 
three years old. 

107. Tincture aconite, 20 drops; wine of antimony, 1J drams; chloro- 
form, 10 drops; elixir terpin hydrate, enough to make 2 ozs. Give tea- 
spoonful every two hours. 

108. Bromoform, 1 oz. Give 5 drops in tablespoonful of water four 
times daily to a child eight years old suffering with whooping cough. 
This dose is to be well mixed and quickly given, because bromoform does 
not mix well with water. It is to be increased by 1 drop every other day 
till about 10 drops are given at a dose. Other ages in proportion. Burn 
also a cresolene lamp. 

109. Tincture bloodroot, 4 J ozs. ; wine of ipecac, 2 drams ; tincture of 
aconite 20 drops ; honey, J oz. ; McMunn's elixir, 1 J drams ; elixir yerba 
santa to make 3 ozs. Take teaspoonful every two hours. 



928 MEDICINES AND THEIR PREPARATIONS. 

110. TVine of ipecac, 2 drams: chloroform, 15 drops: liquid Dover's, 

1 dram ; linoline, or compound emulsion of flax-seed (omitting the chloral 
and morphine) enough to make 3 ozs. One teaspoonful every two hours: 
for hard, dry cough. 

111. Tincture of lobelia, 2 drams; tincture of bloodroot. 4 drams; 
honey, 1 oz. ; dilute hydrocyanic acid, 1 J drams : cherry-laurel water 
enough to make 3 ozs. Give one teaspoonful every two hours. 

112. Syrup of tolu, 1 oz. ; syrup of squills, J oz. : wine of ipecac, 

2 drams; codeia, 2 grs. : mucilage of gum-arabic, lj'ozs. Mix. Take 
a teaspoonful occasionally. 

113. Tincture bloodroot, 2 drams; syrup of tolu, 1 oz. ; mucilage of 
gum-arabic, 3 ozs. ; diluted hydrocyanic acid, 40 drops : codeia, 4 grs. 
Mix. Dose, from one to two teaspoonfuls. 

Carminatives. 

114. Aromatic spirits of ammonia, 2 drams ; tincture of cardamom com- 
pound, 1 oz. : tincture of capsicum, 10 drops; chloroform, 15 drops; 
spirits of lavender compound enough to make 2 ozs. Give teaspoonful in 
wineglass of hot water every fifteen minutes till relieved. 

115. Compound tincture of cardamom, 2 ozs.: compound tincture of 
lavender 2 ozs; Hayden's Viburnum Compound, 2 ozs. Mix. One tea- 
spoonful at a time, as occasion may require. 

Narcotics and Anodynes. 

116. Hayden's viburnum compound, or dioviburnum. One teaspoon- 
ful every J hour while in pain. Two tablespoonfuls of gin, and even of 
brandy in hot water also relieve at times. 

117. Powdered camphor, 12 grs.: powdered Castile soap. 12 grs.; 
codeia, 4 grs. ; syrup, 2 scrs. Mix. Make into 12 pills. Take one 
every hour till the effects of opium are experienced. 

118. Laudanum, J oz. ; wine of ipecac, J oz. : spirits of nitric ether, 
J oz. Mix. One teaspoonful every hour, till narcotic effects are observed. 

119. Camphor, 2 drams: chloroform, 1 dram: the yoke of an egg. 
Mix, and rub together ; and then add, McMunn's elixir, 3 drams ; aromat- 
ic spirits of ammonia, 1 oz. Mix well. Take one teaspoonful every 
hour until it proves anodyne. 

120. Camphor, ^ dram : extract of hyoscyamus, 20 grs. : mucilage of 
gum-arabic, 2 scrs. Make 10 pills. 

121. Chloroform, 2 ozs. ; compound sulphuric ether, 2 ozs. : cardamom, 
2 ozs. : tincture cayenne, 1J ozs. : hydrocyanic acid, diluted. ^ oz. Mix. 
Dose, half a teaspoonful every three hours till anodyne effects are exper- 
ienced. 

122. Extract of belladonna, 10 grs.; hydrocyanic acid, 40 drops: 
tincture Colombo, 1 oz. : simple syrup, 1 oz. : soft water, 2 ozs. Mix. 
One teaspoonful three or four times a day. Excellent in gastralgia and 
irritable dyspepsia. Also in asthma. 

123. Extract of belladonna, 6 grs. ; pulverized ipecac, 10 grs. ; con- 
fection of roses, 2 grs. Mix. Make 30 pills. Take 1 pill twice a day. 



MEDICINES AND THEIR PREPARATIONS. 929 

Diaphoretics and Sedatives. 

124. Tincture of American hellebore, 1 dram ; tincture of blank cohosh, 
2 ozs. Mix. Take one teaspoonful from three to six times a day. 
Excellent for neuralgia. 

125. Pulverized gum arabic, 1 scr. ; soft water, 2 ozs. ; sweet spirits 
of nitre, J oz. ; tincture of veratrum viride, 20 drops. Mix. Give half 
a teaspoonful every half hour. 

126. Phenacetine, 10 grs. taken on tongue with a glass of hot lemon- 
ade ; children in proportion to age. 

127. Dover's powder, 10 grs. on retiring, taken with hot drink. 

Diuretics. 

128. Spirits of Mindererus, 2 ozs. ; sweet spirits of nitre, 1 oz. Tea- 
spoonful every three hours. 10 to 30 drops, diluted, for children. 

129. Diuretin, 10 grs. every two hours. 

130. Infusion of digitalis, 4 ozs.; acetate of potash, 2 drams; sweet 
spirits of nitre, 2 drams ; cinnamon water, 1 J ozs. Mix. A tablespoon- 
ful every four or five hours. 

131. Acetate of potash, 4 drams; lemon juice, 1 oz. ; syrup and water 
of each, 1 oz. Teaspoonful in wineglass of water every two hours. 

Refrigerants. 

132. Cream of tartar, 2 scrs. ; water, 1 quart. Mix. Flavor to suit. 

133. Bicarbonate of soda, 30 grs. ; water, 6 ozs. Mix. To this mix- 
ture add 25 grs. of tartaric acid, and take the whole foaming. 

Stimulants. 

134. Muriate of ammonia, 1 oz. ; soft water, 9 ozs. Mix. Take one 
tablespoonful three or four times a day. 

135. Aromatic spirits of ammonia, 2 drams; ether, 1 dram; chloro- 
dyne, 20 drops ; spirits of camphor, 1 dram. Mix. Half a teaspoonful 
as often as required. 

Alteratives. 

136. Proto-iodide of mercury, 5 grs. ; extract of opium, 5 grs. Mix. 
Make 20 pills. Take one pill night and morning. For syphilis. 

137. Biniodide of mercury, 5 grs. ; extract of conium, 2 scrs. Mix. 
Make 20 pills. Take one pill night and morning. For syphilis. 

138. Compound infusion of sarsaparilla, 1 pint; iodide of potassium, 
J oz. Mix. Take a teaspoonful after each meal. 

139. Compound infusion of sarsaparilla, 1 pint; corrosive sublimate, 
4 grs. Mix. Take a teaspoonful four times a day. For syphilis. 

140. Compound infusion of gentian, 4 ozs. ; iodide of potassium, J oz. 
Mix. One teaspoonful after each meal, well diluted. 



930 MEDICINES AND THEIR PREPARATIONS. 

141. Iodide of arsenic, 5 grs. ; soft water, 1 pint. Mix. One tea- 
spoonful three times a day. 

142. Blue pill, 12 grs. ; pulverized ipecac, 3 grs. ; extract of hyos- 
cyamus, 4 grs. Mix. Divide into 12 parts, one to be given every three 
hours. For syphilis. 

143. Pulverized bloodroot, 1 scr. ; iodide of arsenic, 2 grs.; extract 
of cicuta, 2 scrs. Mix. Make 40 pills. One pill three times a day. 

144. Iodide of potassium, 1 dram ; water, J oz. Mix. Thirty drops 
to a child 7 years old, every hour. 

145. Compound syrup of stillingia, 1 pint; iodide of potassium, 1 oz. 
Mix. A tablespoonful after each meal. 

146. Fluid extract of sarsaparilla, 4 ozs. ; fluid extract of pipsissewa, 
1 oz. ; water, 1 quart; iodide of potassium, 2 ozs. Mix. Take a table- 
spoonful three times a day. 

147. Bicarbonate of potassa, 3 drams; water, 4 ozs. Mix. Add a 
tablespoonful of the solution to the same quantity of lemon juice, pre- 
viously mixed with a tablespoonful of water. To be taken foaming, 
several times a day. 

148. Blue pill, J dram; extract of henbane, 1 scr. Make 10 pills. 
One pill at night. For syphilis. 

149. Mercury with chalk, J dram ; extract of conium, 1 scr. Make 
into 8 pills. Take one pill night and morning. For syphilis. 

150. Corrosive sublimate, 4 grs. ; extract of opium, 5 grs. Mix, and 
make into 20 pills. Take one pill night and morning. For syphilis. 

151. Iodide of potassium, 1 dram; syrup of sarsaparilla, 4 ozs. Mix. 
Take two teaspoonfuls three times a day. For syphilis. 

Astringents. 

152. Sugar of lead, 2 scrs. ; ergotine, 1 scr. ; conserve of red roses, 
1 scr. Beat into a mass, which is to be divided into 30 pills. Take one 
every hour, until beneficial effects are observed. 

153. Tully's powder, \ dram; prepared chalk, 1 scr. Mix, and divide 
into 12 equal powders. 

154. Chalk mixture, 4 ozs. ; tincture of catechu, £ oz. ; papine, 3 
drams. Mix. Dose, in diarrhoea, two to four teaspoonfuls three times 
a day. 

155. Oil of turpentine, 1 dram; mucilage of gum arabic, 1 dram; 
simple syrup, J oz. ; cinnamon water, 2 ozs. Mix. To be taken at a 
draught. 

156. Sugar of lead, 16 grs.; prepared chalk, 1 dram; pulverized ipe- 
cac, 4 grs. ; pulverized opium, 2 grs. Mix. Divide into 16 portions, 
one to be given every three or four hours. 

157. Sugar of lead, 8 grs.; vinegar, 8 drops; white sugar, 1 dram; 
soft water, 1 oz. Mix. A teaspoonful three or four times a day, until 
the discharges are abated. 

158. Prepared chalk, £ dram; pulverized ipecac, 3 grs. Mix. Make 
12 powders. Qive one, two or three times a day. 



MEDICINES AND THEIR PREPARATIONS. 931 

159. Pulverized catechu, 2 drams; bruised cinnamon, J dram; boiling 
water, 5 ozs. Steep in a covered vessel for one hour and strain. A tea- 
spoonful every two, three, or four hours, according to age, nature of the 
case, etc. 

160. Soft water, 1 oz. ; sugar of lead, 5 grs. ; vinegar, 6 drops; loaf 
sugar, 3 drams. Mix. A teaspoonful every hour or two. 

161. Tincture of catechu, £ oz. ; laudanum, 2 drams; spirits of cam- 
phor, 2 drams; tincture of myrrhse, 2 drams; tincture of cayenne, 2 
drams. Mix. Dose, from half a teaspoonful to a teaspoonful, for 
diarrhoea. 

162. Syrup of orange-peel, 1 oz. ; tincture of catechu, 2 grs. ; tincture 
of cinnamon, 6 drams; tincture of cardamom, 2 drams. Mix. Dose, a 
teaspoonful. A valuable remedy in diarrhoea. 

Counter-irritants. 

163. Tincture of Spanish flies, 1 oz. ; olive oil, 2 ozs. ; alcohol, £ pint. 
Mix. To be applied externally, watching the effect, so as not to produce 
a blister. 

164. Water of ammonia, 1 dram; olive oil, 1 oz. Mix. Apply to 
the skin. 

165. Mustard powder, 1 tablespoonful. Mix with a little water to 
make a thick paste. Then spread upon a piece of brown paper or cotton 
cloth, and cover its surface with a piece of thin muslin to prevent the 
mustard from sticking to the flesh. Place it upon the sore or painful part, 
and keep it on fifteen or twenty minutes, or till a good degree of redness 
is produced. 

166. Vinegar of Spanish flies, 1 oz. ; spirits of camphor, 1 oz. Mix. 
To be rubbed gently upon the skin. If applied freely, and rubbed 
thoroughly in, it may produce a blister. 

167. Yellow wax, rosin, lard, each, 6 drams. Melt over a slow fire, 
and then stir in slowly, when at a very moderate degree of warmth, 1J 
drams of pulverized Spanish flies, to make an ointment. 

168. Water of ammonia, strong, 1 oz. ; alcohol, 1 oz. Mix. Wet a 
piece of cotton cloth, and lay it upon the painful part, and cover it with 
flannel to prevent evaporation. 

Ointments. 

169. Mercurial ointment, 1 oz. ; extract of belladonna, 1 oz. ; extract 
of henbane, 1 oz. ; camphor, 10 grs. Mix. For external use. 

170. Extract of belladonna, \ dram; vaseline, \ oz. Mix. To be 
rubbed on the neck of the womb in painful menstruation. 

171. Prussic acid, -2 drams; sugar of lead, 1 dram; cocoanut oil, J 
oz. ; vaseline, \ oz. Make an ointment. 

172. Neapolitan ointment, 2 drams; extract of belladonna, 1 dram. 
Mix. 

173. Extract of belladonna, 15 grs. ; vaseline, 1 oz. Mix. 



932 MEDICINES AND THEIR PREPARATIONS. 

174. Sulphuret of lime, 1 dram ; camphor, in powder, 15 grs. ; vaseline, 

1 oz. Make an ointment. 

175. Elder-flower ointment, 1 oz. ; oxide of zinc, 1 dram. Make an 
ointment. 

176. Oxide of zinc, ointment, 1 oz. 

177. Naphthaline, 2 scrs. ; vaseline, 1 oz. Make an ointment. To be 
spread upon linen, and applied to the diseased skin night and morning. 

178. Mild nitrate of mercury ointment, 3 drams; sugar of lead, 16 
grs. ; rose-water ointment, 1 oz. 

179. Laudanum, J dram ; sulphur, £ dram ; oxide of zinc, 1 dram; oil 
of almonds, 1 oz. ; vaseline, 3 ozs. Make an ointment. 

180. Olive oil, 4 ozs. ; white wax, 2 drams. Melt these together, and 
then add honey, 2 drams ; croton oil, 20 drops. 

181. Elder-flower ointment, 1 oz. ; pulverized blue vitriol, 1 scr. 
Make an ointment. 

182. Purified beeves' marrow, or lard, 6 drams; oil of sweet almonds, 

2 drams ; pulverized Peruvian bark, 1 dram. Mix. 

183. Pulverized sulphate of copper, 10 grs. ; extract of Spanish flies, 
5 grs. ; vaseline, 1 oz. Mix. Rub into the scalp. 

184. Iodide of lead, 1 dram; vaseline, 2 ozs. Mix. To be rubbed 
on the surface. 

185. Iodide of potassium, 1 dram; vaseline, 2 ozs. Mix. 

186. Basilicon ointment, 1 oz. ; red precipitate, 1 dram. Mix. 

187. Iodide of potassium, J dram ; vaseline, 1 oz. Mix. 

188. Veratria, 4 grs. ; vaseline, 5 drams. Mix. 

189. Tobacco leaves (fresh and sliced), 10 ozs. ; diluted acetic acid, 4 
pints; basilicon ointment, 13 ozs. Boil the tobacco in the acid, strain, 
and evaporate the decoction to six ounces. Add this to the basilicon 
ointment, heated, and stir till cold. For gathered breasts. 

Liniments. 

190. Sweet oil, 1 oz. ; strong water of ammonia, 1 oz. Mix. To be 
rubbed on with a piece of flannel. 

191. Lime-water, 2 ozs. ; flax-seed oil, 2 ozs. Mix. Apply outwardly. 

192. Olive-oil, 1 oz. ; solution of potassa, 2 drams; strong mercurial 
ointment, 1 dram. Mix. 

193. Olive-oil, 4 ozs.; oil of amber, 2 drams; oil of rosemary, 2 
drams. Mix. 

194. Spirits of turpentine, 1 oz. ; linseed oil, 1 oz. ; lime-water, 1 oz. 
Mix. For external use. 

195. Oil of hemlock, 2 drams; oil of origanum, 1 dram: camphor, 1 
dram ; opium, 1 dram ; alcohol, 4 ozs. Mix. 

196. Soap liniment, 2 ozs. ; chloroform, 1 dram. Mix. 

197. Tincture of aconite-root, J oz. ; opium liniment, £ oz. Mix. 
For neuralgia, etc. Apply a teaspoonful to the painful part. 






MEDICINES AND THEIR PREPARATIONS. 933 

198. White soap, 12 ozs. ; camphor, 6 ozs. ; oil of rosemary, 1J ozs. ; 
alcohol, 4 pints ; opium, 3 ozs. Mix and filter. An excellent liniment, 
acting at times like a charm in the removal of local pains. 

199. Sulphuric acid, 1 dram; spirits of turpentine, 1 dram; olive oil, 
3 drams. Mix the oil and spirits of turpentine first, then gradually add 
the sulphuric acid. A valuable liniment for chilblains. To be rubbed on 
two or three times a day. 

Washes, Lotions, Gargles, etc. 

200. Bruised white-oak bark, 1 oz. ; water, 1 h pints. Boil down to a 
pint, and strain. To be used as a wash. 

201. Borate of soda or borax, 2 drams; water, 4 ozs. Mix. To be 
used as a lotion. 

202. Alum, 2 drams; water, 4 ozs. Mix. To be used as a lotion. 

203. Tannin, 1 scr. ; water, 4 ozs. Mix. For external use. 

204. Biborate of soda, £ oz. ; rose water, 6 ozs. ; sulphate of morphia, 6 
grs. Mix. To be used as a wash in itching of the female privates. 

205. Chlorinated soda, 1 oz. ; water, 12 ozs. Mix. Rinse the mouth 
with it two or three times a day, but do not swallow. 

207. Rose-water, 5 ozs. ; sugar of lead, 8 grs. ; sulphate of zinc, 8 
grs. Mix. 

208. Rose-water, 4 J ozs. ; nitrate of silver, 2 grs. Mix. 

209. Sulphate of zinc, 8 grs. ; tannin, 1 scr. ; water, 5 ozs. Mix. 

210. Chloride of zinc, 6 grs. ; soft water, 2 ozs. Mix. 

211. Nitrate of silver, 10 grs. ; soft water, 1 oz. Mix. 

212. Corrosive sublimate, 5 grs. ; soft water, 1 pint. Mix. 

213. Alcohol, 1 pint; soft soap of potash, 1 pint. Dissolve and filter, 
then add oil of citron, 1 oz. Mix. It will answer a good purpose if the 
oil of citron be omitted. 

214. Nitrate of silver, 2 scr. ; nitric acid, 12 drops; soft water, 1 oz. 
Mix. Apply with a piece of lint tied to the end of a stick. 

215. Copperas, 1 oz. ; soft water, 1 pint. Mix. 

216. Alcohol, 1\ ozs. ; rose-water, 4 ozs. Mix. 

217. Corrosive sublimate, 6 grs. ; spirits of rosemary, 1 oz. ; alcohol, 1 
oz. ; emulsion of bitter almonds, 6 ozs. Mix. 

218. Solution of sugar of lead, 12 drops; laudanum, 1 dram ; water, 4 
ozs. Mix. To be applied externally only. 

219. Nitrate of silver, 1} drams; soft water, 1 oz. Mix. 

220. White vitriol, 1 dram; rose-water, 3 ozs. Mix. Apply outwardly. 

221. Hydrocyanic acid, 4 drams; sugar of lead, 15 grs.: alcohol, 4 
drams ; water, 7 ozs. Mix. Apply externally. 

222. Corrosive sublimate, 5 grs. ; almond mixture, ] pint. Mix. Ap- 
ply externally. 

223. Rose-water, 4 ozs. ; pulverized borax, -A oz. ; sulphate of morphine, 
6 grs. Mix. To be applied to the parts many times a day. 



934 MEDICINES AND THEIR PREPARATIONS. 

224. Sugar of lead, 2 drams ; laudanum, 1 dram ; soft water, \ pint. 
Mix. For external use. 

225. Corrosive sublimate, 5 grs. ; cologne, 2 ozs. ; soft water, 6 ozs. 
Mix. For external use only. 

226. Acid nitrate of mercury, 1 dram ; soft water, 4 ozs. Mix. Apply 
every second day. 

227. Sugar of lead, 3 grs. ; soft water, 1 oz. Mix. As a wash in in- 
flammation of the mouth in infants. 

228. Mucilage of gum arabic, 1 oz. ; syrup of orange-peel, \ oz. ; 
chloride of lime, 15 grs. Mix. 

229. Decoction of Peruvian bark, 3 ozs. ; syrup of orange-peel, 1 oz. ; 
chloride of soda, 1 oz. Mix. 

230. Creosote, 4 drops ; mucilage of gum-arabic, I oz. ; camphor-water, 
8 ozs. Mix. 

231. Vinegar, 1 dram; alcohol, 3 drams; simple syrup, 1 oz. ; water, 
3 ozs. Mix. 

232. White-oak bark, 1 oz. ; water, 1 pint. Boil away one quarter, and 
strain ; then add alum, 1 scr. Apply to the parts with a soft sponge, or 
dossil of lint, several times a day. 

233. Hydrochloric acid, J dram ; honey, 1 oz. ; rose-water, 1 oz. Mix. 
Apply three or four times a day. 

234. Sulphate of copper, I dram ; soft water, 1 oz. Mix. To be ap- 
plied twice a day to the ulcers in gangrene of the mouth. 

235. White vitriol, 1 dram; soft water, 2 drams. Mix. Then add 
honey, 2 drams ; tincture of myrrh, 2 drams. To be applied twice a day 
to the ulcers in gangrene of the mouth. 

236. Creosote, 1 dram; alcohol, 1 dram. Mix. To be applied, with a 
camel's-hair pencil, to the gangrenous ulcers of the mouth, after running a 
lancet through the sloughs, and touch with a little strong carbolic acid till 
surface is white. Can repeat next day. 

237. Acid nitrate of mercury, 5 dram ; soft water, 1 oz. Mix. To be 
injected into the throat with the shower-syringe, or applied to ulcers with 
a camel's-hair pencil. 

238. Rose-water, 4 ozs. ; sugar of lead, 2 drams. Mix. For external 
use. 

239. Rose-water, 2 ozs.; sugar of lead, 1 scruple. Mix. For ex- 
ternal use. 

240. Tincture of arnica, h oz. ; cold water, 4 ozs. Mix. For external 
use. 

241. Tincture bloodroot, 2 ozs.; solution chloride of soda, 2 ozs.; 
tinct. henbane, 2 ozs. Mix. 

242. Bucket of warm water ; cayenne pepper, pulverized, 1 tablespoon- 
ful ; ground mustard, 2 tablespoonfuls. Mix. As a foot-bath in sup- 
pression, etc. 

243. Chlorate of potash, ] oz. ; strong lrydrochloric acid, 40 drops; 
water, 1 pint. Mix. An excellent wash for chronic fetid ulcers, — soon 
converting a foul ulcer to a healthy-looking one. A good gargle. 



MEDICINES AND THEIR PREPARATIONS. 935 

244. Powdered golden seal, 1 dram; powdered cranesbill, 1 dram; 
powdered witch-hazel bark, 1 dram. Mix. Pour upon these half a pint 
of boiling water. Let them stand till cold. To swab an ulcerated throat 
in scarlet fever, and for other purposes. Still better, listerine, 1 oz. ; per- 
oxide of hydrogen, 2 ozs. ; water, 1 oz. Use as a gargle. 

245. Pulverized cayenne, 1 dram; salt, 1 dram; boiling water, 1 gill. 
Mix, and let them stand fifteen minutes. Then add one gill of vinegar. 
Let them stand an hour, and strain. Put a teaspoonful in a child's mouth 
once an hour, in malignant scarlet fever. 

Injections. 

246. Castor oil, 1 gill; pulv. cayenne, 10 grs. ; molasses, 1 gill; table 
salt, 1 teaspoonful ; warm water, 1 pint. Mix. 

247. Senna leaves, 2 drams. Steep in a pint of water. Then add one 
ounce of epsom salts, and strain. A quarter of this may also be taken as 
a brisk purge. 

248. Castor oil, 2 ozs. ; tincture prickly-ash bark, J oz. ; comp. tinct. 
of Virginia snake-root, 2 drams ; infusion of boneset and senna, equal 
parts, h, pint. Mix. 

249. Castor oil, 1 oz. ; salts of tartar, J oz. ; warm water, 1 pint. Mix. 

250. Epsom salts, 1 oz. ; senna leaves, J oz. ; pulv. cayenne, 10 grs. ; 
boiling water, 1 pint. Let the water stand upon the senna and cayenne 
fifteen minutes. Then pour it off, and add the salts. 

251. Thoroughwort, 1 oz. ; senna, 1 oz. ; lobelia, J dram; cayenne, 10 
grs.; epsom salts, 1 tablespoonful ; molasses, J pint; boiling water, 1 
pint. Make a strong decoction of the herbs, and then add the salt and 
molasses. 

252. Wine of ipecac, 1 oz. ; spirits of turpentine, 1 oz. ; castor oil, 1 
oz. ; molasses, \ pint; warm water, J pint. Mix. 

253. Flax-seed tea, \ pint; laudanum, 40 drops. Mix. 

254. Nitrate of silver Crystals, 10 grains ; corrosive sublimate, 5 grs. ; 
sugar of lead, 1J drams; white vitriol, 1J drams; soft water, 6 ounces. 
Mix. An injection for certain forms of whites, etc. Or corrosive sublimate 
tablets, 1 to 3 pints of water used night and morning. 

255. Bruised galls, J oz. ; two large poppy-heads ; water, 1 pint. Boil 
a quarter of an hour, and strain. For piles. 

256. Common salt, 1 oz. ; chamomile flowers, \oz. ; pulv. aloes, 1 dram. 
Boil the chamomile and aloes five minutes, in one pint of water, then strain 
and add the salt. 

Hair=Oils, Washes, etc. 

257. Cologne, 2 ozs.; tincture of Spanish flies, 2 drams; oil of rose- 
mary, 10 drops; oil of lavender, 10 drops. Mix. Apply cautiously. If 
soreness of the scalp is produced, omit for a short time. 

258. Castor oil, 2J pounds; strongest alcohol, 2J pints; pulverized 
Spanish flies, \ oz. ; oil of bergamot, 2£ ozs. ; otto of roses, 20 drops. 



936 MEDICINES AND THEIR PREPARATIONS. 

Mix. Let them stand for a few days, and filter. A superior preparation 
for keeping the hair from falling, and to prevent dandruff. 

259. Tincture benzoin comp., 2 drams; tinct. Spanish flies, 2 drams; 
castor oil, 6 ozs. ; oil bergamot, 1 dram ; oil of cassia or verbena, 15 
drops ; strong alcohol, 9^- ozs. Mix. As a hair wash, better even than 
the above. 

260. Slaked lime, 2 drams ; bicarbonate of soda, 3 drams ; lard, 2 ozs. 
Mix. 

261. Slaked lime, 1 oz. ; bicarbonate of potassa, 2 ozs.; charcoal in 
powder, 1 dram. Mix. Apply to the parts, and wash off when dry. 
Keep in well stopped bottles. 

262. Slaked lime, 4 ozs. ; orris powder, 1J ozs. Mix. Apply to the 
parts, and wash off when dry. 

263. Spanish white, J pound; litharge,^ pound; slaked lime, h pound. 
Mix. Pulverize in a mortar. To be kept dry. When used, mix with 
water to a paste the thickness of cream. Spread on the hair and lay over 
it a wet cloth over night. 

264. Sulphur, 1 oz ; sugar of lead, 1 oz. ; rose-water, 4 ozs. Mix. 
Apply to the hair. 

265. Nitrate of silver, 1 dram; nitric acid, 1 dram; soft water, 1 pint; 
sap green, 3 drams; pulverized gum-arabic, 1 dram. Mix. Keep well 
corked. 

266. Hydrosulphuret of ammonia, 1 oz. ; liquor potassa, 3 drams; soft 
water, 1 oz. Mix. Apply this with a tooth-brush fifteen or twenty minutes. 
Then brush the hair over with the following : nitrate of silver, 1 dram ; 
soft water, 2 ozs., using a clean comb to separate the hair. 



fliscellaneous. 

267. Fluid extract of spurred rye, 2 ozs. Dose, one teaspoonful three 
times a day. For profuse menstruation from a relaxed state of the womb. 

268. Sulphate of iron, 1 dram ; sub- carbonate of potash, 1 dram. Mix, 
and make into 38 pills. One pill twice a day, and gradually increasing to 
four a day, in chlorosis. 

269. Sulphate of iron, 1 dram; extract of hops, 15 grs. : extract of 
poppies, 15 grs. ; oil of cinnamon, 15 drops. Mix, and make into 24 
pills. One pill two or three times a day. 

270. Oxide of zinc, 2 drams; extract of cicuta, 2 scruples. Mix. Make 
48 pills. 

271. Pulverized savin, 1 scruple; sulphate of copper, 1 scruple. To 
be sprinkled on venereal lumps or tumors, called condylomata, on the 
female genitals, or elsewhere. 

272. Balsam of copaiba, 1 oz. ; oil of cubebs, 2 drams; laudanum, 1 
dram; mucilage of gum arabic, 2 ozs. ; sweet spirits of nitre, \ oz. ; com- 
pound spirits of lavender, 3 drams; camphor- water, 4 ozs. ; white sugar, 
2 drams; oil of partridge-berry, 5 drops. Mix. Take a tablespoonful 
three or four times a day. For gonorrhoea ; or capsules of copaiba and 
cubebs. 



MEDICINES AND THEIR PREPARATIONS. 937 

273. Balsam of copaiba, 1 oz. ; pulverized cubebs, 2 ozs. ; essence of 
peppermint, 30 drops. Make a thick paste, like dough, or get capsules. 

274. Pulverized borax, 1 oz. ; pulverized white sugar, 1 oz. Mix. A 
little to be dissolved on the tongue. 

275. Pulverized borax, ^ oz. ; honey, 4 ozs. Mix. 

276. Hydrochloric acid, 1 dram; honey, 1 oz. Mix. For touching 
large curdy patches in sore mouth of children. 

277. Pulverized ipecac, 3 grains; precipitated sulphur, 2 scruples; 
extract of hyoscyamus, 6 grains. Mix. Divide into 12 parts. One to 
be taken every three or four hours. 

278. Pulverized belladonna-root, 5 grains ; compound ipecac powder, 10 
grains ; precipitated sulphur, \ dram ; white sugar, 2 scruples. Mix. 
Make 20 powders. One every three hours to a child two years old. 

279. Pulverized alum, 25 grains ; extract of cicuta, 12 grains ; syrup of 
red poppies, 2 drams ; spearmint water, 3 ozs. Mix. A dessert-spoonful 
every six hours for a child two or three years old. 

280. Camphor, 1 dram; sulphuric ether, 1 oz. Mix. Ten drops every 
half hour. 

281. Pulverized rhubarb, 1 scruple; one half scruple Gray powders ; 
aromatic powder, 5 grains. Mix. Divide into 10 powders. One every 
four or five hours. 

282. Pulverized bloodroot, \ to 1 oz. ; chloride of zinc, \ to 2 ozs. ; 
water, 2 ozs. Add enough wheat flour to make a paste as thick as mo- 
lasses. 

283. Sal. volatile, \ dram ; camphor- water, 1 oz. Mix. 

284. Tincture of nux vomica, \ oz. ; tinct. aconite, 2 drams; volatile 
tinct. of guaiacum, 2 drams. Mix. Thirty drops every three hours. 

285. Tincture of black cohosh, 2 ozs. ; tinct. of digitalis, 2 drams. 
Mix. One teaspoonful from two to five times a day. 

286. Barberry bark, 1 oz. ; pipsissewa herb, 2 ozs. ; wild cherry bark, 
1 oz. ; bitter- root, 1 oz. Mix. Infuse for several hours in 4 pints of 
water. One tablespoonful three or four times a day. 

287. Horse-radish root, 1 oz. ; bayberry bark, 1 oz. ; barberry bark, 1 
oz. ; wild cherry bark, 1 oz. ; prickly-ash bark, 1 oz. Reduce the whole 
to a coarse powder, and infuse for several hours in 4 pints of cider. A 
tablespoonful three or four times a day. 

288. Mercury, 95 parts; balsam of storax, 48 parts; diacalon plaster, 
312 parts; wax, rosin, turpentine, each, 16 parts; ammonia, bdellium, 
each, 5 parts ; olibanum and myrrh, each, 5 parts ; saffron, 3 parts ; spirits 
of lavender, 2 parts. Mix, and spread. For external use only. 

289. Populin, 20 grs. ; sanguinarin, 10 grs. ; pulv. white sugar, 30 grs. 
Rub well together, and divide into 16 powders. Take one four times a 
day. At the same time use prescription 73. 

290. Ptelein, 24 grs. ; hydrastin, 24 grs. ; extract of belladonna, 3 grs. ; 
extract of nux vomica, 2 grs. Mix. Make 24 pills. Take one three 
times a day. 

291. Strychnia, 2 grs.; pulv. cantharides, 4 grs.; pulv. arnica-leaves, 
1 dram. Mix. Divide into 32 powders. One to be taken three times a 
day. 



938 MEDICINES AND THEIR PREPARATIONS. 

292. Wine of colchicum seeds, 1 oz. ; fluid extract of dandelion, 1 oz. 
Mix. One teaspoonful three times a day. 

293. AYillow-bark, 1 oz. ; boiling water, 1 pint. Boil for ten minutes, 
and strain. Dose, a wineglassful once in three hours. 

294. Canada balsam, 1 dram; slaked lime, 1 dram. Mix, to form a 
paste. An excellent remedy for toothache, when pressed into the cavity; 
or use a drop or two of a 4 % cocaine solution. 

295. Tincture black cohosh, 1 oz. ; iodide of potassium, 2 drams; syrup 
of ipecac. 1 oz.; spring- water, 2 ozs. Mix. A teaspoonful three or four 
times a day, in rheumatism and cell-dropsy. 

296. Tincture black cohosh, 1 oz. ; tinct. myrrh, 6 drams; camphor, 1 
dram ; tinct. cayenne, 1 dram. Mix. Take 30 or 40 drops four times a 
day, for dropsy. 

297. Solution chloride of soda, 6 drops; water, 2 ozs. Mix. To be, 
taken at a draught. A sure remedy for offensive breath from deranged 
stomach. 

298. Cream of tartar, J oz. ; fresh lemon-peel, bruised, 4 ozs. ; white 
sugar, 4 ozs. ; boiling water, 3 pints. Mix, and after standing a while, 
strain. 

299. Citric acid, J dram ; bi-carbonate of potassa, \ dram ; lemon syrup, 

1 oz. ; soft water, 6 ozs.; epsom salts, 1 oz. Mix. Two tablespoonfuls, 
to be repeated every four hours, if necessary. 

300. Hardwood ashes, 1 quart; common soot, \ gill; water, 6 pints. 
Digest, settle, and filter. Take one tablespoonful three times a day, in 
acidity of stomach. Milk of magnesia is also a very simple and efficient 
remedy. 

301. Peppermint water, 1£ ozs. ; wine of colchicum-root, J oz. ; iodide 
of potash, 3 drs. ; magnesia, 1 scruple. Dose. — One teaspoonful three 
or four times a day. Excellent for rheumatism of a chronic or gouty type. 
For the acute form of ordinary rheumatism, some form of salicylic acid 
must be used, like the following: Salicylate of soda, 4 drs. ; tinct. carda- 
mom comp., tinct. gent. comp. of each, 2 oz. Mix, and take one tea- 
spoonful in water every two hours, till ears ring, then once in three or four 
hours. Tongaline in one-dram doses, every two hours, is an excellent all- 
round rheumatic medicine. 

302. Cream of tartar, \\ ozs.; sulphate potassa, J oz. ; pulv. squills, 

2 drs. ; tartar emetic, 2 grs". A teaspoonful of this mixture to be taken 
four or five times a clay, in dropsy. 

303. Pulv. alum, J dram; white precipitate, 1 grain. Rub these well 
together, and place the powder in a bottle; then add 1J drams of glycerin. 
Shake the bottle until the mixture is of the consistence of cream, and re- 
peat the shaking whenever it is about to be applied to the skin. For ex- 
ternal use in erysipelas. 

304. Copaiba, 5 drams; yolk of one egg; gum of extract of opium, 1 
grain; water, 7 ounces. Mix. To be used as an injection several times 
a day in gonorrhoea. 

305. Tannin, 3 grains; extract belladonna, f gr. ; extract conium, 2J 
grains ; infusion of senna, 3 ozs. ; fennel-water and syrup of marshmallow, 
each U ozs. Mix. A tablespoonful to be taken every two hours, in chronic 
bronchitis and other complaints. 



MEDICINES AND THEIR PREPARATIONS. 939 

306. Glycerin, 1 dram; tannin, 1 dram. Dissolve the tannin in the 
glycerin. Excellent for sore nipples, and for chaps and excoriations 
generally. 

307. Collodion, 1 oz. ; Venice turpentine, | oz. ; castor oil, 2 drams. 
Mix. To be applied outwardly, for chilblains and chaps. For cancer, 
manganic acid. Not as painful as other caustics. 

308. Sulphate of copper, 2 grains ; wine of opium, 1 dram ; soft water, 
2 drams. Mix. Apply freely with a soft camel hair brush, three times a 
day, for purulent ophthalmia. 

309. Pure acetic acid, 2 drams; soft water, 3 ozs. ; simple syrup, 3 
drams. Mix. A teaspoonful is to be taken every three hours, in scar- 
let fever, at the same time using sheet baths with tepid water. 

310. Compound tincture of Peruvian bark, 4 ozs. ; citrate of iron, 44 
grains ; citric acid, 20 grains. Dissolve the citric acid in the tincture, and 
then the citrate of iron. After a few days filter. Dose, one to two tea- 
spoonfuls. 

311. No. 1. Gallic acid, 10 grains; dissolve in alcohol, 2 drams; 
water, 6 drams. No. 2. Crystals of nitrate of silver, J dram; water, \ 
oz. Dissolve and add strong liquor of ammonia till it becomes clear; 
then add powdered gum-arabic, and dilute, if necessary, to 6 drams. 
This will color black ; to color brown, reduce it. An excellent hair-dye. 
Use the common directions- where there is a No. 1 and No. 2. 

312. Epsom salts, 2 drams; magnesia, 1 scruple; syrup of ginger, 1 
dram; spearmint water, 11 drams. Mix. To be taken at a draught. 
This will be retained by the stomach when most other things are rejected. 

313. Diluted nitro-muriatic acid, 2 drams; sweet spirits of nitre, 2 
drams; simple syrup, \ oz., water, 1\ ozs. Mix. Two tablespoonfuls 
are to be taken three times a day. Excellent in dyspepsia, with foul 
tongue and inactive liver. 

314. Rose-leaves, 1 scruple; boiling water, 8 ozs. ; diluted nitric acid, 
2J drams. Mix. After standing half an hour, strain, and use as a wash 
for ulcers. 

315. White vitriol, 1 dram; water, 1 pint. Mix. To be used as a 
wash for ulcers, etc. 

316. Citrate of iron and strychnine, 1 dram; syrup of orange-peel, 2 
ozs. ; soft water, \ pint. Mix. Give one teaspoonful three times a day 
in neuralgia, and in other cases in which a nerve-tonic is needed. 

317. Aloes and soap pill, 10 grains. Divide into two pills ; or, com- 
pound pill of aloes, 10 grs. Divide into two pills. 

318. Compound colocynth pill, 2 \ scruples ; castile soap, 9 grs.; oil 
of anise, 2 drops. Mix, and make 12 pills. Two to be taken at bed- 
time. 

319. Compound tincture of senna, 2 drams; epsom salts, 2 drams; 
diluted sulphuric acid, 8 drops ; spirits of nitric ether, \ dram ; infusion 
of rhubarb, 10 drams. Mix. To be taken at a draught. 

320. Sulphate of iron, 2 grs. ; epsom salts, 2 scr. ; diluted sulphuric 
acid, 10 drops ; compound tincture, 1 dram; syrup of poppies, \\ drams ; 
pimento water, 9 drams. To be taken at a draught twice a day. 



940 MEDICINES AND THEIR PREPARATIONS. 

321. Pulverized rhubarb, 12 grs. ; carbonate of magnesia, 10 grs. ; 
aromatic spirit of ammonia, -J dram ; syrup of ginger, 1 dram ; spearmint 
water, 10 drams. Mix. To be taken at a draught. 

322. Comp. infusion senna, 5 drams ; infusion rhubarb, 5 drams ; comp. 
tincture cardamon, J dram; syrup, 1^ drams. Mix. To be taken at a 
draught, by dyspeptic persons. 

323. Carbonate of soda, 10 grs; aromatic spirit of ammonia, J dram ; 
tincture of orange-peel, 1 dram ; syrup of orange-peel, 1 dram ; compound 
infusion of gentian, 10 drams. Mix. To be taken at a draught twice 
a day. 

324. Trisnitrate of bismuth, 1 dram; comp. tragacanth powder, 2 
drams ; compound tincture cardamom, i ounce; tincture of ginger, -J oz. ; 
spearmint water, 7 ounces. Mix. Two tablespoonfuls to be taken twice 
a day, in dyspepsia. 

325. Solution of acetate of ammonia, J oz. ; tincture of orange-peel, 1 
dram ; syrup of orange-peel, 1 dram ; tincture of cayenne, 20 drops ; 
comp. infusion of orange-peel, 6 drams. Mix. The whole to be taken to 
relieve headache, after intoxication. 

326. Magnesia, 15 grs. ; solution of potassae, 15 drops; comp. tincture 
of senna, 1 dram; comp. infusion of senna, 6 drams; syrup of ginger, 
1 dram ; comp. infusion of orange-peel, -J oz. Mix. Taken at a draught, 
as an aperient, in sick and bilious headaches. 

327. Aromatic spirits of ammonia, 1 dram ; tincture of Colombo, 1 dram ; 
infusion of Colombo, 10 drams; syrup of poppies, 1 dram. Mix. To be 
taken at a draught, three times a day. 

328. Diluted sulphuric acid, 15 drops; diluted hydrochloric acid, 10 
drops ; tincture of orange-peel, 1 dram ; comp. infusion of gentian, 6 drams ; 
syrup of poppies, 1 dram. To be taken at a draught, three times a day, 
half an hour before meals. 

329. Diluted nitric acid, 12 drops; diluted hydrochloric acid, 8 drops; 
infusion of cascarilla, 11 drams; syrup of poppies, 1 dram. Mix. To be 
taken at a draught, twice a day. 

330. Colocynth co., 6 grs. ; comp. pill of rhubarb, 4 grs. ; ext. hyoscy- 
amus, 2 grs. Mix. Make two pills ; 1 pill to be taken at night. 

331. Ext. hyoscyamus, 2| grs. ; pulv. camphor, 2 \ grs. Mix. Make 
two pills ; one to be taken when the pain is most severe, in nervous head- 
ache ; or even better, acetanilid, 8 grs. ; camphor, 2 grs. ; citrate of caf- 
feine, 4 grs. Divide in four capsules, one every half-hour, for three or 
four times. 

332. Comp. tragacanth powder, 8 grs. ; oil of lemon, 3 drops ; camphor- 
water, 11 drams; comp. tinct. cardamom, \ dram; tincture hyoscyamus, 
J dram ; chloroform, 15 drops. Mix. 

333. Tinct. hyoscyamus, J dram ; aromatic spirit of ammonia, \ dram ; 
syrup of orange-peel, J dram ; peppermint water, 10 drams. Mix. In 
nervous and hysterical cases. 

334. Soap liniment, 2£ ozs. ; liquor ammonia, \ dram ; laudanum, £ oz. 
Mix. Make a liniment. 



MEDICINES AND THEIR PREPARATIONS. 941 

335. Comp. pill of colocynth, 7 grs. ; ext. of colchicum, 2grs. ; oil of 
caraway, 1 drop. Mix, and make two pills. To be taken at bedtime in 
rheumatic headaches. 

336. Chloride of zinc, 6 oz. ; pulv. bloodroot, 2 ozs. ; myrtle wax, 1 
oz. ; water of extract of opium, 6 drams; extract of conium, 6 drams. 
Mix, and make an ointment. 

337. Iodide of lead, 1 scr. ; glycerin, 1 dram; spermaceti ointment, 2 
ozs. Make an ointment. 

338. Rhubarb pulv., J oz. ; spearmint herb, pulv., J oz. ; pulv. casca- 
rilla, J oz. ; pulv. bicarbonate of potassa, J oz. ; pulv. wild-cherry bark, £ 
oz. Mix, and pour on one quart of hot water. Let this stand till cold, 
and add half a pint of brandy. Dose, half a wineglassful. 

339. Ext. belladonna, 6 grs. ; pulv. ipecac, 10 grs. ; confection of 
roses, 2 grs. Mix. Make 30 pills, one pill to be taken twice a day. 

340. Dioscorein, 12 grs. ; pulv. camphor, 4 grs. ; pulv. cayenne, 12 
grs. ; white sugar, 1 scr. Mix. Divide into four powders. Give one 
every fifteen minutes. 

341. Leptandrin, 12 grs. ; geranium, 12 grs.; myricin, 12 grs. Mix. 
Divide into twelve powders, of which one may be given three or four 
times a day. 

342. Quinine, J dram; pulv. catechu, 1 dram; pulv. opium, 15 grs. 
Mix. Make 32 pills. Give one pill three times a day. 

343. Compound syrup of rhubarb and potassa, 4 ozs. ; tincture of 
prickly-ash berries, 1 oz. ; essence of peppermint, 1 dram; paregoric, 4 
drams. Mix. A tablespoonful should be given every hour until it oper- 
ates gently on the bowels. 

344. Pulv. camphor, \ dram; pulv. opium, 16 grains; pulv. cayenne, 
\ dram. Mix. Make 16 pills; one every hour, in cholera. 

345. Rhubarb, 4 ozs.; black-cohosh root, 2 ozs.; wild-cherry bark, 2 
ozs. ; geranium, 2 ozs. : coarsely powder them, and mix. Add two pints 
of brandy and two pints of water. Let the mixture stand five or six days, 
stirring often, and then strain. Add four pints of water to the dregs, boil 
slowly to two pints, strain, and add to this the previous tincture. Sweeten 
with white sugar. Take a tablespoonful every one, two, or three hours. 

346. Beth root, 1 oz. ; geranium, 1 oz. ; blackberry -root, 1 oz. ; wild- 
cherry bark, 1 oz. ; cinnamon, 1 oz. Powder the whole, and add to them 
1 J pints brandy, and 1 J pints water. Let them stand several days, stir- 
ring frequently. Add sweetening if preferred. Dose, one or two tea- 
spoonfuls every two or three hours. 

347. Raspberry leaves, 1 oz. ; geranium, 1 oz. ; blackberry-root, 1 oz. ; 
leptandra root, 1 oz. Mix, and make three pints of strong decoction. 
Dose, a teaspoonful every hour. Suitable for a gargle. 

348. Sugar of lead, 24 grs. ; vinegar, 1 dram; syrup of poppies, 1 oz. ; 
rose-water, 3 ozs. ; soft water, 4 ozs. Mix. Dose, one or two table- 
spoonfuls. 

349. Potassio- tartrate of iron, \ oz. ; syrup of orange-peel, 1 oz. ; water, 
4 oz. Mix. Take two teaspoonfuls three times a day. 



94:2 MEDICINES AND THEIR PREPARATIONS. 

350. Geranium, golden seal, marshmallow, wild-indigo root, rosemary, 
each half an ounce. Mix, and make one pint of strong infusion. After 
straining, add two drams powdered borax and one gill of honey. An 
excellent astringent gargle. 

351. Bromide of soda, 3 drams; syrup of orange, or any other syrup, 
three ounces. Take one teaspoonful in water as often as needed. For 
headache, nervousness, etc., can take every half- hour. 

352. Wine of ipecac, 10 drops in water every half-hour to croupy child, 
one year old ; 30 drops to vomit the child. 

353. Hydrochlorate of ammonia, J oz. ; diluted acetic acid, h oz. ; al- 
cohol, h oz. ; camphorated mixture, 15 ozs. Mix. A good scattering 
wash for hydrocele, etc. 

354. Chloride of soda, nitrate of potash, and hydrochlorate of ammonia, 
equal parts, and water enough to dissolve them. Mix. An excellent 
freezing mixture. 

355. Antipyrin, 3 drams; syrup or water, 2 ozs. Teaspoonful every 
hour till fever is less; or phenacetine, 8 grs., every two hours till fever is 
subdued, then once in four hours. 

356. Chloral hydrate, 4 drams ; syrup acacia and syrup checkerberry, of 
each, 1 oz. ; Teaspoonful in water every hour till asleep. If the taste is 
very objectionable it may be taken in two teaspoonful doses by rectum in 
a little cold starch-water. 

357. Bromidia; teaspoonful in water every hour till asleep. 

358. Jaborandi, fluid extract, 3 drams; syrup, 1 oz. Teaspoonful every 
hour, to produce sweating. 

359. Pill, compound cathartic. Two for a dose. 

360. " Green Soap." Rub well in at night and wash off in the morning 
with water. 

361. Powdered camphor and chloral, equal parts, sufficient quantity to 
make a liniment, rubbed well together. External use. 

362. Wilkinson's Ointment. (See Scabies.) 

363. Dilute hydrocyanic acid, 1 dram ; solution acetate of ammonia, 2 
ozs. ; tincture digitalis, 3 drams ; rose-water, 5 ozs. For pruritus, itch- 
ing, etc. 

364. Corrosive sublimate, 2 grs.; tincture benzoin, £ dram; almond 
emulsion, 1 oz. Used to destroy the epidermis in cases of freckles, acne, 
pimples, etc. 

365. Alum, 5 parts; salicylic acid, 45 parts. Dust on freely. 

366. Corrosive sublimate, 4 grs. ; dissolved in 1 oz. tincture of myrrh. 
Paint on to the part affected by ringworm night and morning. 

367. Bromide of soda and ammonia, 20 grs. each, in a cup of valerian 
tea four times a day. Increase up to 8 or 10 times a day if former dose 
proves insufficient. Take also daily oxide of zinc and extract of bella- 
donna, of each £ gr., morning and night. In bad cases use pill 4 times 
daily. 



MEDICINES AND THEIR PREPARATIONS. 943 

368. Fluid extract gelseminum, 3 drops in water every half hour for 
3 or four times. Useful in facial neuralgia ; or exalgine, 4 grs. every 
hour for two or three times. 

369. Atropia, yj^ of a gr- One such pill each night for sweating; one 
such pill 2 or 3 times a day for acute cold in head, with watery secre- 
tions ; or pill " coryza," one every half hour for three times, then once an 
hour till throat is dry, afterwards once in three or four hours. 

370. Sulphate quinine, J gr. ; ext. belladonna, ^ gr. ; pulv. ipecac, ^ 
gr. ; comp. ipecac powder, y 1 ^ gr. One such pill every two hours, for 
chronic bronchitis and emphysema. 

371. Carron oil. Made by adding equal parts linseed-oil and lime-water. 
For burns, apply freely; also boracic acid, 18 grs., dissolved in 1 dram 
hot glycerin and olive-oil, 1 oz. 



PROPRIETARY AND PATENT MEDICINES. 



Nothing in the world has given rise to so much superstition and 
blind folly as the following of fanatic leaders in the curing of disease. 
Since Hippocrates, and even back to Apollo himself, if we may be- 
lieve old Grecian and Roman tales, qnackery in medicine has reigned 
supreme. 

It pleases people to follow up what appears miraculous in life. 
Results are more important to the minds of many people than the 
circumstances effecting results ; hence, if a person by hook or crook 
recovers from a disease while using some patent medicine, he as- 
cribes to its employment some specific usefulness, irrespective of the 
natural course of the malady, or whatever else he may or may not 
have done. 

In this way ancient amulets and modern patent medicines have 
seemed to cure cancer, leprosy, liver and kidney and other diseases ; 
and in this way enormous fortunes have been made by advertising in 
gorgeous attire some specific oil or balsam, the apparent defenders of 
health and strength. Patent medicines are sold to make money, and 
not to cure the public ; their usefulness is generally in inverse ratio 
to their labels. 

There are, however, some good patent medicines. In some cases 
they will prove just the thing the system needs, but the risk is too 
great unless recommended by some physician. It is their blind, in- 
discriminate use that we condemn. Their formula not being known 
is what makes them dangerous. They usually are made up of some 
powerful stimulant which makes the patient feel better for a time, 
and then leaves the system more relaxed than ever, and hurts the 
nerves or digestion. We will point out a few that are useful. 

There is another class of medicines which are put up by the 
great pharmaceutical houses, which deserve popular use. Their com- 
position being known, there is no secrecy about them. They are 
prepared in the most scientific manner. These houses have a name 
to preserve, and have ample means to procure the services of the best 
chemists, and, using such large quantities of drugs, they can procure 
the best and most uniform. They do not claim to be cure-alls, but 
are compounded for special diseases or conditions, which are plainly 
stated, and are only claimed to be a remedy for such diseases or con- 

944 






PKOPRIETARY AND PATENT MEDICINES. 945 

ditions of the system. They are just what your physician would 
prescribe. The difficulty is in rightly choosing from the vast number. 

Of late there has sprung up a class of houses who make it a cus- 
tom to imitate any well-known medicine which has proved valuable, 
and, by selling their imitations cheaper and using some flaring label, 
palm off these imitations as being just as good. We would advise 
that they be shunned like the plague. If there is anything that 
ought to be pure, it is the drugs, stimulants and nourishment that we 
take as medicine. 

While we do not claim to give a list in this chapter of all valu- 
able remedies, we recommend several of the best and most valuable, 
which have stood the test of use, and can be taken with safety and 
benefit. Read in the front part of the book a description of your 
trouble, then turn to the department in this chapter corresponding 
to it, and choose the remedy. In all cases the directions will be 
found on the wrapper of the remedy. 

Asthma. — Kola-Koloid (T. Metcalf Co.). The well-known integrity 
of this house is a sufficient guarantee of the value of this remedy. Soden's 
Mineral Pastilles are also good. 

Anti=Fat. — Phytoline is used very extensively. Thyroid Tablets of 5 
grains each 3 times a day are very effectual. 

Anti=Scrofulous. — Succus Alterans (Lilly), anti-syphilitic and al- 
terative. This is a purely vegetable medicine and will not hurt the most 
delicate stomach. It contains no mercury or iodide of potash. It elim- 
inates specific poison from the blood and its tonic power increases the red 
corpuscles and enables the system to throw off disease. It attacks the 
seat of the disease, which is impure blood. Chapoteant Sol. Iodide Stron- 
tium is much used, is easily digested, but is rather expensive. 

Also iodia, an alterative and tonic, is much used by the best physicians. 
It improves the nutrition and eliminates waste. Is purely vegetable. 

Biliousness. — Garfield Tea and Fig Syrup contain no salicylic acid, 
minerals or opium. Are purely vegetable remedies, and can be used by 
infants, children and adults with safety. India Cholagogue is an old 
remedy of worth. 

Consumption. — Cod Liver Oil is an old and much-used remedy, not 
only for consumption but for all wasting diseases. It nourishes the body 
and builds up the tissues. The trouble is to get it pure. The pure, pale 
oil, extracted from the fresh, healthy livers of the fish, known as Burnett's, 
sold by Theo. Metcalf Co., Boston, is the most desirable. It can be emul- 
sionized with an egg-beater. The dose should rarely be over a table- 
spoonful and can be combined with coffee, eggs, milk or ice cream well 
beaten together to make it more palatable and more easily digested. 

Coughs. — King's Consumption Cure is one of the best cough mixtures. 
Linonine is composed of flaxseed-oil combined with chloroform, and is 
good to soften and allay a common hard cough. 

Diabetes. — Gluten Flour (Metcalf) is the best food and is free from 



946 PROPRIETABY AND PATENT .MEDICINES. 

starch. In making the bread it should be mixed with a spoon with wheat 
bran. The hands should never touch the Gluten Flour. No other bread 
should be eaten, or potatoes or other starchy foods. If the patient gets 
tired of Gluten Flour alternate with Soga Bean Meal. 

Digestive Medicines. — Horsford's Acid Phosphate. It promotes di- 
gestion without injury and thereby relieves the diseases caused by indiges- 
tion. It is excellent for acidity of the stomach and is a very pleasant and 
healthful drink combined with some syrup and soda. There are so many 
different causes of dyspepsia, it is often necessary to try several remedies. 
The following are good : Liquid Lactopeptine, Liquid Pancreaticus more 
especially for bowel indigestion. The various preparations of pepsin are 
good. 

Disinfectants. — Eucaline {T. Metcalf Co.) is used around the house 
as a disinfectant during disease as a preventative from contagion. Diluted 
it makes a good tooth and mouth wash, a few drops in a tumbler of water. 
Is good to sweeten bowls and bath-tubs. Can be used in the water-pan 
of furnaces to cleanse the air and in fact where any disinfectant is used. 
Chloride of lime and sulpho-naphthol are also much used. 

Foods, Invalid and Baby. — Mellin's Food is one of the oldest and 
best ; it needs no cooking. Mixed with milk it contains all that is neces- 
sary to nourish the body. It is the best known baby food and is invalu- 
able for those suffering from nervous prostration or non-assimilation of 
food. Malted Milk is a good food for all ages but is more particularly 
adapted for adult invalids. Bartlett's Food is good for nervous children. 
Robinson's Groats and Barley, intended for children, is a laxative food. 

Headaches The remedies for headaches are numberless. If they 

are constant or chronic it is well to leave off smoking, tea or coffee drink- 
ing for three months and see if that is not the sole cause. If a female, 
have a physician and see if they are not caused by some womb trouble. 
For immediate relief a cup of black coffee without sugar or milk is as safe 
and good as anything. Most of the headache powders, pills, etc., are 
made up of caffeine, bromides, guarana and the cootar products. 

Quinacetine (Metcalf) is one of the best remedies and has the advantage 
of leaving no unpleasant effects. 

The following are good for immediate relief : Bromo-Caffeine, Broino- 
Seltzer, Elixir Guarana, Nervease and Phenacetine. The last two should 
be used sparingly. 

Hypnotic and Sleep-Producing Medicines. — Bromidia is much 
used. It is composed of chloral and the bromides. Every fluid dram 
contains 15 grains each of pure chloral hydrate and purified bro. pot., 
and J grain each of gen. imp. ex. cannabis ind. and hyoscyam. In the 
restlessness and delirium of fevers it is invaluable. It is well to take out- 
door exercise and drink a cupful of Mellin's Food, warm or malted milk 
just before retiring. 

Iron Preparations. — Elixir Three Chlorides is a good blood-maker. 
Schlotterbeck's Syrup, Phospho-Chloride of Iron is a good preparation of 
liquid iron and easily digested. 

Liquid Beef Preparations. — Beef Peptonoids, Liquid Beef Pepto- 
noids, and Liquid Peptonoids with Creosote, are preparations of beef in a 



PROPRIETARY AND PATENT MEDICINES. 947 

very digestible form, palatable and very nourishing. Bovox, Bovinine 
and Wyeth's Beef Juice are very nourishing and are valuable for travellers 
and to take between meals when faint. 

Liver and Kidney Medicines Garfield Tea is a good family med- 
icine, is harmless, contains no minerals and clears the liver and kidney of 
effete matter. Buchu and Hyoscyamus Comp. (Tyree's) to soothe an irri- 
table bladder. In kidney troubles consult the best- physicians obtainable. 

Liquid Malts. — Are chiefly serviceable in inability to digest starchy 
foods, and in convalescence. All of the following are good : Tarrant's 
and Hoff's Malts, Liquid Bread, Trommer's Malt with Iodides, Trommer's 
Citrate of Iron and Quinine, and Trommer's Malt with Pepsin. 

Laxatives. — For chronic constipation there is nothing more useful 
than Rhamnus Fragula (Metcalf ) , made from buckthorn bark. It is a 
simple and harmless remedy, the results good and sure, and invigorates the 
bowels. — Glycones (Lilly) . Frequently, especially for babies and young 
children, it is well to move the bowels without taking medicine internally. 
Glycones are the best. They are in two sizes, children's and adults'. 
They are invaluable for travellers. They produce prompt, painless and 
copious stools. Garfield Tea is mild, harmless and sure. One of the best 
and pleasant to take, and has no nauseating effects. For babies, Garfield 
Fig Syrup. 

Loss of Nervous Energy, and Impotency. — Sterility in both the 
male and female. The first thing to do is to break off at once and forever 
even the thoughts of what causes impotency and loss of energy. If male, 
bathe the parts in cold water night and morning and pay no attention to 
various advertisements of free remedies, etc. See chapter on Masturbation 
and Impotency. The best remedy for loss of energy and impotency is Kola 
(Metcalf). Nothing can compare with Kola Koloid. Its use by the 
negro in Africa has extended all over the world. It is well known that 
they raise the largest families and their energy in this respect can perhaps 
be traced to the use of Kola. 

Nerve Tonics. — Coca Wine. As a stimulating tonic there is perhaps 
no better remedy known than Metcalf's Coca Wine. It is an invigorator 
for the aged, a quick builder for the enfeebled, is a palliation for mental 
troubles, and is valuable to tone up the system after a run of fever. 
Chapoteant Sol. Bromide Strontium is a good and agreeable preparation 
and is well tolerated by the stomach. Phillips' Phospho. -Muriate Quinine 
Compound is a good general tonic. Of the bromides the following are 
good : Elixir Potassium Bromide, Elixir Sodium Bromide, Elixir Ammo- 
nium Bromide. Coca Wine is the safest and best. 

Neuralgia. — Is usually caused by poverty of the blood. See Nerve 
Tonics. Quinacetine (Metcalf) is one of the best remedies. Its use is 
not followed by any unpleasant effects. 

Painful Menstruation and Vaginal Remedies. — Orange Blossoms 
(J. A. McGill) come in the form of suppositories and is administered 
direct to the seat of the disease. They are safe and harmless. Have stood 
the test of use, can easily be administered by the patient and are a specific 
for profuse menstruation. Wine of American Ash (Metcalf) , made from 



948 PROPRIETARY AND PATENT MEDICINES. 

the outside bark of the white ash, is used in the treatment of the various 
uterine affections, namely, prolapsus, versions, menstrual irregularities, 
inflammation, leucorrhoea, etc., depending upon chronic enlargement for 
their basis. While relief and marked benefit may be obtained by a few 
weeks' use it may be as many months before absolute freedom from suffer- 
ing may result. Iodia is much used. It is a combination of the active 
principles obtained from the green roots of stillingia helonias, saxifraga 
menispermum and aromatics. Each fluid dram also contains five grains 
each iod. potas. and phos. iron. Used especially for leucorrhoea, impaired 
vitality, habitual abortion and general uterine debility. The surgical 
craze for the treatment of diseases of the pelvic organs has prevented phy- 
sicians from studying as carefully as they should the medical treatment. 
At least it would be well to see what medicines will do before resorting to 
the knife. Antiseptic Vaginal Cones and Boro-Glyceride Suppositories 
are also good. 

Piles. — Hamamelis Suppositories and Comfort Powder are both good 
remedies. See chapter on Hemorrhoids. 

Plasters. — Their number is legion. Bell-Capsic, Cuticura and Cap- 
sicum are all good. 

Pain Medicines. — One of the very best of all opium preparations is 
Papine and it is efficacious in most cases. Papine is the anodyne or pain- 
relieving principle of opium, the narcotic and convulsive elements being 
eliminated. One fluid dram is equal in anodyne power to J of a grain of 
morphine. 

Prostate Gland Diseases. — Sommetto is used largely for these 
troubles, especially for the aged. 

Rheumatic Medicines. — Quinacetine (Metcalf). This remedy is 
safe and has no unpleasant or injurious effects. Merrill's Alkaline Elixir 
is a pleasant and effective remedy in many varieties of rheumatism. 
Tongaline is used in both rheumatism and gout. It is laxative if taken 
too often. Iodia is a good remedy for chronic rheumatism. 

Salves. — Cuticura and Salvacea. 

Stimulants. — Coca Wine (Metcalf) is one of the best and most 
harmless. Kola Koloid is another excellent preparation. Vin de Chapo- 
teant is a good stimulant on the old beef, iron and wine plan. 

Skin Diseases. — The very best remedy we consider is Succus Alter- 
ans (Lilly) as it strikes at the root of the trouble — impoverished and im- 
pure blood. Skin troubles cured by this remedy are likely to remain so. 
Hamamelis for an external application is soothing and cooling. It is ex- 
cellent for reducing inflammation. 

Syphilis. — Iodia is a purely vegetable remedy made from the juices of 
the green herbs. Can be taken for a long time without injury to any 
organs of the body. It improves the nutrition, purifies the blood and is a 
specific for syphilis in all stages. Succus Alterans is another good 
remedy. It is a vegetable remedy, anti- syphilitic and alterative. It 
builds up the system by purifying and enriching the blood. 



PROPRIETARY AND PATENT MEDICINES. 949 

Stomach Tonics. — Horsford's Acid Phosphate for indigestion, Tar- 
rant's Seltzer Aperient for acidity and belching of wind. For a strict tonic 
the following are good : Elixir Calisaya Bark and Bismuth, Elixir Calisaya 
and Iron, Elixir Calisaya, Bismuth and Pepsin. 

Throat Tablets. — Chloramine Tablets, Wyeth'sRed Gum Lozenges, 
and Troches Guaiac are all good. 

Vaginal Remedies. — Orange Blossoms are the best for general use. 
Antiseptic Vaginal Cones and Boro-Glyceride Suppositories are also largely 
used. 

Whooping Cough. — Vapo-Cresoline. Is a liquid to be burned over 
a night-lamp. It relieves the cough and hastens recovery. 

Wounds. — Aristol, Dermatol and Iodoform are used to promote 
healing. 



PHYSICAL CULTURE — GYMNASTICS. 



In America the noblest interests of the race have reached unpar- 
alleled development. In no other country, in no other age, has 
mental culture been so complete and universal. It is an era in the 
progress of the race. The fruits of labor which in other times and 
lands have been wasted upon the abnormal life of the few, have here, 
like air and light, the two great representative gifts of Heaven, found 
their way to the normal life of the million. 

But in this hour of triumph the national life is jeopardized by 
physical exhaustion. While the admiring world looks on, our bodies 
upon which as a foundation our higher faculties must rest, crumble 
and give way. Precocious brains are borne about by doubtful spines; 
brilliant talents are linked with dying bodies. 

Men, women, and children should be strong, but it should be the 
strength of grace, flexibility, agility, and endurance ; it should not be 
the strength of a great lifter. Let me allude to the gymnastics of the 
circus. Permit me to call special attention to three features — to the 
man who lifts the cannon, to the india-rubber man and to the general 
performer. The lifter and the india-rubber man constitute the two mis- 
chievous extremes. It is impossible that in either there should be 
the highest physiological conditions ; but, in the persons of general 
performers, is found the model gymnast. They can neither Hit great 
weights nor tie themselves into knots, but they occupy a point 
between these two extremes. They possess both strength and flexi- 
bility, and resemble fine, active, agile, vigorous carriage-horses, which 
occupy a point between the slow cart-horse and the long-legged, loose- 
jointed animal. The race-horse has a much more vigorous circula- 
tion than the cart-horse. It is a fact not unfamiliar to horsemen, 
that when a horse is transferred from slow, heavy work to the car- 
riage, the surface veins about the neck and legs begin at once to en- 
large ; when the change is made from the carriage to the cart, the 
reverse is the result. 

And when we consider that the principal object *of all physical 
training is an elastic, vigorous condition of the nervous system, the 
superiority of light gymnastics becomes still more obvious. The 
nervous system is the fundamental fact of our earthly life. All other 

950 



PHYSICAL CULTURE. 951 

parts of the organism exist and work for it. It controls all, and is 
the seat of pain and pleasure. 

The impressions upon the stomach, for example, resulting in a bet- 
ter or worse digestion, must be made through the nerves. This su- 
preme control of the nervous system is forcibly illustrated in the 
change made by joyful or sad tidings. 

Could we have an unbroken succession of good news, we should 
all have good digestion without a gymnasium. But in a world of 
vexation and disappointment, we are driven to the necessity of muscle 
culture, and other hygienic expedients, to give the nervous system 
that support and vitality which our fitful surroundings deny. 

If we would make our muscle-training contributive in the highest 
degree to the healthful elasticity of our nerves, the exercise must be 
such as will bring into varied combinations and play all our muscles 
and nerves. Those exercises which require great accuracy, skill and 
dash are just those which secure this happy and complete intermar- 
riage of nerve and muscle. 

Another point I take the liberty to urge. Without accuracy in the 
performance of the feats, the interest must be transient. This prin- 
ciple is strikingly exemplified in military training. Those who have 
studied our infantry drill have been struck with its simplicity, and 
have wondered that men could go through with its details every day 
for years without disgust. If the drill-master permits carelessness, 
then authority alone can force the men through the evolutions ; but 
if he enforce the greatest precision, they return to their task every 
morning for years with cheerfulness. 

At this point it may be urged that those exercises which hasten the 
action of the thoracic viscera to any considerable degree are simply 
exhaustive. This is another blunder of the " big-muscle " men. They 
seem to think you can determine every man's constitution and health 
by the tape-line ; and that all exercises whose results are not deter- 
minable by measurement are worthless. 

I need scarcely say there are certain conditions of brain, muscle, 
and of every other tissue, far more important than size ; but what I 
desire to urge more particularly in this connection is the importance, 
the great physiological advantages, of just those exercises in which 
the lungs and heart are brought into active play. These organs are 
no exceptions to the law that exercise is the principal condition of 
development. Their vigorous training adds more to the stock of 
vitality than that of other organs. 

I have said an elastic tone of the nervous system is the physiolog- 
ical purpose of all physical training. If one may be allowed such an 
analysis, I would add that we exercise our muscles to invigorate the 
thoracic and abdominal viscera. These in their turn support and in- 
vigorate the nervous system. All exercises which operate more di- 
rectly upon these internal organs, as, for example, laughing, deep 
breathing, and running, contribute most effectively to the stamina of 



952 PHYSICAL CULTURE. 

the brain and nerves. It is only this mania for monstrous arms and 
shoulders that could have misled the intelligent gymnast on this 
point. 

As our artificial training is designed to fit us for the more success- 
ful performance of the business of life, I suggest that the training 
should be, in character, somewhat preparatory for those duties. If 
you would train a horse for the carriage, you would not do it by 
driving at a slow pace before a heavy load. If you did, the first fast 
drive would go hard with him. 

Just so with a man. If he is to lift barrels of flour, or kegs of 
nails, as a business, he may be trained by heavy lifting ; but if his 
business requires the average velocity and free motions of human 
occupations, then upon the basis of his heavy slow training, he will 
find himself, in actual life, in the condition of the dray-horse, who is 
pushed before the light carriage at a high speed. 

Is it true that in either intellectual or physical training, bold, 
brilliant efforts, under proper conditions and limitations, exhaust the 
powers of life? On the contrary, is it not true that we find in vigor- 
ous, bold, dashing, brilliant efforts the only source of vigorous, bold, 
dashing and brilliant powers ? 

In this discussion I have not considered the treatment of invalids. 
The principles presented are applicable to the training of children 
and adults of average vitality. 

I will rest upon the general statement that all persons of both 
sexes, and of every age, who are possessed of average vitality, should, 
in the department of physical education, employ light apparatus, and 
execute a great variety of feats which require skill, accuracy, cour- 
age, dash, presence of mind, quick eye and hand, — in brief, which 
demand a vigorous and complete exercise of all the powers and 
faculties with which the Creator has endowed us ; while deformed 
and diseased persons should be treated in consonance with the phi- 
losophy of the Sivedish Movement Cure, in which the movements are 
slow and limited. 

We rejoice to see that the American people of all classes and both 
sexes are taking more and more interest in outdoor sports. The 
bicycle, if used in reasonable moderation, will prove a great factor 
in the physical development of both sexes ; but the danger is that 
the American idea of trying to outdo others will cause the young 
with untried muscles to attempt century runs and generally to overdo ; 
while, if they should take reasonable rides, and enjoy the fresh air 
and scenery, it would prove a benefit to mind and body. 

There are many simple contrivances to use at home, if not conven- 
ient to take full gymnastic courses. We give a description of two, 
either of which, if faithfully used, will be of great benefit. 



PHYSICAL CULTURE. 



953 



The Whitely Exerciser. 

As this method is introduced with the strictly American idea of 
furnishing " the shortest route and fastest time " to health and 
strength, you may expect some radical departures from older meth- 
ods. 

After your regular day's work is ended, you are not asked to do 
another each evening, performing feats of strength which tax your 
endurance to the utmost, and leave you " all broke up " the next 
day. It has been demonstrated that heavy gymnastics, like numer- 
ous other ponderous and unwieldy things of the past, are by no means 
the best. On the contrary, exercises that admit of numerous move- 
ments of the muscles without greatly taxing the vital forces, 
produce larger development and better quality. Muscular tissue 
built in this way is not only strong, but quick and active, while that 
developed with heavy weights is hard and slow. 

You are not required to waste time in the preliminary study of 
an intricate system of movements. For brain-workers, a system that 
requires study is directly at variance with one of the prime objects 
of muscular exercise, namely, entire relief from mental strain. But, 
if you don't have to think, it is because someone has done it for 
you ; for the exercises, howbeit simple, are scientifically arranged to 
bring into action every muscle in your body. 

Dumb-bells and Indian clubs exercise the muscles of the arms and 
shoulders but do not reach the muscles that pull the arms down- 
ward. 

The Whitely Exerciser is at once complete, compact and noiseless ; 
requiring no floor-room, no changing of weights, for it adjusts itself 
to any degree of resistance ; no buckling of straps or other parapher- 
nalia ; can be put up in two minutes without the use of a single tool, 
and if desired can be removed from the hooks and put out of sight in 
a moment and readjusted for use just as quickly. It imparts an easy, 
gliding motion, necessary to successful development. 

It is equally adapted to ladies, gentlemen and children. 

Directions for Puttirrg up. — The Exerciser will work at any 
angle, so select any place in your room that permits an unobstructed 
floor space in any direction. Better work toward a window that will 
permit of ventilation from above than away from it. 

Standing on an ordinary chair, screw two hooks into the door or 
window-frame on a level with your nose and from two to six inches 
apart as best suits the form of the woodwork ; lower hooks two inches 
from the floor, or in the floor if you are short of stature. 

Should there be a sill or other obstruction to be avoided, put the 
lower hooks in the floor at sufficient distance from the wall to make 
the cords clear the obstruction. 

The middle pulley is purposely made without a swivel to prevent 



954 PHYSICAL CULTURE. 

twisting of the cord when in use, so run out any twist between it 
and the pulleys attached to the triangle before putting it on the 
hook. The pulleys on the triangle are swiveled that the Exerciser 
may adjust itself to any movement or work in any direction, and if 
the cords twist together between them and the handles a pull on the 
latter will untwist them. 

The rubber cord, or rather cable, is calculated to withstand unlim- 
ited use and a much greater tension than required for ordinary exer- 
cise, but don't, on that account, abuse it unnecessarily. 

Don't use a cord that is too strong for you. If you do you will 
be exhausted but not benefited by your exercise. The cords are made 
of various strengths, be sure you obtain one adapted to you ; that is, 
one that pulls easily when close to the Exerciser. As you grow 
stronger, you have only to stand a little further from the Exerciser 
to obtain a resistance suited to your increasing strength. 

It is not how much you pull, but how often, so use no more force 
than is agreeable. 

If your exercise is too vigorous or too heavy, you will be exhausted 
before you can complete it. It is better to exercise all parts of the 
bod} r a little than a few much. If you are sick or weak, exercise 
very moderately, and stop the moment you feel the least exhausted. 
If well and strong, be moderate for the first week or two, or exercise 
will make you sore. When a muscle is tired it hurts, and to force 
it beyond that point is harmful. 

Exercise when you have time for it. Not for an hour after meals, 
certainly, unless it be very moderately. After eating, your stomach 
needs all your force, and much of your blood, which under exercise 
would be drawn to the muscles. 

Perhaps the most convenient time to exercise is just before retir- 
ing, as it puts the body and brain in condition for refreshing sleep. 
Sedentary people should keep the apparatus in the office, if possible, 
to exercise when they feel the need of it, — that is when your brain 
is tired, and your thoughts refuse to flow freely. A little vigorous 
exertion will renew the supply of blood in the brain, and with new 
blood will come clear thought and new ideas. 

A tired feeling is not always due to exhaustion ; it is more fre- 
quently due to congestion of the blood in some particular spot, and 
is quickly dispelled by exercise. Make the attempt, but if the tired 
feeling does not soon disappear, you will understand that it is true 
exhaustion for which sleep is the only remedy. 

Make up your mind that }^ou will exercise, be it midnight or morn- 
ing, when you retire, and you will be repaid for it in the quality of 
sleep that follows ; though at such times, unless excited, it is well to 
somewhat curtail the amount of each movement, or you will tire be- 
fore you finish the list. At such times, also, some regard to the mus- 
cles that have beeen used during the da}^ is advisable ; but when you 
have time to exercise each group of muscles completely, this matter 



PHYSICAL CULTURE. 



955 



will regulate itself, for those that have been used during the day 
will tire sooner than the others. Nature puts a limit to muscular 
development, beyond which no amount of exercise will force it, and 
it is therefore only necessary to exercise all the muscles regularly, to 
eventually bring the entire body to a symmetrical shape, and the 
highest stage of development. 

If practicable, take your exercise in the condition indicated in the 
cuts ; for at least once a day the body should be free to act without 
restraint of clothing, and moreover, fresh air is a tonic to the skin 
which lessens your chances of taking cold. 

Fresh air is an indispensable adjunct to exercise, but the room 
should never be chilly. 

Never exercise beyond the ability of the heart to keep pace with 
you ; palpitation is a sure indication of excess. Exercise only as 
vigorously as is agreeable, and in keeping with your strength. 

Do not exercise long or hard early in the morning, as it is apt to 
exhaust }^ou before the vital forces are fully aroused, and you do not 
recover during the day. If you rise as late as half past eight or nine, 
vigorous exercise is not likely to hurt you, unless you bolt your 
breakfast, and rush off to work immediately following it. 

In making the movements, endeavor to forget you are exercising, 
and, if possible, imagine you are doing the things the movements in- 
dicate. 

Exercise No. 1 . — Throwing. Suspend the apparatus as in posi- 
tion No. 4, grasp the handles with either hand, and make a move- 
ment exactly as though throwing a ball or light stone. Having tired 
the muscles on one side, change to the other and repeat the move- 
ment until that side is tired, also. 





This movement brings into play the muscles in front of the neck, 
the large muscles on the front of the chest, the muscles on the front 



956 



PHYSICAL CULTURE. 



and side of the abdomen, nearly all the muscles of the legs, and broad- 
ens the chest. Draw in the breath as you take the first position, and 
blow it out forcibly as you make the movement. 

If the tension is not strong enough with one handle, it may be 
doubled by taking both in one hand. 

Before releasing your hold on the handles relax the tension and 
give the cords time to untwist. If oiled the swivels will revolve 
without assistance. 

Exercise No. 2. — Hoisting. — Take a handle in each hand and 
make a movement as though hoisting a bucket of pitch or gravel to 
the roof of a high building. 





This exercise brings into action the muscles on the sides of the 
neck, muscles of the fore-arms, back-arms, muscles of the back that 
draw the shoulders together, side muscles, and muscles on front of 
thighs. In making this movement, endeavor to send the " bucket " 
as high as possible at each sweep of the arm. In doing so, you will 
draw the arm back and around in a way that is necessary to develop 
the particular muscles which this movement is intended to reach. 

Take in the breath as one hand is drawn down, and as the other 
comes down, expel it. 

Exercise No. 3 Suspend Exerciser as per cut, and use each hand 

alternately. This exercise strengthens the muscles of the arm, 
shoulder and thigh. Another exercise is made by turning the back 
to the Exerciser. Putting the cords over the shoulders, hands on 
back, then bend forward and back. This movement is particularly 
intended to reach the large muscles on the front of the chest and 
abdomen. 




PHYSICAL CULTURE 




Exercise No. 4 Swimming and Rowing. — Exercises the mus- 
cles used in swimming or rowing, that is, the large muscles of the 
back that pull the arms downward and backward. This movement may 
be made sitting or standing. If made sitting, it is well to spread the 





knees as you draw the arms down, and as the arms go up, bring them 
together. This latter part of the movement exercises the muscles 



958 



PHYSICAL CULTURE. 



on the inside of the legs which are much used in swimming. Draw 
in the breath as the arms go up, and expel it as you draw them down. 
This movement is a good chest-expander. 

Exercise No. 5. — Putting the shot. — Shift the apparatus to 
position No. 6. Grasp the handle in one hand, and make a move- 
ment as though throwing a heavy stone or shot. Draw in the breath 
as you begin the movement, expel it as you finish. When the 
muscles of one side are tired, change to the other and repeat the 
movement. 





The exercise expands particularly the upper portion of the chest, 
exercises the fore-arm and biceps, or front muscles of the upper arm, 
triceps, or back muscles of the upper arm, the upper portion of the 
large muscles on front of the chest, and muscles on side of shoulder ; 
also the side muscles of the body, and nearly all the muscles of the 
legs and feet. 



Exercise No. 6. — Bowing. 




This movement may be made either 
sitting or standing, though it is 
better made sitting. With a 
handle in each hand, make a 
movement as you would in 
rowing: as the body goes for- 
ward spread the knees, as rep- 
resented in the first cut, and as 
you go back, bring them to- 
gether as shown in the second. 
The breath may be drawn in 
either as the body goes forward 
or backward, but as a rule, in 
any exercise, it is better to take 



PHYSICAL CULTURE. 



959 



the breath before the exertion. In this movement be careful to draw 
the arms and shoulders well back ; for rowing, as it is generally per- 
formed with the sliding seat, tends 
to contract the front of the chest. 
The movement made as indicated 
in the cuts, or in rowing without 
the sliding seat, overcomes that 
objection to the sport. In rowing, 
we use the muscles of the fore-arm, 
biceps, back muscles of the shoul- 
ders, nearly all the muscles of the 
back, and the muscles of the back 
of the neck have considerable to 
do. With the sliding seat, the 
muscles in front of the legs do 
much of the work, but as all the 
other movements exercise the legs, 
there would be nothing gained in 
having the seat for this exercise. 
In fact, the development of the 

muscles on the inside of the legs, as is done in the way the move- 
ment is here described, is much more to the point ; for with the 
exception of exercise No. 4, these muscles have had little work. 

Exercise No. 7. — Lie down on floor. Head to Exerciser. Lift 
hands straight over head, touch the floor and sink to hips. Raise 
body to sitting position without lifting feet from the floor. 





This exercise plays particularly on the front muscles of the shoul- 
ders, and some muscles in the back, and is specially designed to 
strengthen the abdominal muscles. 



960 



PHYSICAL CULTURE. 



Inhale the breath fully as the arms ascend, and expel it forcibly as 
they descend. 

Exercise No. 8. — Bowling. — Suspend one handle again as in 
position No. 6 ; with the other hand free, make a movement as though 




to throw a ball as in bowling. Draw in the breath and expel it in 
the forward movement. 

This exercise develops the muscles of the arms and legs. 

As a finishing touch, this old-fashioned exercise for expanding the 
chest is given. From a position with the hands down at the sides, 
raise the arms laterally to a position high over your head, keeping 





the elbows straight. Inhale all the breath you possibly can as the arms 
go up : bring the arms down again to the position first indicated, but 
retain the breath for a moment after you have finished the movement. 



PRONOUNCING DICTIONARY. - GLOSSARY. 



Ab-do'rwen. The belly. 

A-ce-tab'u-lum. The socket for the 
head of the thigh bone. 

Ab-dom'i-nal cav'i-ty. The cavity of 
the belly. 

Ab-duc'tor. A muscle which draws one 
part of the body towards another. 

Ab-sor' bents. Glands and vessels 
which absorb or suck up substances 
from within or without; also, medicines 
which, though nearly or quite inactive 
themselves, absorb, or combine with 
acid matter in the stomach or bowels. 

A-cro'mi-on. That part of the scapula, 
or shoulder-blade, which unites with the 
collarbone. 

Al-bu-gin'e-a. The white of the eye. 

Al'ter-a-tives. Medicines which gradu- 
ally reestablish health, without sensibly 
increasing the circulation, or augment- 
ing the perspiration, urine, or other ex- 
cretions. 

Al' ve-o-lar. Relating to the sockets of 
the teeth. 

Al'vine (Al'vin) . Relating to the intes- 
tines, as alvine discharges, — discharges 
from the bowels. 

A-mor'phous. Having no regular form. 

Am-ni-ot'ic liq'uid. The fluid sur- 
rounding the fetus in the womb. 

An-aes-the'sia. Suspended sensibility. 

An-as'to-mose. The uniting of arteries 
and veins by joining their mouths. 

An-chy-lo'sis. A stiff or useless joint. 

An-i-mal'cu-lae. Animals so small that 
they can only be seen with a microscope. 

An-ae'mi-a. Privation of blood; a com- 
paratively bloodless state. 

An'o-dynes. Medicines which diminish 
sensibility, abate pain, and induce sleep. 
It should always be remembered that 
anodynes when frequently, and long 
taken, lose their influence in disease. 

Ant-a'cids. Preparations which neu- 
tralize acidity of the stomach and bowels. 

Ant-al'ka-lies. Agents which neutral- 
ize alkalies. 

An-ta-phro-dis'i-acs. Agents which les- 
sen or blunt the sexual propensities. 



An-thel-min'tics. Medicines which de- 
stroy and expel worms. 

An'ti-dotes. Medicines which counter- 
act and destroy the effects of poison. 

An-ti-pe-ri-od'ics. Medicines which pre- 
vent or cure diseases of a periodical char- 
acter. 

An-ti-phlo-gis'tics. Medicines or diet 
which remove or appease inflamma- 
tion. 

An-ti-spas-mod'ics. Medicines which 
prevent or allay spasms, commonly 
called cramps. 

An-ti-syph-i-lit'ics. Medicines which 
cure syphilis. 

An-ti-sep'tic. "Whatever checks or 
counteracts putrefaction. 

An-ti-scor-bu'tics. Articles which pre- 
vent and cure scurvy. 

A-pe'ri-ents. Medicines which gently 
open the bowels. 

A-pho'ni-a. A loss of the voice. 

Aph-ro-dis'i-acs. Medicines supposed 
to excite and promote the sexual appe- 
tite. 

A-pon-eu-ro'sis. The membranous ex- 
pansion of tendons and muscles. 

A-re-o'la. A colored circle, as the cir- 
cle around the nipple. 

Ar-o-mat'ics. Medicines which have a 
grateful, spicy smell, and an agreeable, 
pungent taste. 

As-phyx'i-a. Suspended animation ; 
apparent death. 

As-then'ic. Relating to debility ; or to 
disease marked by debility. 

As-trin' gents. Medicines which have 
the power to constringe or pucker up the 
tissues of the body, and thereby check 
discharges. 

At'ro-phy. A wasted condition ; lean- 
ness. 

Ax-il'la. The arm-pit. 

Aus-cul-ta'tion. The art of detecting 
disease by listening to the sounds of the 
lungs, heart, etc. 

Au-top'sy. Personal inspection, — used 
in the sense of a post-mortem examina- 
tion. 

961 



962 



GLOSSARY 



A-zo'te. Nitrogen ; one of the constit- 
uents of the atmosphere. 

Bron'chi-a. The pipes which convey 
the air through the iungs. 

Bursas mu-co'sa. Small sacs, situated 
under tendons, about the joints, contain- 
ing a sticky fluid. 

Cal'cu-lus. A solid, unorganized body 
formed in the kidneys, or bladder, and 
called a stone. The plural is calculi. 

Cap'il-la-ry. Small, resembling a hair. 

Cap'sule. A membranous bag, enclos- 
ing a part. 

Car'ti-lage. Gristle attached to the 
ends of the bones. 

Car-min'a-tives. Medicines which ex- 
pel wind from the stomach and bowels, 
and allay the pain caused by it. 

Ca-thar'tics. Medicines which purge 
the bowels. 

Cer'vix. The neck. Cer'vix Wter-i. 
The neck of the womb. 

Car'di-ac. Relating to the heart. 

Car' pal. Relating to the wrist. 

Cat-a-me'ni-a. The monthly flow of 
females. 

Ca-thar'sis. Purging. 

Cath'e-ter. A tube for drawing off the 
urine. 

Cel-lu'lar. Relating to cells. 

Cer'e-bral. Relating to the brain. 

Cha-lyb'e-ate. Containing iron or steel. 

Che-mo'sis. A swelling of the eye, in 
which the eye projects, with a depression 
in tht centre. 

Cho' la-gogue. A medicine which causes 
a discharge of bile. 

Clo'nic spasms. Spasms which are 
rigid and relaxed alternately. 

Col-li' qua-tive . This term is applied to 
excessive and exhausting discharges. 

Co-los'trum. The first secretion of milk. 

Co' ma. Profound stupor, or sleep. 

Con'dyle (kon'dil). A knob; applied 
to certain projections of bones at joints. 

Con'flu-ent. Not distinct ; running to- 
gether. 

Con-gen'i-tal. Existing at the time of 
birth. 

Con-ges'tion. Distention of parts by 
an accumulation of blood in them. 

Con-junc'ti-va. The membrane which 
covers the eye and lines the eyelid. 

Con'tra-in'di-ca-ted. Not indicated ; 
the opposite implied. 

Cord'ials. Medicines which have a 
grateful, warming and exhilarating ef- 
fect upon the stomach. 

Coun'ter-ir'ri-tants. Articles which by 
irritating one part, withdraw blood from, 
and relieve another. 

Cri' sis. The turning point of a disease. 

Cu'ti-cle. The epidermis; the scarf- 
skin. 



De-cid'u-a. A thin, external membrane, 
within the womb, thrown off after child- 
bearing. 

De-liq'ui-um. Fainting. 

De-mul 'cents. Medicines of a softening 
nature, which correct acrid conditions, 
and, by their bland effects, soothe in- 
flamed and irritated parts. 

De-ple'tion. Diminishing the fullness 
of a part or parts, as by purgatives, or 
bleeding. 

De-squa-ma'tion. Separation of the 
skin in scales; scaling off. 

De-ter'gents. Medicines which cleanse. 

Di-ag-no'sis. The art of determining 
the nature of diseases. 

Di-a-pho-ret'ics. Medicines which pro- 
mote sweating. 

Di-ath'e-sis. Any particular disposi- 
tion, state, or habit of body. 

Di-u-re'sis. Copious flow of urine. 

Dil'u-ents. Watery drinks, which in- 
crease the fluidity of the blood, and ren- 
der several of the secretive and excretive 
fluids less viscid. 

Dis-cu'tients. Medicines which scatter, 
resolve, or disperse tumors. 

Dis-in-fec'tants. Articles which purify 
or cleanse infected places. 

Di-u-ret'ics. Medicines which increase 
urinary secretions. 

Dras'tics. Strong and violent purga- 
tives. 

Dysp-nce'a. Difficulty of breathing. 

E-me'sis. Vomiting. 

E-met'ics. Medicines which cause the 
stomach to reverse its action, and throw 
its contents up through the mouth. 

Em-men'a-gogues. Medicines supposed 
to have the power of exciting or increas- 
ing the menses. 

E-mol'lients. Those substances which 
have the power of softening or relaxing 
the animal fibre, when applied externally. 

En-denVic dis-eas'es. Diseases pre- 
vailing in certain localities or districts. 

Ep-i-dem'ic dis-eas'es. Diseases ex- 
tending over a large extent of country. 

Ep-i-glot'tis. The cartilage, which, in 
the act of swallowing, shuts down upon 
the top of the wind-pipe, and prevents 
food from going into the breath-passage. 

£p-is-pas'tics. Substances which in- 
flame the skin, and raise the cuticle, and 
cause what is called a blister. 

Es-cha-rot'ics. Articles which burn, 
corrode, disorganize, and destroy the 
animal tissues, causing what is called an 
eschar, or slough, which is dead matter, 
and falls off. 

Ex-pec' to-rants. Articles which act 
upon the system, so as to make the dis- 
charge of mucus and other substances 
from the air-tubes more easy. 



GLOSSARY. 



963 



Er'rhines. Substances which cause 
sneezing and a discharge of mucus 
from the nose when snuffed. 

Es'char. The dead part, killed by 
caustic or mortification, which falls off; 
a slough. 

£x-f o-li-a 'tion . A scaling off, as a piece 
of dead bone. 

Fau'ces. The back part of the mouth. 

Fe'brile. Belonging to fever. 

Fe'ces. The matter discharged from 
the bowels. 

Feb'ri-fu-ges. Medicines which assuage 
or remove fevers. 

Fla'tus. Wind, or rather, gas, in the 
stomach or bowels. 

Fol'li-cle. A little bag or sac. 

Fo-ra'men. A hole or opening. 

For-mi-ca'tion. A sensation like the 
creeping of ants. 

Fur-fu-ra'ceous. Branny or scaly. 

Gang'li-on. An enlargement in the 
course of a nerve. 

Gan'grene. Mortification; partial death. 

Gas'tric. Belonging to the stomach. 

Ges-ta'tion. The period of pregnancy. 

Glot'tis. The opening into the wind- 
pipe, covered by the epiglottis. 

Gran'u-lar. Like small grains. 

Gran'u-la-ted. Covered with granula- 
tions. 

Gran-u-la' tion. The filling up or cover- 
ing of a wound or ulcer, with small, red 
elevations, looking like grains. 

Hae-mop'ty-sis. Raising blood from 
the lungs. 

Haem'or-rhage. A flow of blood. 

Haem-or-rba'gic. Having a tendency to 
bleed. 

He-mi-cra'ni-a. Pain on one side of the 
head. 

He-pat' ic. Belonging to the liver. 

Hy-per-ca-thar'sis. Excessive purg- 
ing. 

Hy-per'tro-phy. An unnatural enlarge- 
ment of an organ, without change of 
structure. 

Hyp-not'ics. Medicines which cause 
sleep. 

Ich'or (Ik f or). A thin, watery, and 
acrid discharge. 

In-ter-cos'tal. Between the ribs. 

Lar'ynx. The top of the windpipe; 
the cavity which contains the vocal liga- 
ments. 

Lax'a-tives. Medicines which render 
the bowels a little more relaxed than 
natural, but do not purge. 

Lig'ate. To secure with a ligature. 

Lig'a-ture. A cord or thread. 

Lo'chi-a. The bloody discharge from 
the womb for some time after child- 
birth. 

Lo'chi-al. Relating to the lochia. 



Lymph. A whitish fluid contained by 
the lymphatic vessels. 

Lym-phat'ics. The vessels which carry 
lymph. 

Mac-er-a'tion. The act of softening or 
soaking a thing by letting it stand in 
water. 

Mac'u-lae. Colored spots; blemishes. 

Ma-la' ri-a. Noxious gases from de- 
composed matter. 

Mam'ma. The female breast. 

Man-dib'u-lar. Relating to the jaw. 

Mas-ti-ca'tion. The act of chewing. 

Mas- tur-ba' tion. The act of exciting 
the genital organs with the hands. 

Men'stru-um. Any solvent, or vehicle. 

Met-a-car'pus. The hand, between the 
wrist and the fingers. 

Me-tas'ta-sis. The changing of a dis- 
ease from one place to another. 

Met-a-tar'sus. That part of the foot 
between the ankle and the toes. 

Mi-as-mat' ic. Partaking of the nature 
of miasm. 

Mu'co-pu'ri-form. Composed of both 
mucus and pus. 

Mu'co-se'ro-lent. Composed of both 
mucus and serum. 

Nar-cot'ics. Medicines which relieve 
pain and produce sleep. 

Nau'se-ants. Medicines which cause 
sickness at the stomach, or a disposition 
to vomit. They are often used as ex- 
pectorants. 

Nos-oV o-gist (Nose-ol'o-gist). One who 
explains and classifies diseases. 

Nu'cle-us. A central spot. 

Nu-cle-o'lus. A spot within a nucleus. 

Or-thop-nce'a. Great difficulty of 
breathing. 

Os-si-fi-ca'tion. The formation of 
bone. 

Os u'ter-i. The mouth of the womb. 

O'va. Eggs. 

O'vum. An egg. 

Pa-pil'la. A red, elevated point upon 
the tongue, or elsewhere. Certain dis- 
eases make these points more promi- 
nent. 

Par-a-cen-te'sis. The operation of 
puncturing the chest, or the abdomen, 
for the purpose of drawing off water. 

Par-a-phle' gi-a . Paralysis of th e lower 
half of the body. 

Par'ox-ysm. A fit of disease taking 
place periodically. 

Par-tu'ri-ent. Bringing forth, or giv- 
ing birth. 

Par-tu'ri-ents. Medicines which pro- 
mote child-bed labor, by causing con- 
tractions of the womb. 

Par-tu-ri'tion. Child-birth. 

Pec'to-rals. Medicines intended to cure 
or relieve diseases of the chest. 



964 



GLOSSARY. 



Pel'vis. The bony cavity, or basin, at 
the lower part of the body, containing 
the womb, abdomen, rectum, etc. 

Per-i-ne'um. The part, or space, be- 
tween the anus and testicles. 

Per-i-os'te-um. A thin, hard mem- 
brane, covering the bones. 

Per-i-os-ti'tis. Inflammation of the 
periosteum. 

Per-i-to-ne'um. A serous membrane 
lining the cavity of the belly, and folded 
over most of the organs contained in it. 

Pet-e'chi-se. Purple spots which ap- 
pear upon the skin in low fevers, looking 
like flea-bites ; called also ecchymoses. 

Pha-ge-den'ic. Corroding, eating, — ap- 
plied to ulcers. 

Pha-lan'ges. The bones of the fingers 
and toes. 

Phar'ynx. The upper part of the 
throat. 

Phleg-mo'nous in-flam-ma'tion. Inflam- 
mation marked by redness, heat, and 
pain, and a tendency to form matter. 

Prog-no 'sis. The art of foretelling the 
termination of diseases. 

Pty'a-lism. Salivation. 

Pri'a-pism. A continued erection of 
the penis from exciting, morbid causes. 

Re-frig' er-ants. Medicines which les- 
sen the heat of the body. 

Re-lax'ants. Medicines which relax 
the tension of the muscles. 

Re-mis 'sion. A lessening or mitiga- 
tion of the severity of the symptoms of 
a disease. 

Res-o-lu'tion. Dispersion of an inflam- 
mation before pus is formed. 

Re-vul' sives. Medicines or appliances 
which remove a disease by causing a de- 
termination to some other part. 

Ru-be-fa'cients. Applications which ex- 
cite the skin, causing the blood to flow 
to it, and making it red. 

Sa'nies. A thin fluid discharged from 
ulcers, having some of the properties of 
pas and blood. 

Sed'a-tives. Medicines which dimin- 
ish the action of the heart and nerves, 
and which are used when we wish to 
allay any excited action in the system. 

Se'rous. Watery. 

Scro'tum. The bag which contains 
the testicles. 

Scyb'a-la. Hard, round lumps in the 
feces. 

Si'a-la-gogues. Medicines which in- 
crease the flow of saliva. 

Slough (Sluff). Any part of the body 
killed by mortification, or caustic, and 
cast off. 

Sper-mat'ic cords. Two cords, com- 
posed of nerves, veins, and arteries, de- 
scending, one on each side, from the ab- 



domen into the scrotum, and suspending 
the testicles. 

Squa'mous. Scaly ; having scales. 

Sor'des. The dark matter deposited 
upon the lips and teeth, in low fevers. 

Ster'num. The breast-bone. 

Ster'tor. Noisy breathing, as in apo- 
plexy. Snoring. 

Ster'tor-ous. Snoring and noisy, as 
applied to breathing. 

Stim'u-lants. Medicines which in- 
crease the activity of the system. 

Sto-mach'ics. Medicines which sup- 
port and renovate the stomach, making 
its action healthy. 

Stru'ma. Scrofula. 

Styp'tics. Substances which, when 
applied externally, have the power to 
constringe or pucker up bleeding ves- 
sels, and stop the loss of blood. 

Sub-cu-ta'ne-ous. Under the skin. 

Sub-max' il-la-ry. Under the lower 
jaw. 

Sub-sul'tus ten'di-num. Slight twiteh- 
ings of the tendons, winch occur in low 
forms of fever. 

Su-do-rif ics. Medicines which cause 
a flow of perspiration, rather more free 
than that produced by diaphoretics. 

Sup-pos' i-to-ries. Solid medicinal sub- 
stances, of a conical or cylindrical shape, 
which are placed in the rectum for the 
purpose of relieving constipation and the 
piles, and for removing stricture. 

Syn'co-pe. Fainting; swooning. 

Te-nes'mus. A painful bearing down 
in the lower bowel, and a distressing de- 
sire to go to stool. 

Ton'ics. Medicines which gradually 
give tone and strength to weakened or- 
gans, or to the whole system. Some act 
upon the nervous system, and some upon 
the other tissues, by condensing, hard- 
ening, and invigorating them. 

Tor'mi-na. Griping pain. 

U-re'ters. The tubes which convey the 
urine from the kidneys to the bladder. 

U-re'thra. The canal which conveys 
the urine from the bladder out of the 
body. 

U'ter-us. The womb. 

Vag'i-na (Vadg' i-na) . The passage 
from the external genital organs to the 
womb. 

Va'ri-cose veins. Veins which are 
morbidly enlarged, and present along 
their course soft, knotty, purplish tu- 
mors. 

Ver'ti-go. Dizziness; giddiness. 

Ve-si-ca'tion. Blistering. 

Vi'rus. Poison; contagion. 

Vis'cus. A liver, stomach, kidney, 
heart, or any organ within one of the 
cavities of the body. 



GENERAL INDEX. 



Abbreviations and signs, 
810. 

Abdominal cavity, 122, 291 ; 
Diseases of, 291-359. 

Abies Canadensis, 840 ; Ex- 
celsa, 824 ; Picea, 824. 

Abortion, 428. 

Abscesses, 526; Of brain, 
167. 

Absence of menses, 394. 

Absorbent vessels, 40. 

Abstinence demanded by 
anger, 76. 

Acacia catechu, 827. 

Accidents, 509-516 ; On 
water, 512; By poison- 
ing, 513. 

Acetate of ammonia, 816; 
Of copper, poisoning by, 
514 ; Of lead, poisoning 
by, 514; Of lead oint- 
ment, 900. 

Acetum, 883. 

Achillea millefolium, 888. 

Acid, acetic, 813 ; Benzoic, 
819 ; Citric, 813 ; Diluted 
hydrochloric, 813 ; Di- 
luted hydrocyanic, 813 ; 
Diluted nitric, 813; Di- 
luted sulphuric, 813 ; Di- 
luted nitro - muriatic, 
813; Tannic, 814; Tar- 
taric, 814. 

Acids, poisoning by, 515. 

Acne, spotted, 155. 

Aconite, 855 ; Poisoning by, 
515 ; Tincture of, 913. 

Aconitum napellus, 887. 

Acorus calamus, 881. 

Adenoid growths, 212. 

Adipose tissue, 18. 

Adipous sarcoma, 575. 

Advanced life, changes in, 
500. 

Affusion, 752. 

Age, influence of, 125. 

Ague, brow, 204 ; Fever and, 
473. 

Ague-cake, 474. 

Ague-root, 879. 



Air, supply of, 115 ; In 
chest, 260 ; Swellings, 
321 ; And ventilation, 
112. 

Air-cells or vesicles, 36 ; 
Enlargement of, 258. 

Albinos, 154. 

Albumen, 15. 

Albuminous foods, 69. 

Albuminuria, 338 ; Dieting 
in, 802. 

Alcohol, 814. 

Alder, tag, 881. 

Aletris farinosa, 879. 

Alexander's operation, 412. 

Alimentary tube, 32. 

Aliments, fluid, 779. 

Allium cepa, 859 ; Sativum, 
837. 

Almond mixture, 898. 

Almonds, 814; Syrup of, 
909. 

Alnus rubra, 881. 

Aloes, 814 ; Comp. tinct. of, 
915 ; And canella, comp. 
powder of, 907. 

Alpinia cardamomum, 826. 

Alterative inhalant, 243. 

Alteratives, 926, 929. 

Althaea officinalis, 854. 

Alum, 814 ; Whey, 795. 

Amaurosis, 591. 

Amenorrhcea, 394. 

American hellebore, 814 ; 
Ipecacuanha, 815; Ivy, 
815 ; Valerian, 888. 

Ammonia, aromatic spirit 
of, 816; Carbonate of, 
816; Comp. liniment of, 
896; Muriate of, 816; 
Poisoning by, 513 ; Solu- 
tion of acetate of, 816 ; 
Water of, 815. 

Amount of food to betaken, 
83. 

Ampelopsis quinquefolia, 
815. 

Amusements, 118; Games 
for, 119; Selection of, 
119; Want of, 121. 



Amygdalus communis, 814 ; 

Persica, 861. 
Anaemia, 288. 
Anaesthetics, 600. 
Anagallis arvensis, 870. 
Anasarca, 358. 
Anatomy, 14 ; Of the bones, 

18. 
Anchylosis, 573. 
Aneurismal tumors of heart, 

280. 
Aneurisms, 577. 
Anger demands abstinence, 

76. 
Angina pectoris, 289 ; Diet 

in, 786. 
Anidrosis, 154. 
Animal food, 84. 
Anise, 816. 

Ankle, dislocation of, 568. 
Annual plants, when to 

gather, 808. 
Anodyne poultice, 906. 
Anodynes, 928. 
Anteflexion of womb, 411. 
Anteversion of womb, 410. 
Anthemis nobilis, 829. 
Anthrax, 534. 
Antidotes of poisons, 513. 
Antihemorrhagic inhalants, 

244. 
Antimony, poisoning by, 

513. 
Antipathies, 770. 
Antiseptic dressings, 432, 

542; Inhalant, 244. 
Antiseptics, 518. 
Antispasmodics, 926. 
Aorta, 37, 38. 
Aperient, Metauer's, 899. 
Apocynum, 819 ; Androsae- 

mifolium, 819 ; Canna- 

bium, 844. 
Apoplexy, 177 ; Of the old, 

507; Diet in. 785; Pul- 
monary, 259. 
Apothecaries' weights, 810. 
Apparent death from va- 
rious causes, 509-512. 
Appendicitis, 316. 

965 



966 



GENERAL INDEX. 



Apple-water, 792. 

Approximate measures, 811. 

Aptha communis, -491. 

Apthae, 458. 

Aqua calcis, 851. 

Arachnitis, 165. 

Arachnoid, 46 ; Inflamma- 
tion of, 165. 

Aralia hispida, 836; Nudi- 
caulis, 875 ; Raceinosa, 
875 ; Spinosa, 868. 

Arbutus, trailing, 882; 
Comp. infusion of, 895. 

Argenti nitras, 857. 

Aristolochia serpentaria, 
884. 

Arm, fractures of, 553-554. 

Arnica, 817. 

Aromatic confection, 892; 
Powder, 907; Spirit of 
ammonia, 816. 

Arrowroot, 817 ; Gruel, 792 ; 
Poultice, 906. 

Arsenic, poisoning by, 514. 

Arsenical solution, 877. 

Artemisia absinthium. 887. 

Arteries, 37, 38; Pulmo- 
nary, 37, 38. 

Articles for a medicine- 
chest, 809. 

Arum triphyllum, 844. 

Asarum canadense, 886. 

Ascaris (pin-worm), 332. 

Asclepias, incarnata, 881 ; 
Syriaca, 831 ; Tuberosa, 
864. 

Asclepidin, 864. 

Ascites, 356. 

Asepsin, 249. 

Aseptic and septic. 518. 

Asiatic cholera, 329. 

Asphyxia, 509. 

Aspidum filix mas, 853. 

Assafcetida, 817 ; Comp. 
tinct. of, 916. 

Asthma, 270; of the aged, 
507 ; diet in, 786. 

Astringent inhalant. 244. 

Astringents, 540, 930. 

Atmosphere, pressure of, 
112. 

Atmospheric inhalation, 
250. 

Atropa belladonna, 835. 

Atrophy, of brain, 173 ; of 
heart, 281. 

Attendants, unhired, 769. 

Aurantii cortex, 860. 

Auricles, 37, 274. 

Auscultation, 230. 

Bacteria, cause inflamma- 
tion, 525. 
Baldness, 163. 
Balm, 817 ; of Gilead, 817. 



Balmony, 817. 

Balsam, copaiba, 817 ; Tolu, 
818. 

Balsamodendron rnyrrha, 
856. 

Bandages, wet. 741. 

Banting treatment for cor- 
pulence, 799. 

Baptisia tinctoria, 886. 

Barberry, 818. 

Barber's itch, 156. 

Bark, when to gather, 808. 

Barley, 80; -coffee, 790; 
-water, 789. 

Barosma crenataj 823. 

Barrenness, 419. 

Base-ball, 94. 

Basilicon ointment, 892. 

Bath, cataract, 747 ; Cold, 
733 ; Effects of cold, 734 ; 
Cold foot, 753; Douche, 
747 ; Eye and ear, 754 ; 
Half, 748; Head, 750; 
Hose, 747; Hot, 734; 
Effects of hot, 736 ; Leg, 
750 ; Mouth or oral, 
755 ; Nose, 754 ; Pail 
douche, 748 ; Plunge, 
749 ; Restoration of de- 
sirable, 111 ; Shower, 
747; -Sitz, 750; Tepid, 
734; Effects of tepid, 
735 ; Towel and sponge, 
752 ; Vapor, 734 ; Warm, 
734; Effects of warm, 
735 ; Wading foot, 753 ; 
Warm foot, 754 ; Wash- 
tub, 751 ; Wave or sluice, 
748. 

Bathing and cleanliness, 
105; sea, 736; with ref- 
erence to Turkish and 
Russian baths, 803. 

Baths of the ancients, 107 ; 
Cold, 109, 733; Division 
of, 732 ; Names of, 108 ; 
Neglect of, 108; Reac- 
tion after. 111 ; Shower, 
806; Sponge, 109; Vap- 
or, 804; Warm, 805; 
Warm for children, 457. 

Bayberry, 818 ; ointment, 
900. 

Bean, St. Ignatius', 879. 

Beans, 73, 82. 

Bearberry, 818. 

Beds and bedding, 758. 

Bedbugs, 160. 

Bed-sores, 774. 

Beef, Essence of, 793, 797 ; 
-galls, 818; -tea, 793, 797. 

Beets, 82. 

Belladonna atropa, 835 ; 
Ointment, 900; Plaster, 
903 ; Poisoning by, 515. 



Belly, dropsy of, 356; 
Symptoms affecting, 128. 

Belly-ache, 320. 

Benzoic acid, 819. 

Benzoin, 880 ; Comp. tinc- 
ture of, 916. 

Berberis vulgaris, 818. 

Bethroot, 819. 

Bichloride of gold, 839 ; of 
Mercury, 832. 

Biennial plants, when to 
gather, 808. 

Big ivy, 856. 

Bile in stomach, 67. 

Biliary calculi, 299. 

Bilious colic, 321 ; Head- 
ache, 203, 206; Remit- 
tent fever, 471. 

Binary compounds, 14. 

Bismuth, 820. 

Bites of insects and snakes, 
545. 

Bitter-root, 819. 

Bittersweet, 820. 

Black alder, 820. 

Black cohosh, 821; Comp. 
tincture of, 916. 

Black root, 821. 

Black willow, 821. 

Blackberry, 820. 

Black vomit, 475. 

Bladder, 35 ; Acute inflam- 
mation of, 335 ; Chronic 
inflammation of, 336. 

Bleeding from kidneys, 
341 ; Nose, 597 ; Wounds, 
599. 

Blenorrhagia, 369. 

Blistering plaster, 892. 

Blood, buffy coat of, 522; 
Composition of human, 
247; in Scrotum, 580; 
Need of a good supply 
of, 59, 61 ; Poisoning, 
438. 

Bloodroot, 821. 

Bloody flux, 330. 

Blue cohosh, 822; Comp. 
tincture of, 916. 

Blue disease, 467. 

Blue flag, 822. 

Blue pill, 823. 

Body, structure of. 14 ; 
Chemical properties of, 
14 ; Lice, 159 ; Physical 
properties of, 16 ; Tem- 
perature of, 132 ; Vital 
properties of. 18. 

Boiled flour, 793. 

Boils, 533. 

Bone's bitters, 918. 

Bones and muscles, 122 ; 
Anatomy of, 18 ; Broken, 
how they unite, 549 ; 
Diseases of, 570 ; D»>ath 



GENERAL INDEX. 



967 



of, 570 ; of Head, 20 ; of 
Trunk, 21; of Upper 
extremities, 23; of Low- 
er extremities, 24 ; Time 
required for uniting, 
550 ; Unnatural growth 
of, 570; Ulceration of, 
570 ; Uses of, 27. 

Boneset, 823. 

Bony formations in heart, 
281. 

Borax, 876. 

Bowel, falling of, 465. 

Bowels, affections of, 787 ; 
Acute inflammation of, 
314 ; Chronic inflamma- 
tion of, 315 ; Looseness 
of, 327 ; Looseness of, in 
infants, 463. 

Brachial plexus, 48. 

Brain, 45, 122, 164 ; Abscess 
of, 167 ; Diet in affections 
of, 785 ; Dropsy of, 175 ; 
Enlargement of, 173 ; 
Exercise of, 60, 61; 
Fever, 165; Health of, 
59; Induration of, 167; 
Inflammation of, 165 ; 
And nerves, diseases of, 
164-207; Need of a 
healthy, 59; Need of 
exercise for, 60 ; Old 
people's, 61 ; Overwork- 
ing, 61 ; Shrinking of, 
173; Softening of, 166; 
Tumors of, 167. 

Bran, decoction of, 789. 

Brandy mixture, 899. 

Bread, Franklin Mills, 796. 

Bread-and-water poultice, 
905. 

Breast, broken, 441 ; In- 
flammation of, 441. 

Breastbone, fracture of, 556. 

Breathing murmurs, 232 ; 
Objects of, 113; Phi- 
losophy of, 112 ; Symp- 
toms affecting, 129. 

Bright's disease of kidneys, 
338. 

Broiled beef essence, 797. 

Broken bones, 546-561 ; 
Breast, 441. 

Bronchial consumption, 
237; Flux, 506; Tubes, 
36. 

Bronchitis, 209 ; Acute, 
255 ; Chronic, 257. 

Bronchocele, 578. 

Broncho-pneumonia, 269. 

Bronchorrhoea, 506. 

Broth, clam, 797 ; Mutton, 
797. 

Brow-ague, 204. 

Bruises, 569. 



Bubo, 361-369. 

Buchu, 823 ; Tinct. of, 914. 

Buckhorn brake, 824. 

Buckthorn, 824. 

Buckthorn bark, 

Buckwheat, 81. 

Buffy coat of blood, 522. 

Bugleweed, 824. 

Bulbous roots, when to 

gather, 808. 
Bunions, 161. 
Burdock, 824. 
Burgundy pitch, 824. 
Burns and scalds, 535. 
Butternut, 824. 

Cabbage, 82. 

Calamine cerate, 891 ; Pre- 
pared, 889. 

Calcined deer's horn, 825. 

Calculus, 299-354. 

Calendar for married ladies, 
443. 

Calf's-feet-jelly, 794. 

Calico bush, 856. 

Calomel, 825. 

Calvities, 157. 

Calx, 851; Chlorinata, 851. 

Camphor, 826 ; Liniment, 
896 ; Water, 897. 

Camphorated soap liniment, 
897. 

Canada balsam, 826 ; Flea- 
bane, 826 ;Snakeroot,886. 

Canal, alimentary, 32. 

Canals, semicircular, 53. 

Cancer, 573 ; Of intestines, 
317 ; Of womb, 413. 

Canella, 826. 

Canker, 491 ; Lettuce, 871; 
Of mouth (cancrum oris), 
458. 

Cannabis indica, tinct. of, 
914. 

Cantharides, tinct. of, 914. 

Cantharis vesicatoria, 877. 

Capillaries, 38. 

Capsicum annum, 827 ; Plas- 
ter, comp., 904. 

Capsules, supra-venal, dis- 
eases of, 337. 

Caput obstipum, 586. 

Caraway, 826. 

Carbo ligni, 829. 

Carbonate of ammonia, 816. 

Carbuncle, 534 ; malignant, 
535. 

Cardialgia, 308. 

Cardamom, 826 ; Compound 
tinct. of, 916. 

Carditis, 283. 

Care of children, and their 
diseases, 445-468 ; Teeth, 
601; Of the sick, 57; Of 
the skin, 503. 



Caries, 570; Of teeth, 602. 
Carminatives, 924, 928. 
Carriage-riding as exercise, 

97. 
Carrots, 82 ; Poultice of, 905. 
Cartilage, 26 ; Arytenoid, 

42 ; Cricoid, 42 ; Thyroid 

cartilaginous tissue, 17 ; 

Productions in heart,281. 
Carum carui, 826. 
Caryophyllus aromaticus, 

830. 
Cascarilla, 826. 
Casein, 16. 
Cassia acutifolia, 874 ; 

Buds, 829. 
Castor, 827. 
Castor-oil, 827. 
Castoreum, 827. 
Catalepsy, 186. 
Cataplasms, 905. 
Cataract bath, 747. 
Catarrh, nasal, 209; Of 

bladder, 336. 
Catarrhal ophthalmia, 589. 
Catechu, 827 ; Confection of , 

893 ; Comp. infusion of, 

894; Tinct. of,915 ; Comp. 

tinct. of, 916 ; Comp. 

powder of, 907. 
Cathartics, 921. 
Catnip, 915. 
Caulophyllum thalictroides, 

822. 
Caulophyllin, 822. 
Caustic potassa, 865. 
Cayenne pepper, 827 ; Tinct. 

of, 915. 
Ceanothus Americanus, 870. 
Celandyne, 828. 
Cellular tissue, 16. 
Cerates, 891. 
Cerebellum, 46. 
Cerebrum, 45. 
Cerevisae fermentum, 888. 
Cessation of menses, 403. 
Cetaceum, 878. 
Cetraria islandica, 844. 
Chafing, 598. 
Chalk, 828; Mixture, 899; 

Comp. powder of, 907. 
Chalk-stones, 479. 
Chamomile, 829. 
Chancre, 361. 
Change of circumstances, 

bad effect of, 60. 
Changes occurring in ad- 
vanced life, 500. 
Charbon, 535. 
Charcoal, 829 ; Apparent 

death from burning, 509 ; 

Poultice, 906. 
Chelidonium majus, 828. 
Chelone glabra, 817. 
Chemical Food, 911; In- 



968 



GENERAL INDEX. 



juries, 535 ; Properties of 
the body, 14. 

Chenopodium anthelminti- 
cum, 887. 

Cherry, cordial, pulmonic, 
249 ; Wild, 885. 

Chest, affections of, 785; 
Air in, 260 ; Diseases of, 
229-273 ; Sounds, philoso- 
phy of, 232; Symptoms, 
affecting, 128 ; Water in, 
261. 

Chicken-pox, 141. 

Chicken-water, 794. 

Chickweed, red, 870. 

Chilblains, 537. 

Child-bed fever, 438. 

Children, care and diseases 
of, 445-468 ; Clothing of, 
445 ; Food of, 445 ; Nurs- 
ing sick, 453 ; Weaning 
of, 450. 

Children's sore mouth, 457. 

Chimaphila umbellata, 863. 

Chloride of zinc, 889. 

Chloroform (chloroform- 
urn), 601, 829. 

Chlorosis, 401; Diet in, 784. 

Choice of sick-room, 756. 

Cholera, Asiatic, 329 ; Diet 
in, 788; Infantum, 463; 
Morbus, 328. 

Chorea, 187 ; Chronic, 188. 

Choroid coat, 50. 

Chromidrosis, 154. 

Chyle, 67. 

Chyme, 66. 

Ciliary processes, 51. 

Cimicifuga racemosa, 821. 

Cimicifugin, 821. 

Cinchona, 862. 

Cinchonia, 862. 

Cinnamon, 829; Tinct. of, 
915 ; Comp. tinct. of, 916. 

Circulation, organs of, 37- 
39. 

Cirrhosis of liver, 296. 

Cirsocele, 584. 

Citrate of potassa, 867. 

Citric acid, 813; Syrup of, 
909. 

Citrine ointment, 901. 

Citrus limonum, 850. 

Clam-broth, 797. 

Clap, 369. 

Clavicle, fracture of, 552. 

Cleaning the teeth, 605. 

Cleanliness, 105; In sick- 
room, 760. 

Cleavers, 830. 

Clergymen's sore throat, 
212. 

Climate, 74, 125. 

Clothing, 101 ; As con- 
ductors of heat, 102 ; 



Catching fire, 512; Color 
of, 104; Cotton, 102 
Hair as, 103 ; Linen, 102 
Should be porous, 104 
Silk, 103; Tight, 105 
Woollen, 103. 

Clover, red, 870. 

Cloves, 830. 

Clovus, 152. 

Clysters, 895. 

Coaptation, 547. 

Coats of the eye, 50. 

Coca Wine, 

Cocaine, 601. 

Cocculus palmatus, 831. 

Coccus cacti, 830. 

Cochineal, 830. 

Cochlea, 53. 

Cochlearia armoracia, 843. 

Cod-liver-oil, 830, 945. 

Coffee, 88, 780 ; Barley, 790 ; 
Crust, 790 ; Milk, 796. 

Cohosh, black, 821; Blue, 
822 ; Tincture of, 916. 

Colchicum autumnale, 855 ; 
Comp. tinct. of, 916. 

Cold, effects of, 536 ; Baths, 
109; Cream, 901; Foot- 
bath, 753; Water at 
meals, 65. 

Colds, 224. 

Colic, 464 ; Bilious, 321 ; Of 
infants, 464 ; Painters', 
322 ; Wind, 320. 

Colitis, 330. 

Collar-bone, fracture of, 
552 ; Dislocation of, 563. 

Collodion, 830. 

Colocynth, 831. 

Colombo, 831. 

Colon, 33, 291. 

Color of clothing, 104 ; Of 
skin, disorders affect- 
ing, 153. 

Colored patches on skin, 
153. 

Coltsfoot, 831, 886. 

Coma, an alarming symp- 
tom, 773. 

Comedones, 155. 

Comfrey, 831; Compound 
wine of, 898. 

Common silk-weed, 831. 

Comptoniaasplenifolia,881. 

Compound fractures, 550. 

Compound infusion of cate- 
chu, 894 ; Of gentian, 
894; Of geranium, T95; 
Of parsley, 895 ; Of senna, 
895 ; Of trailing arbutus, 
895 ; Resin cerate, 892. 

Compresses, 741. 

Compression, 540. 

Conception, 421. 

Condoms, 430. 



Confections, 892 ; Aromatic, 
892; Of catechu, com- 
pound, 893 ; Of senna, 
893. 

Congestive fever, 473 ; 
Headaches, 205 ; Inflam- 
mation of skin, 135. 

Conium maculatum, 864; 
Poisoning by, 515. 

Conjunctiva, 52. 

Conservative leaders, 11. 

Conserves, 892. 

Constipation, 324. 

Constitution, 122, 124; Idio- 
syncrasy of, 125. 

Constitutional differences, 
238; Treatment, 245. 

Constriction of bowel, 318. 

Consumption, 229-254; A 
general disease, 241 ; Of 
the bowels, 313 ; Bron- 
chial, 237; Causes of, 
235,239; Dieting in, 801 ; 
Sweating in, 773 ; Tuber- 
cular, 233. 

Contused wounds, 544. 

Contusions, 569. 

Convalaria multiflora, 877. 

Convolvulus scammonia, 
873, 

Convulsions, 773; Diet in, 
783. 

Cookery for sick-room, 789- 
797. 

Copaifera officinalis, 817. 

Copper, 832; Subacetateof, 
832 ; Sulphate of, 832. 

Corallorhiza odontorhiza, 
833. 

Corn, Indian, 81. 

Cornea, 50 ; Inflammation 
of (corneitis), 590. 

Corns, 161. 

Cornu cervinse ustum, 825. 

Cornus Florida, 835 ; Seri- 
cea, 881. 

Corpulence, diet for, 799. 

Corrosive sublimate, 832 ; 
Poisoning by, 514. 

Corydalis formosa, 883. 

Coryza, 135. 

Cost of foods, 77, 79, 80. 

Costiveness, 324 ; During 
pregnancy, 425, 426. 

Cotton, 832 ; Clothing, 102. 

Cough, during pregnancy, 
427 ; Symptoms indicated 
by, 130, 772 ; Whooping, 
462 ; Preparations, 927. 

Counter extension, 547 ; Ir- 
ritation, 524; Irritants, 
931. 

Cow-pox, 141. 

Coxalgia, 571. 

Cramp-bark, 842. 



GENERAL INDEX. 



969 



Cramps, 188 ; Iu stomach, 

309, 427. 
Cranesbill, 833. 
Cranial nerves, 46, 47. 
Crawley, 833. 
Cream, 777. 
Cream of tartar, 866. 
Creosote (creosotum), 248, 

833 ; Ointment, 900. 
Cricoid cartilage, 42. 
Crocus sativus, 872. 
Croton eleuteria, 826 ; Oil, 

834; Oil liniment, 896; 

Tiglium, 834. 
Croup, 460 ; Dangerous 

symptoms in, 772. 
Crow-corn, 879. 
Crural phlebitis, 437. 
Crust-coffee, 790. 
Crusted tetter, 148. 
Cubebs (cubebee), 834. 
Cucumber, wild, 885. 
Cucumus colocynthia, 831. 
Cultivating trees, 115. 
Culver's root, 834. 
Cupping and leeching, 524. 
Cupri subacetas, 832 ; Sul- 
phas, 832. 
Cuprum, 832. 
Curcuma longa, 883. 
Cyanosis, 467. 
Cypripedin, 849, 889. 
Cypripedium pubescens, 

849, 888. 
Cystine deposits in urine, 

353. 
Cystirrhcea, 336. 
Cystitis, 335. 

Dancing, 95. 

Dandelion, 835. 

Dandruff, 162. 

Darkening of sick-room, 
761. 

Datura stramonium, 880. 

Deadly nightshade, 835 ; 
Poisoning by, 515. 

Deafness, 596 ; Not an un- 
favorable symptom, 772. 

Death, apparent, from nox- 
ious vapors, 509 ; Proofs 
of, 807 ; Of bones, 570. 

Decoction of bran, 789. 

Decoctions, 893. 

Deformities of spine, 584. 

Delivery, 430. 

Delirium tremens, 167. 

Dementia, 194. 

Dens leonis, 835. 

Depilatories, 158. 

Deposits, phosphatic, 349; 
Urinary, 345, 356. 

Derangement of mind, 191. 

Derbyshire neck, 578. 

Dermoid tissue, 17. 



Deshler's salve, 892. 

Diabetes, 340 ; Dieting in, 
802. 

Diaphoretics and sedatives, 
929. 

Diarrhcea,;327 ; Diet in, 788 ; 
In consumption, 250 ; Of 
infants, 463 ;When a dan- 
gerous symptom, 773. 

Dictionary, 000. 

Diet, a complex subject, 
71 ; In consumption, 252 ; 
For the old, 501 ; During 
confinement, 436 ; Of 
nursing women, 446 ; In 
disease and convales- 
cence, 775; In general 
diseases, 781. 

Dieting in regard to health, 
799; In disease, 801. 

Difficult teeth-cutting, 459. 

Difficulty of breathing, 773; 
Of swallowing, 772. 

Digestibility of foods, 71, 
72. 

Digestion, 64 ; Symptoms 
relating to, 131 ; Table, 
72. 

Digestive organs, 31. 

Digitalis purpurea, 837. 

Dilatation of ventricles, 278. 

Dioscorea villosa, 886. 

Diospyros Virginiana, 861. 

Diphtheria, 219, 485. 

Diseases, general, 469-492 ; 
Of children, 445-468 ; Of 
the old, 496-508 ; Of the 
bones, 570 ; Of the joints, 
571 ; Peculiar to modern 
times, 493-495. 

Disinfectants, 764. 

Dislocations, 561-568; Of 
ankle-joint, 568 ; Of 
bones of hand, 565; Col- 
lar-bone, 563 ; Elbow- 
joint, 564 ; Hip-joint, 
565 ; Knee-pan or patella, 
567 ; Knee-joint, 568 ; 
Lower jaw, 563; Shoul- 
der-joint, 563 ; Wrist, 
565. 

Displacement of heart, 
290; Womb, 411. 

Disturbed sleep, 200. 

Diuretics, 929. 

Dizziness, 200. 

Dock, yellow, 888; Comp. 
syrup of, 913. 

Dogwood, 835 ; Poisoning 
by, 516 ; Swamp, 881. 

Domestic management of 
the sick-room, 756-788. 

Domestic measures, 811. 

Doses, 810, 811; Frequency 
of, 126. 



Douche bath, 747 ; Pail 
748. 

Dover's powder, 908. 

Dragon-root, 844. 

Dress, wet, 743. 

Dresses, tight, 116. 

Dressing wounds, rules 
for, 541. 

Dressings, antiseptic, 542. 

Drinks for the sick, 780, 
790. 

Dropsy of belly, 356; Of 
brain, 175; Of cells, 
358 ; General, 358 ; Diet 
in, 784. 

Drowning, 509. 

Dry pimples, 150. 

Drunkard's delirium, 167. 

Dumb-bell exercises, 96. 

Dura mater, 46 ; Inflamma- 
tion of, 164. 

Dwarf elder, 836. 

Dysentery, 330; Diet in, 
788 ; Chronic, 331. 

Dysmenorrcea, 399. 

Dyspepsia, 303 ; Causes of, 
304; Diet in, 787, 801; 
Treatment of, 307; Uri- 
nary deposits* in, 304. 

Dyspeptics, 84. 

Dystrichiasis, 587. 

Ear, affections of, 594-596 ; 
Baths, 754; Drum of, 
52; External, 52; For- 
eign substances in, 599 ; 
Wax in, 596. 

Earache, 596. 

Eating, rapid, 64. 

Ecletics, 7. 

Ecstasy, 186. 

Ecthyma, 149. 

Eczema, 144. 

Effervescing draught, 867. 

Eggs, 777 ; Egg-nog, 797. 

Egophony, 263. 

Egyptian ophthalmia, 588. 

Elbow, fractures of, 554; 
Joint, dislocation of, 
564. 

Elder, 836 ; Dwarf, 836. 

Elecampane, 836. 

Electricity, 504. 

Electro-magnetism, 836. 

Electuaries, 892. 

Electuary, lenitive, 893. 

Elixir proprietatis, 915 ; 
Salutis, 918; Vitriol, 
915. 

Elm, slippery, 875. 

Elongation of uvula, 221. 

Emetics, 920. 

Emphysema, 258. 

Encephalitis, 165. 

Encephaloid tumor, 575 



970 



GENERAL INDEX. 



Encysted tumor, 577. 

Endocarditis, 283. 

Endosmosis, 738. 

Enlarged veins, 428, 581. 

Enlargement of air-cells, 
258; Brain, 173; Neck 
of womb, 386. 

Enteritis, 314; Diet in, 
787. 

Enuresis, 344. 

Epigaea repens, 882. 

Epigastrium, 291. 

Epiglottis, inflammation 
of, 227. 

Epilepsy, epileptic fits, 
184. 

Epistaxis, 597. 

Epsom salts, 853. 

Ergot, 878. 

Erigeron, canadense, 826. 

Eruptions, scaly, 149, 363; 
Tubercular, 363 ; Vesicu- 
lar, 363. 

Eruptive fevers, Diet in, 
782. 

Erysipelas, 141 ; diet in, 
783. 

Erythema, 144. 

Erythematic stomatitis, 
457. 

Essence of beef, 793, 797. 

Essences, 893. 

Eucaline, 000. 

Euonymus atropurpureus, 
884. 

Eupatorin, 823. 

Eupatorium perfoliatum, 
823; Purpureum, 869. 

Euphorbia ipecac, 815. 

Eupurpurin, 869. 

Eustachian tube, 53. 

Excoriation, 598; When a 
bad symptom, 773. 

Exercise, 92-98 ; Active and 
passive, 93, 96; Exces- 
sive, 92, 95; In cold 
weather, 94; In con- 
sumption, 252; In diet- 
ing, 73; In-door, 96; 
Mental cooperation in, 
98; Outdoor, 94-98 ; Pas- 
sive, 96-98 ; Pleasurable, 
92, 98; Regular, 92; For 
students, 93; For the 
aged, 504; When to 
take, 93,98; With wands, 
94; For young women, 
000. 

Exerciser ,the Whitely, 960. 

Exhalants, 41. 

Exhaustion, headaches 
from, 204. 

Exosmosis, 738. 

Exostosis, 570. 

Extension, 547. 



Expectorant inhalant, 243. 

Expectorants, 927. 

Expectoration, symptoms 
indicated by, 130. 

External irritants, 250; 
Parts, itching of, 417. 

Extracts, 893; Fluid, 894; 
Of rhubarb and potassa 
(neutralizing), 899. 

Eye, 50-52; Affections of, 
586-593; Coats of, 50; 
Diseases cause head- 
aches, 202; And ear bath, 
754; Foreign bodies in, 
586; Globe of, 50; Hu- 
mors of, 51. 

Eyebrows, 52. 

Eyelashes, disorder of, 587. 

Eyelids, 52; Inflammation 
of, 587. 

Faba Sancti Ignatii, 879. 

Face not to be covered 
while asleep, 100 ; Symp- 
toms affecting, 127. 

Face-ache, 190. 

Fainting, 199, 427; An 
alarming symptom, 772. 

Falling of bowel, 465 ; Sick- 
ness, 184; Of womb, 409. 

Fallopian tubes, 383; In- 
flammation of, 414. 

False grape, 815; Joints, 
551; Measles, 143; Sarsa- 
parilla, 875; Unicorn, 
841. 

Fat, 15; How to grow, 798. 

Fathers of our race, 498. 

Fatty degeneration of heart, 
281. 

Fatty foods, 78. 

Fatty tumor, 575. 

Favus, 158. 

Febrifuge inhalant, 244. 

Feeding infants, rules for, 
448. 

Fel bovinum, 818. 

Felon, 572. 

Female diseases, 379-442. 

Female weaknesses, 393. 

Fern, male, 853. 

Ferri, ammonio-citras, 846 ; 
Citras, 846; Iodidum, 
846; Lactas, 846; Oxi- 
dum hydratum, 846; 
Oxidum nigrum, 846; 
Phosphas, 847; et Po- 
tassae tartras, 848; Pro- 
toxidum,847; Pulvis,847; 
et Quinise citras, 846; 
Subcarbonas, 847; Sul- 
phas, 848; Syrupus io- 
didi, 848. 

Ferrum, 845. 

Ferunculus, 533. 

Fever, 469; And ague, 473; 



Bilious remittent, 471; 
Childbed,438 ; Congestive, 
473; Diet in, 781; Gas- 
tric, of infancy, 465 ; In- 
termittent, 473; Lung, 
266; Malarial, 473; Per- 
nicious intermittent, 473 ; 
Prognostics in, 771; Re- 
freshing drinks in, 790; 
Typhoid, 470; Typhoid 
lung, 268; Yellow, 475. 

Feverfew, 836. 

Fibrin, 15. 

Fibrous tissue, 17. 

Figwort, 836. 

Filling teeth, 604. 

Fingers, fractures of, 555. 

Fire, clothes catching, 512; 
In sleeping-rooms, 99. 

Fish, 777. 

Fistula, 527. 

Fits, 184; Of children, 468. 

Flag, sweet, 881. 

Flatulency, 320. 

Flaxseed, 837; Lemonade, 
797; Poultice, 906. 

Flesh, to reduce, 799. 

Flies, Spanish, 877. 

Flour, boiled, 793; Gruel, 
797. 

Flowers, when to gather, 
809. 

Flooding, 434, 440. 

Fluctuation, 526. 

Fluid aliments, 779; Ex- 
tracts, 894; Nutritive, 
796. 

Fluor albus, 393. 

Folded wet sheet, 744. 

Follicles, 41. 

Follicular inflammation of 
mouth, 458. 

Folliculitis, solutions for, 
220. 

Fomentations, 894. 

Food, 68; Adapted to dif- 
ferent periods, 76 ; Albu- 
minous, 69, 77; Amount 
of, to be taken, 83 ; And 
digestion, 64; Animal 
and vegetable, 70, 84; 
Articles of, 79-83; Azo- 
tized and non-azotized, 
70; Choice of, 73; Cost of, 
77, 79, 80; Digestibility, 
of, 71, 72; Fatty, 78; 
in winter, 75; For con- 
valescents, 776; For in- 
fants, 447 ; Gelatinous, 
69; Heat-generating, 70; 
Human structure de- 
mands mixed, 85; Na- 
ture and destination of, 
68; Nutritive, 71 ; Oleag- 
inous, 69; In old age, 



GENERAL INDEX. 



971 



76; Organic, 69; Propor- 
tions of animal and vege- 
table, 86 ; Saccharine, 
69; Starch and sugar, 
69,78; Value of, 70, 71, 
72, 79, 80; In youth and 
manhood, 76. 

Foot, fractures of, 560. 

Foot-bath, cold, 753; Warm, 
754. 

Fore-arm, fractures of, 554. 

Foreign bodies in ear, 599 ; 
In eye, 586; In gullet, 
599; In nose, 598; In 
windpipe, 599. 

Fowler's solution, 877. 

Foxglove, 837. 

Fractures, 546-561; Com- 
pound, 550, 560; Of bones 
of foot, 560; Of bones of 
nose, 551 ; Of breast-bone, 
556; Of collar-bone or 
clavicle, 552; Of elbow, 
554; Of fore-arm, 554; 
Of hand and fingers, 555; 
Of haunch-bones or pel- 
vis, 556; Of knee-pan, 
558; Of leg, 558; Of 
lower jaw, 551; Reduc- 
tion of, 547; Of ribs, 
555; Of snoulder-blade, 
553; Of skull, 551; Of 
thigh-bone, 556; Union 
of, 549, 550; Of upper arm- 
bone, 553; Of wrist, 555. 

Franklin mills bread, 796. 

Freckles, 154, 160. 

Freezing mixtures, 765. 

French decimal weights, 
811. 

French milk-porridge, 793. 

Frequency of doses, 126. 

Frost-bite, 536. 

Frostweed, 837. 

Fruits, 778. 

Fumigants, 764. 

Fumigation of infected 
places, 763. 

Fungus hematoides, 575. 

Galbanum plaster, comp., 
904. 

Galium aparine, 830. 

Gall-bladder, 34. 

Ctail-stones, 299. 

GajTs, 837; Comp. ointment 
of; 900. 

Gamboge, 837. 

Gangrene, 527; Of mouth, 
458. 

Gardening as exercise, 96. 

Garfield Tea, 000. 

Garget, 865. 

Gargles, 933. 

Garlic, 837; Syrup of, 909. 

Gastric fever of infancy, 



465; Juice, 64; Not se- 
creted without limit, 65 ; 
Nor in sickness, 65; 
Secretion favored by 
cheerfulness, 65. 

Gastritis, 301, 302. 

Gastrodynia, 309. 

Gaultheria procumbens, 886. 

Gelatin, 15. 

Gelatinous foods, 69. 

Gelseminin, 888. 

Gelseminum sempervirens, 
888. 

Gengivitis, 458. 

General diseases, diet in, 
781; Symptoms, 126; 
And nerve tonics, 925. 

General system, diseases 
of, 469-492. 

Gentian, 838; Comp. infu- 
sion of, 894; Tincture of, 
917. 

Gentiana lutea, 838. 

Geranium maculatum, 833; 
Comp. infusion of, 895. 

Geraniin, 833. 

Germ or ovum, 382. 

Germ-wheat bread, 796. 

Gill-over-the-ground, 839. 

Ginger, 838 ; Wild, 886 ; Syr- 
up of, 909. 

Ginseng, 838. 

Glands, 40, 41, 52. 

Glauber's Salts, 876. 

Gleet, 371. 

Glossary, 000. 

Glottis, 43; Spasm of, 461. 

Gluten Flour, 000. 

Glycerin, 838. 

Glycerrhiza glabra, 851. 

Glycones, 000. 

Goitre, 578. 

Gold, 839. 

Golden seal, 839; Comp. 
powder of, 907; Tinct. 
of, 917; Wine of, 898. 

Golden tincture, 917. 

Gonorrhoea, 369. 

Gossypium herbaceum,832. 

Goulard's cerate, 891. 

Gout, 479 ; Di et in , 784, 802. 

Granulation, 544. 

Gravel, 345 ; Symptoms of, 
347; Uric-acid, 347. 

Gravel-root, 869. 

Green sickness, 401; Diet 
in, 784. 

Grippe, la, 226. 

Ground-ivy, 839. 

Ground ric milk, 793. 

Grubs or worms, 155. 

Gruel, 780; Arrow-root, 
792; Flour, 797; Oat- 
meal, 797; Rice, 789; 
Sago, 792; Water, 791. 



Guaiac, ammoniated tinct. 

of, 917. 
Guaicol, 248. 
Guaiacum, 840. 
Gullet, the, 32; Foreign 

bodies in, 599. 
Gum- Arabic, 840. 
Gum, hemlock, 840 ; Sweet, 

881. 
Gums, inflammation of, 

458. 
Gunshot wounds, 545. 
Gymnastics, 948; Treatise 

on, 94. 

Habits, 125. 

Haemastasis, 840. 

Haematocele, 580. 

Haematoxylon Campechia- 
num, 852. 

Haematuria, 341. 

Haemidrosis, 154. 

Hair, as clothing, 103. 

Hair and hair-tubes, dis- 
orders of, 157. 

Hair-cap moss, 840. 

Hair-oils and washes, 935. 

Half bath, 748; pack, 744. 

Hamamelis Virginica, 886. 

Hand, Dislocation of bones 
of, 565; Fractures of, 
555. 

Hanging, apparent death 
from, 512. 

Hardhack, 841. 

Hardleaf golden-rod, 841. 

Haunch-bones, fractures of, 
556. 

Hay-asthma (Hay fever), 
272. 

Head, affections of, 785; 
Bath, 750; Face and 
neck, symptoms affect- 
ing, 127; Water in, 174. 

Headaches, 201-207, 427. 

Hearing, organs of, 52. 

Heart, 37; Diseases, 274- 
290; Altered sounds of, 
276 ; Aneurismal tu- 
mors of, 280; Atrophy of, 
281 ; Bone and cartilage 
in, 281; Dilatation of 
ventricles of, 278, 279; 
Displacements of, 290; 
Enlargement of ventri- 
cles of, 276 ; Fatty de- 
generation of, 281 ; Hy- 
pertrophy and dilata- 
tion of, 279 ; Impulse of, 
275 ; Induration of, 280 ; 
Inflammation of, 281, 
282, 283; Inflammation 
of lining of, 283, 284; 
Murmurs, 286; Neural- 
gia of, 289 ; Palpitations 



972 



GENERAL INDEX. 



of, 588; Fercussion of, 
276; Polypus of, 298; 
Shrinking of, 281; Soft- 
ening of, 280; Sounds 
of, 275; Valves of, 274, 
285, 287. 

Heartburn, 308. 

Heart-case, acute inflam- 
mation of, 281; Chronic 
inflammation of, 282; 
Water in, 287. 

Heat-generating foods, 70; 
incompatible with ex- 
citement, 76. 

Hectic Fever, 523. 

Hedeoma pulegiodes, 861. 

Heiianthemum Canadense, 
837. 

Helianthus annuus, 880. 

Hellebore, American, 814; 
White, 885; Ointment, 
902. 

Helonias, 841. 

Helpless dependence of the 
aged, 499. 

Hemicrania, 190. 

Hemiphlegia, 180. 

Hemlock, comp. tincx. of, 
917 ; Gum, 840 ; Poison, 
864. 

Hemorrhage,440 ; During la- 
bor, 434 ; Of wounds, 539. 

Hemorrhoids, 325, 576. 

Henbane, 841. 

Hepar, 868. 

Hepatica Americana, 851. 

Hepatitis, 293. 

Herb-teas, 780. 

Hernia, 581. 

Herpes, 145. 

Hiccough, 199 ;When alarm- 
ing, 772. 

High cranberry, 842; Comp. 
tinct. of, 917. 

Hip-joint, disease of, 571 ; 
Dislocation of, 565. 

Hippuric acid in urine, 353. 

Hives (nettle-rash; , 141, 
143. 

Hoarseness, unfavorable in 
small-pox, 771. 

Homoeopathy, 608. 

Homoeopathic remedies, 
609. 

Honey-diseases (honey- 
scab), 148. 

Hopeful considerations, 63. 

Hops, 842. 

Hordeolum, 587. 

Horehound, 842 ; Water,884. 

Horn-pox, 141. 

Horse, should be owned, 98. 

Horseback-riding as exer- 
cise, 97. 

Horsemint, 843. 



Horseradish, 843. 
Horsford's Acid Phosphate, 

946. 
Hose-bath, 747. 
Hot Drops, 918. 
Houseleek, 843. 
Human blood, composition 

of, 247. 
Humors of the eye, 51. 
Humulus lupulus, 842. 
Huxham's tincture, 918. 
Hydatids, uterine, 407. 
Hydrangea, aborescens, 

843. 
Hydrargyrichloridum mite, 

825; Pilluhe, 823. 
Hydrastin, comp. powder 

of, 839, 907. 
Hydrastis Canadensis, 839. 
Hydriodate potassa, 845. 
Hydrocele, 579. 
Hydrocephalus, acute, 174 ; 

Chronic, 175. 
Hydrochloric acid, 813. 
Hydrocyanic acid, 813. 
Hydropathic treatment, 

732-755. 
Hydropathy, 6. 
Hydropericardium, 287. 
Hydrophobia, 182. 
Hydrothorax, 261. 
Hygiene, 54, 121. 
Hyoscyamin, 841. 
Hyoscyamus niger, 841 ; 

Poisoning by, 515. 
Hypertrophy, of brain, 173 ; 

Of heart, 279 ; Of lungs, 

259. 
Hypochondria, 197. 
Hypochondrium, 292. 
Hypogastrium, 292. 
Hypophosphites,comp. syr- 
up of, 910. 
Hyssop, 843. 

Hyssopus officinalis, 843. 
Hysteria, 405. 
Hysteric headache, 264. 

Ice, for wounds, 540 
Ice-plant, 844. 
Iceland moss, 844. 
Ichthyocolla, 849. 
Icterus, 298. 
Idiocy, 194. 
Idiosyncrasy, 125. 
Idrosis, 154. 
Ignatia amara, 879. 
Ileum, 33. 
Iliac fossa, 292. 
Imperfect vision, 591. 
Impetigo, 148. 
Impregnation, 421. 
Incised wounds, 539. 
Incontinence of urine, 344. 
Incubus, 200. 



Indian corn, 81; Hemp, 
844; White, 881; Tinct. 
of, 914; Turnip, 894. 

Indian-meal poultice, 906. 

Indigestion, 303; Diet in, 
787 ; Causes headaches, 
203 ; Headaches from, 
205. 

Indigo, wild, 886. 

Indolent ulcers, 532. 

Induration, of brain, 167 ; 
Of heart, 280. 

Infants, gastric fever of, 
465; Milk for, 447; Moral 
treatment of, 452 ; Sum- 
mer complaint of, 463; 
While sleeping, 451. 

Inflammation, 520, 526; 
Of the arachnoid or 
pia mater, 165 ; Of the 
bladder, 335; Of the 
bowels, 314, 316; Of 
breast, 441 ; Of dura 
mater, 164 ; Of epiglottis, 
227; Of Fallopian tubes, 
414; Of heart-case, 281; 
282; Of iris, 591; Of 
kidneys, 333 ; Of lachry- 
mal sac, 588 ; Of larynx, 
213; Of liver, 293; Of 
mouth, 457, 458 ; Of neck 
of womb, 386; Of ova- 
ries, 390; Of perito- 
neum, 312, 313; Of 
pharynx, 212 ; Of spinal 
cord, 176; Of spleen, 
297; Of stomach, 301, 
302; Of tonsils, 222,223; 
Of tympanum, 596; Of 
vagina, 416 ; Of veins, 
580; Of windpipe, 214; 
Of womb, 408. 

Inflammatory blush, 144. 

Influenza, 224. 

Inebriety, 168. 

Infusion of malt, 791. 

Infusions, 812, 894. 

Ingrowing toe-nail, 597. 

Inhalants, 243-246; Object 
of, 244. 

Inhalation, atmospheric, 
250. 

Inhaling, mode of, 245; 
Powder, 908. 

Injections, 737, 895, 935. 

Injuries, chemical, 535 ; 
Mechanical, 538. 

Insanity, 191; Causes of, 
195; Cure of, 195; On 
one subject, 193. 

Insects, bites of, 545. 

Insensible perspiration, 106. 

Instruments for throat- 
diseases, 216-221. 
Interalgia, 320. 



GENERAL INDEX. 



973 



Intermarriages, improper, 
59. 

Intermittent fever, 473. 

Intestinal obstruction, 318. 

Intestines, 32, 291 ; Cancer 
of, 317. 

Introductory remarks, 5. 

Inula helenium, 836. 

Iodide o£ potassium, 845 ; 
Of mercury, ointment, 
901; Of zinc, 889. 

Iodine, 894. 

Ipecacuanha, 845; Ameri- 
can, 815 ; Comp. powder 
of, 908; Syrup of, 910; 
Wine of, 898. 

Ipomcea jalapa, 849. 

Iridin, 822. 

Iris, 50 ; Inflammation of 
591 ; Versicolor, 822. 

Irish moss, jelly of, 792. 

Iritis, 591. 

Iron, 845 ; Ammonio-citrate 
of, 840 ; Black oxide of, 
846; Citrate of, 846; 
Citrato of, and quinia, 
846; Citrato of, and 
strychnia 5 846 ; Comp. 
mixture of, 899; Hy- 
drated, in consumption, 
250; Oxide of, 846; Io- 
dide of, 846 ; Lactate of, 
846; Persalt of, 847; 
Phosphate of, 847 ; Pow- 
der of, 847 ; Precipitated 
carbonate of, 847 ; Pro- 
toxide of, 847; Solutions 
of protoxide of, 847, 
848; Suipnate of, 848; 
Syrup of iodide, 848; 
Syrup of iodide of, and 
manganese, 848; Tar- 
trate of, and potassa, 
848 ; Tincture of muriate 
of, 848; Valerianate of, 
848. 

Irritations of spine, 584. 

Irritants, external, 250 ; 
Counter, 931. 

Ischuria renalis, 342. 

Isinglass, 849 ; Jelly, 792. 

Itch, 145 ; Barbers', 156. 

Itching, 153 ; Of genitals, 
417, 428. 

Ivy, American, 815 ; Big, 
856 ; Ground, 839 ; Poi- 
soning oy, 516. 

Jackson's itch, 156. 

Jalap, 849 ; Comp. powder 

of, 908. 
Jamestown weed, 880. 
Janipha manihot, 882. 
Jaundice, 298. 
Jaw, fractures of lower, 



551 ; Dislocation of lower, 

563. 
Jejunum, 33. 
Jelly, calf's-feet, 794 ; Irish 

moss, 792; Isinglass, 792 ; 

Tapioca, 792. 
Jerusalem oak, 887. 
Jessamine, yellow, 887. 
Joints, the, 25 ; Diseases of, 

571;False,551; Stiff, 573. 
Juglandin, 825. 
Juglans cinerea, 824. 
Juniper, 849. 
Juniperus sabina, 873. 

Kalmia angustifolia, 856 ; 

Latifolia, 856. 
Kidneys, 35 ; Acute inflam- 
Mnation of, 333; Bleed- 
Jfing from, 341; Bright's 
m disease of, 338; Chronic 
* inflammation of, 335. 
King's evil, 480. 
Kino, 849; Comp. powder 

of, 908. 
Knee, fractures of, 558. 
Knee-joint, dislocation of, 

568. 
Knee-pan, dislocation of, 

567. 
Kola Koloid, 945. 
Krameria triandra, 870. 

Labor, 430. 

Labyrinth, 53. 

Lacerated wounds, 544. 

Lachrymal canals, 52 ; 
Gland, 52; Sac, inflam- 
mation of, 588. 

Lacteals, 33, 67. 

Lactuca sativa, 850. 

Ladies' slipper, 849. 

Lappa minor, 824. 

Laryngeal shower-syringe, 
216. 

Laryngismus stridulus, 461. 

Laryngitis, 209; Follicular, 
213. 

Larynx, 36, 42; Inflamma- 
tion of, 213. 

Laudanum, 915; Poisoning 
by, 515. 

Laurel, narrow-leaf-, 856; 
Sheep, 856. 

Laurus, camphoras, 826 ; 
Sassafras, 872. 

Lavender, comp. tinct. of, 
917. 

Laws, physiological, of life 
and health, 54. 

Lead, 850; Acetate of, 850; 
Colic, 322; Ointment, 
comp., 902; Palsy, 181; 
Pipes, 90; Plaster, 905; 
Plaster, comp., 904. 



Looseness of bowels, 327. 

Leaders, conservative, 11. 

Leaves, when to gather, 
808. 

Leeching, 524. 

Leg, fractures of, 558. 

Leg-bath, 750. 

Lemon, 850; Syrup, 910; 
Water, 790. 

Lemonade, 791; Flaxseed, 
797. 

Lenitive electuary, 893. 

Leonurus cardiaca, 855. 

Leopard's bane, 817. 

Leprosy (lepra), 149. 

Leptandra Virginica, 834. 

Leptandrin, 834. 

Lettuce, 850. 

Leucorrhcea, 393. 

Lice, 159. 

Lichen, 150. 

Life, completeness of, 121', 
The infancy of being, 54. 

Life-root, 850. 

Ligaments, the, 26. 

Ligature, 539. 

Lightning, apparent death 
from, 512. 

Lily, white pond, 885. 

Limbs, symptoms affect- 
ing, 129. 

Lime, 851; Chloride of, 851; 
"Water, 851. 

Linen clothing, 102. 

Liniments, 896, 932. 

Linum usitatissimum, 837. 

Liquidamber styraeiflua, 
881. 

Liquor ammonite, 815; 
Ammoniae acetatis, 816 ; 
Potassge, 867 ; Potasses 
arsenitis, 877; Potassee 
citras, 867. 

Liquorice, 851. 

Liriodendrontulipifera, 882. 

Liver, 34, 291; Acute in- 
flammation of, 293 ; 
Chronic inflammation of, 
294 ; Cirrhosis of, 296; 
Congestion of, 295 ; Com- 
plaints, diet in, 788; Of 
sulphur, 868. 

Liverwort, 851. 

Lobelia (inflata) , 852 ; poul- 
tices, 906; Tinct. of, 915; 
Comp. tinct. of, 917; And 
capsicum, comp. tinct. 
of, 918; Vinegar of, 919. 

Lobelin, 852. 

Local palsy, 181. 

Locked jaw, 184. 

Logwood, 852. 

Loneliness of the aged, 
498. 

Long sight, 592. 



974 



GENERAL INDEX. 



Looseness of bowels, 327. 
Lost parts, reproduction of, 

544. 
Lotions, 933, 934. 
Lower jaw, dislocation of, 

563. 
Lumbago, see Eheumatism. 
Lumbar plexus, 48. 
Lumbar region, 292. 
Lumbricus, 332. 
Lung fever, 266; Typhoid, 

268; Other forms, 270; 

Diet in, 785. 
Lungs, 36; And heart, 122 ; 

Swelling (hypertrophy) 

of, 209; Should be well 

filled, 116. 
Lupulin, 843. 
Lupus, 151. 
Luxations, 561. 
Lycopus Virginicus, 824. 
Lye, poisoning by, 514. 
Lymphatics, 40. 
Lypemania, 193. 

Maculae, 153. 

Magnesia, 852; Carbonate 

of, 853; Sulphate of, 853. 
Malaria, 473. 
Male Fern, 853. 
Malignant pustule, 535. 
Malt, infusion of, 791. 
Mammary abscess, 441. 
Mandrake, 883. 
Mania, 193; Apotu,167. 
Manna, 854. 

Maranta arundinacea, 817. 
Marks, mother's, 152. 
Married ladies' calendar,443. 
Marshmallow, 854. 
Marsh-rosemary, 854. 
Marubium vulgare, 842. 
Mastic, 854. 
Masturbation, 375. 
Materia medica, 808-890. 
Matico, 855. 
Mattery pimples, 148. 
Meadow cabbage, 874 ; 

Saffron, 855. 
Meals, number of, 780. 
Measles, 135; Diet in, 782; 

False, 143. 
Measures, domestic, 810, 

811. 
Meat, 80; Americans eat 

too much, 85 ; Majority 

of mankind eat no, 86; 

Mode of cooking, 501. 
Meatus auditorius, 52 ; 

Inflammation of, 595. 
Mechanical injuries, 538. 
Mediastinum, 36. 
Medical knowledge wanted, 

13; Treatment of the 

old, 505. 



Medicated waters, 897 ; 
Wines, 898. 

Medicine, progress of, 5-9 ; 
Chest, articles for, 809. 

Medicines and their prep- 
arations, 808-943; Pa- 
tent and proprietary,944. 

Medulla oblongata, 46. 

Medullary cancer, 575. 

Megrims, 204. 

Melancholy, 193. 

Melanosis, 575. 

Melissa officinalis, 817. 

Mellin's Food, 946. 

Membrane, synovial, 26. 

Menispermum Canadense, 
889. 

Menopause (turn of life), 
413. 

Menorrhagia, 396. 

Menses, absence of, 394; 
Cessation of, 403; Es- 
tablishment of, 380. 

Menstruation, disturbance 
of, 388; Painful, 399; 
Profuse, 396. 

Mentha piperita, 861; Vir- 
ides, 877. 

Mercury, bichloride of, 832 ; 
Nitrate of, ointment of, 
901 ; Ked iodide of, oint- 
ment, 901. 

Mesenteric disease, 466. 

Mesentery, 34. 

Metastasis, 477. 

Metauer's aperient, 899. 

Metric weights, 811. 

Metritis, 408. 

Midwifery, 424. 

Milk, 77 ; Coffee, 796 ; Crust, 
148; For convalescents, 
777; For infants, 447, 
491 ; For old persons, 
502 ; Leg, 437 ; Mother's, 
448 ; Porridge, 793 ; Sick- 
ness, 311 ; Sterilization 
of, 449 ; And soda-water, 
795 ; Sugar of, 247. 

Milkweed, swamp, 881. 

Mind, derangement of, 
191 ; How it gets knowl- 
edge, 55 ; State of in 
dieting, 75. 

Mindererus, spirit of, 816. 

Miscarriage, 428. 

Miscellaneous diseases, 469- 
492; Prescriptions, 936. 

Mitchella repens, 861. 

Mitral valves, diseases of, 
285. 

Mixtures, 898. 

Modern diseases, 493 ; Sur- 
gery, 517. 

Modus operandi of water, 
737. 



Moles, 154. 

Momordica elaterlum, 885. 

Monarda punctata, 843. 

Monkshood, 855, 887. 

Monomania, 193. 

Monotropa uniflora, 844. 

Monsel's styptic, 847. 

Moral treatment of infants, 
452. 

Morphia (morphine), 860; 
Poisoning by, 515. 

Mortality in cold weather, 
503. 

Mortification, 524, 527. 

Mosquitos, bites of, 545. 

Mother's cordial, 911 ; 
Marks, 152. 

Motherwort, 855. 

Mountain laurel, 856. 

Mouth, inflammation of, 
457 ; Follicular inflam- 
mation of, 458; Gan- 
grene of, 458. 

Mouth-bath, 755. 

Mucous tissue, 16. 

Mucus, 15. 

Mullein, 856. 

Mumps, 228. 

Muriate of ammonia, 816; 
Of soda, 876. 

Muriatic acid, poisoning 
by, 515. 

Murmurs, breathing, 232; 
Of heart, 286. 

Muscae voiitantes, 591. 

Muscles, 27 ; Action of, 29 ; 
And bones, 122 ; Number 
of, 29 ; Shape of, 28. 

Muscular and nervous de 
rangements from 
wounds, 183; Tissue, 17. 

Mustard, 856 ; Poultice, 
906; Volatile oil of, 856 ; 
Whey, 794. 

Mutton broth, 797. 

Myopia, 592. 

Myrica cerifera, 818. 

Myricin, 818. 

Myristica moschata, 858. 

Myrospernum toluiferum, 
818. 

Myrrh, 856; Comp. tinct. 
of, 918. 

Naphtha, 857. 
Napthalin, 857. 
Narcotics, 928. 
Nasal catarrh, 209 ; Duct, 

52 ; Shower syringe, 217. 
Natural surgery, 531. 
Nausea, during pregnancy, 

426. 
Neck, symptoms affecting, 
i 127. 
Necrosis, 570. 



GENERAL INDEX. 



975 



Nepeta cataria, 827; Gle- 
chonia, 839. 

Nephritis, 333. 

Nerve-root, 888 ; Tonics, 
925. 

Nerves, cranial, 46, 47; 
Diseases of brain and, 
164; Optic, 47, 50; Pain 
of, 189; Of skin, dis- 
ordered, 153; Spinal, 48; 
Sympathetic, 45. 

Nervine and tonics, 862, 
925. 

Nervous complications in 
dyspepsia, 303 ; Derange- 
ments from wounds, 183 ; 
Diseases, effects of, 62; 
Headaches, 204, 206; 
System, 45, 54 ; System, 
sympathetic, 62; System, 
symptoms affecting, 129 ; 
Tissue, 18. 

Nettle-rash, 143. 

Neuralgia, 189; Of heart, 
289. 

Neutral mixture, 867. 

Neutralizing cordial, 912 ; 
Extract, 899 ; Powder, 
908. 

New Jersey tea, 870. 

Nicotiana tobacum, 882. 

Nightmare, 200. 

Night-nurse, 757. 

Night-sweats, 250. 

Nipples, sore, 426, 442. 

Nitrate of mercury oint- 
ment, 901; Of potassa, 
858; Of potassa, poison- 
ing by, 515; Of silver, 
857. 

Nitre, 858 ; Sweet spirit of, 
858. 

Nitric acid, 77, 813; Poi- 
soning by, 515; Ether, 
spirit of, 878. 

Nitrogenous foods, 70. 

Nitro-muriatic acid, 813. 

Nose, bleeding from, 597; 
Foreign substances in, 
598; Fractures of, 551. 

Nose-bath, 754. 

Noxious vapors, apparent 
death from, 509. 

Nurse, activity of, 768; 
Age of, 767; Education 
of, 769; Habits of, 768; 
Health of, 767 ; Strength 
of, 767; Temper, etc., of, 
767; Wet, 446. 

Nursing bottles, 447 ; Sick 
children, 453; Sore 
mouth, 440 ; Women, 
445. 

Nutmeg, 858. 

Nutrition table, 70. 



Nutritive fluid, 796. 
Nux vomica, 858. 
Nymphaea odorata, 885. 
Nymphomania, 417. 

Oak, white, 885. 

Oatmeal gruel, 797; Poul- 
tice, 905. 

Oats, 80. 

Obstruction of intestines, 
318. 

(Esophagus, 32. 

Oil of cajuput, 859; Of 
mustard, volatile, 856; 
Of turpentine, 859. 

Oil-glands, 44; Disordered, 
154. 

Oil-nut, 824. 

Ointments, 900-903, 931. 

Old age, and its diseases, 
496-508; Diet in, 76; 
Preservation of health 
in, 500. 

Oleaginous foods, 79. 

Oleum cajuputi, 859 ; Mor- 
rhuae, 830; Olivee, 859; 
Pacini, 827 ; Terebin- 
thime, 859; Tiglii, 834. 

Olive-oil, 859. 

Omentum, 34. 

Onion, 859; Poultice, 906. 

Operations, surgical, prep- 
arations for, 519. 

Ophthalmia, catarrhal,589 ; 
Purulent (Egyptian), 
588; Of children, 589; 
Scrofulous, 590 ; Tarsi, 
587. 

Opium, 859; Camphorated 
tinct. of, 918 ; Liniment, 
896; Poisoning by, 515; 
Tinct. of, 915. 

Opodeldoc, liniment, 897. 

Orange blossoms, 949. 

Orange-peel, 860 ; Tinct. of, 
914 ; Whey, 795. 

Orbits, 52. 

Orchitis, 371. 

Organized compounds, 15. 

Organs, digestive, 31 ; Of 
hearing, 52; Of circula- 
tion, 37; Of secretion, 
41; Of sight, 50; Inspi- 
ratory, 36 ; Vocal, 42. 

Origanum vulgare, 860. 

Ornus Europasa, 854. 

Osmidrosis, 154. 

Osseous tissue, 17. 

Otalgia, 596. 

Otitis, 596. 

Otorrhaea,595. 

Ovarian disease, 774; Tu- 
mors, 414. 

Ovaries, 384 ; Inflamma- 
tion of, 390. 



Ovaritis, 390. 

Ovum, 382. 

Oxalic acid, poisoning by, 

515; Deposits in urine, 

351, 359. 
Oxide of zinc ointment, 

901. 
Pack, half, 744 ; Wet sheet, 

742. 
Pail-douche, 748. 
Pain, symptoms indicated 

by, 130; Sudden disap- 
pearance of, 772. 
Painters' colic, 322. 
Pallidness, when a bad 

symptom, 772. 
Palpitation, of heart, 288, 

427. 
Palsy, 179; Diet in, 784; 

Lead, 181; Local, 181; 

Shaking, 181. 
Panada, 791. 

Panax quinquefolium, 838. 
Pancreas, 34, 291. 
Papaver somniferum, 859. 
Papillse-, 152. 
Papulous scall, 149. 
Paralysis, 179. 
Paraphlegia, 180. 
Paregoric elixir, 918. 
Parrilla, yellow, 889. 
Paronychia, 572. 
Parotid gland, 31. 
Parotitis, 228. 

Parsley, 860; Comp. infu- 
sion of, 895. 
Parsnips, 82. 
Partridge-berry, 861 ; Comp. 

syrup of, 911. 
Passive congestion of liver, 

295. 
Patches, colored, on skin, 

153. 
Patella, dislocation of, 567; 

Fracture of, 558. 
Patent and proprietary 

medicines, 944-949. 
Patients, how to examine, 

126. 
Peach, 861. 

Pear-leaf wintergreen, 871. 
Pearlash, purified, 866. 
Peas, 82. 

Pectoriloquy, 242. 
Pelvis, fractures of, 556. 
Pemphigus, 147. 
Pennyroyal, 861. 
Pepper, red, 827; Water, 

884. 
Peppermint, 861. 
Pepto-mangan, 250. 
Perennial plants, when to 

gather, 808. 
Pericarditis, 281. 
Pericardium, 37. 



976 



GENERAL INDEX. 



Periods of life, 125, 126. 

Peritoneum, 291; Acute 
inflammation of, 312 ; 
Chronic inflammation of, 
313. 

Peritonitis, 312, 313. 

Pernicious intermittent fe- 
ver, 471. 

Perpetual calendar for 
married ladies, 443. 

Persalt of iron, 847. 

Persimmon, 861. 

Perspiration, 106 ; Symp- 
toms indicated by, 132. 

Perspiratory tubes, 45, 106. 

Peruvian bark, 862 ; Tinct. 
of, 918. 

Pessaries, 411. 

Petroleum, 863. 

Petroselinum sativum, S30. 

Phagadenic ulcers, 532. 

Pharmacy, 891. 

Pharyngeal shower syr- 
inge, 217. 

Pharyngitis, 208, 212; Fol- 
licular, 212. 

Pharynx, 32 ; Inflammation 
of, 212. 

Philosophy of breathing, 
112 ; Of chest sounds, 
232. 

Phlebitis, 580 ; Chronic, 
581. 

Phlegmasia dolens, 437. 

Phosphate of iron, 847. 

Phosphates, comp. syrup 

■ of. 911. 

Phosphatic deposits in ur- 
ine, 349, 355. 

Phosphorus, 246, 863. 

Phrenitis, 165. 

Phthisis, 229. 

Physical culture, 950-960. 

Physiological laws, 54. 

Physiologists, 8. 

Phytolacca decandra, 865. 

Phytolaccin, 865. 

Pia mater, 46 ; Inflamma- 
tion of, 165. 

Picra, 907. 

Picrcena excelsa, 869. 

Pigeon-berry, 865. 

Pile-ointment, 900, 902. 

Piles, o25. 576; During 
pregnancy, 426 ; Oint- 
ment for, 902. 

Pills, 903. 

Pimpinella anisum, 816. 

Pimples, dry, 150 ; Mattery, 
148 ; Watery, 144. 

Pin-worms, 332. 

Pink-root, 863. 

Pinna, 52. 

Piper angustifolium, 855. 

Pipsissewa, 863. 



Pistacia lentiscus, 548. 

Pityriasis, 150. 

Pix liquida, 882. 

Plantain (plantago major), 
864. 

Plants and animals, re- 
lation of, 115 ; Medicinal, 
when to gather, 808. 

Plasters, 903. 

Plastic lymph, 522; Diet 
in, 786. 

Plethoric headaches, 205 ; 
Causes of. 202. 

Pleurisy (pleuritis), 262; 
Diet in, 786; Koot, 864. 

Plumbi acetas, 850. 

Plumbum, 850. 

Plunge-bath, 749. 

Pneumonia, 266; Broncho-, 
269 ; Typhoid, 268 ; Diet 
in, 785. 

Pneumothorax, 260. 

Podophyllin, 853. 

Podophyllum pelatum. 853. 

Poison hemlock, 864 ; Oak, 
865 ; Ointment, 901. 

Poisoned wounds, 545. 

Poisoning accidents, 513. 

Poisons, antidotes of, 513 ; 
Vegetable, 515. 

Poke, 865 ; Ointment, 901. 

Poke-root poultice, 906. 

Polygala senega, 873. 

Polygonum punctatum,884. 

Polypus, 576; Of heart, 
290 ; Of womb, 406. 

Polytrichum juniperum, 
840. 

Pompholix, 147. 

Poplar, 882. 

Pores, of skin, should be 
kept open, 107. 

Porridge, milk, 7 93. 

Porrigo, 157. 

Position of patient, impor- 
tance of, 772. 

Potassa, 865; Acetate of, 
866; Bicarbonate of, 866; 
Bitartrate of, 866; Car- 
bonate of, 866 ; Chlorate 
of. 866; Citrate of, 867; 
Solution of, 867; Solu- 
tion of arsenite of, 577; 
Aud soda, tartrate of, 
876; Sulphate of, 867; 
Tartrate of, 867. 

Potassse acetas, 866; Ar- 
senitis, liquor, 877; Bi- 
carbonas, 866 ; Bitartras, 
866; Carbonas, 866; Ci- 
tras,867; Citratis, liquor. 
867 ; Liquor, 867 ; Nitras, 
858; Sulphas, 867; Tar- 
tras, 867. 

Potassii, bromidum, 867; 



Cyanuretum, 868 ; Iodi- 

dum, 845 ; Sulphuretum, 

868. 
Potassium, 867; Bromide 

of, 867 ; Cyanuret of, 868 ; 

Sulphuret of, 868. 
Potatoes, 82. 
Poultices, 905-906. 
Powders, 906-908. 
Pox, 360. 
Pregnancy, baths during, 

740 ; Prevention of, 429 ; 

Treatmentof,425; Tubal, 

418. 
Prejudice and antipathies, 

770. 
Preparations, of medicines, 

808 ;Pharmaceutical,891. 
Prepared calamine, 889; 

Chalk, 828. 
Presbyopia, 593. 
Prescriptions, 920. 
Preservation of old people's 

health, 500. 
Pressure of the atmos- 
phere, 112. 
Prickly ash, 868; Elder, 

868. 
Princes' pine, 863. 
Prinos verticillatus, 820. 
Private organs, symptoms 

affecting, 129. 
Probang, now superseded, 

217. 
Prognostics, 771. 
Progress of medicine, 9. 
Prolapsus ani, 465; Uteri, 

409. 
Pronouncing dictionary, 969. 
Proofs of death, 807. 
Prophylaxis, 489. 
Propriety of imparting 

physiological knowledge, 

420. 
Protoxide of iron, 847. 
Provisional callus, 549. 
Prunus Virginiana, 885. 
Prurigo, 151 ; Of vulva, 417. 
Pruritus, 153. 
Prussic acid, poisoning by, 

516. 
Psoriasis, 149. 
Ptelea trifoliata, 874. 
Pterocarpus marsupium, 

849 ; Santalinus, 870. 
Ptisan, suet, 794. 
Ptosis, 588. 

Puerile respiration, 233. 
Puerperal fever, 438. 
Pulmonary apoplexy, 259; 

Consumption, 233. 
Pulmonic cherry cordial, 

249. 
Pulse, symptoms indicated 

by, 131. 



GENERAL INDEX. 



977 



Pumpkin seeds, 869. 

Punctured wounds, 543. 

Purges, 921. 

Purple disease (purpura 
hemorrhagica), 484; 
Spots, 773. 

Purtussis, 462. 

Purulent ophthalmia, 588; 
Of children, 589. 

Pussy-willow, 821. 

Pyaemia, 528. 

Pyrethrum parthenium, 
836. 

Pyrola rotundifolia (round- 
leaved), 871. 

Pyrosis, 309. 

Quassia, 869. 

Queen of the meadow, 869. 
Queen's root, 869. 
Quercus alba, 885; Infec- 

toria, 837. 
Quinacetine, 946. 
Quinia, sulphate of, 862 ; 

Valerianate of, 863. 

Rabies, 182. 

Ramollissement, 166. 

Rashes on children, 454. 

Recipes, 920-943. 

Rectum, 33, 291. 

Red chickweed, 870; Clo- 
ver, 870 ; Iodide of mer- 
cury ointment, 901 ; Pep- 
per, 827 ; Oxide of lead 
plaster, 905 ; Osier, 881 ; 
Root, 870; Eose, 870; 
Saunders, 870; Willow, 
881. 

Reduction of fractures, 
547. 

Refreshing drinks in fe- 
vers, 790. 

Refrigerants, 929. 

Rennet whey, 794. 

Reproduction of life, 419; 
Of lost parts, 544. 

Resin cerate, 892 ; plaster, 
eomp., 904. 

Resolution, 523. 

Respiratory organs, 36. 

Rest and sleep, 98. 

Restorative, 795 ; Wine bit- 
ters, 898. 

Retention of urine, 343 ; An 
unfavorable sign, 773. 

Retina, 51. 

Retroflexion of womb, 411. 

Retroversion of womb, 410. 

Rhamnus catharticus, 824. 

Rhatany, 870. 

Rheum palmatum, 871. 

Rheumatic headaches, 205, 
206. 

Rheumatism, acute, 496 ; 



Chronic. 478; Diet in, 
784, 802. 

Rhubarb, 871; Aromatic 
syrup of, 910; Comp. 
tinct. of, 918; Comp. 
powder of, 908; And 
potassa, comp. powder 
of, 908; And potassa, 
comp. syrup of, 912; 
Tinct. of, 915. 

Rhus glabrum, 880; Toxi- 
codendron, 865. 

Ribs, fracture of, 555. 

Rice, 81 ; Water, 789. 

Ricinus communis, 827. 

Rickets, 467. 

Riding, as exercise, 97. 

Rigors, 772. 

Ringworm, 158. 

Rochelle salts, 876. 

Roman baths, 107. 

Roots, when to gather, 808. 

Rosa gallica, 870. 

Rosemarinus officinalis,871. 

Rosemary, 871. 

Roseola, 143. 

Rose-rash, 143; Red, 870; 
Water ointment, 901 ; 
Willow, 881. 

Rosin, 870. 

Rotting of teeth, 602. 

Round-leaved pyrola, 871. 

Rubbing wet sheet, 745. 

Rubeola, 135. 

Rubus villosus, 820. 

Rudbeckia laciniata, 882. 

Rue, 872. 

Rules for using water, 739. 

Rumex crispus, 888. 

Running and leaping, 94. 

Rupia, 147. 

Rupture, 581. 

Ruptures of tendons, 569. 

Russian and Turkish baths, 
803. 

Ruta graveolens, 872. 

Rye, 81; Spurred, 878. 

Saccharine foods, 79. 

Sacral plexus, 48. 

Saffron, 872. 

Sage, 872; Tea, 790. 

Sago-gruel. 792. 

Sailing, as exercise, 96. 

Saint Ignatius' Bean, 879. 

Sal-ammoniac, 816. 

Salep powders, comp., 791, 
792. 

Salicin, 886. 

Saline mixture, 900. 

Salix alba, 886; Nigra, 821. 

Salpingitis, 415. 

Salt, common, 876; Glau- 
ber's, 876; Of tartar, 
866. 



Saltness of the ocean, 91. 
Saltpetre, 858; Poisoning 

by, 515. 
Salt-rheum, 144. 
Salvia officinalis, 872. 
Sambucus Canadensis, 836. 
Sanguinaria Canadensis, 

821. 
Sanguinarin, 821. 
Sapo, 875. 
Sarcoma, 575. 
Sarsaparilla, 872; Comp. 

syrup of, 912; False 

(wild), 875. 
Sassafras, 872. 
Savin, 873; Cerate, 892. 
Scabies, 145. 
Scalds, 535. 

Scaly eruptions, 149, 363. 
Scammony, 873. 
Scarification, 544. 
Scarlatina, 136; Diet in, 

783. 
Scarlet fever, 136. 
Sciatica, 191. 
Scilla maritima, 879. 
Sclerotic coat of eye, 50. 
Scoke, 865. 
Scorbutus, 483. 
Scrofula, 480. 

Scrofulous ophthalmia, 590. 
Scrophularia nodosa, 836. 
Scrotum, blood in, 580 ; 

Water in, 579. 
Scullcap, 873. 
Scurvy, 483. 

Scutellaria lateriflora, 873. 
Sea-bathing, 736. 
Seasickness, 310. 
Secale cornutum, 878. 
Secretion, organs of, 41. 
Sedatives, 929. 
Seidlitz powders, 876. 
Self-pollution, 375. 
Semen, 422. 

Semilunar valves, 37 ; Dis- 
ease of, 285. 
Sempervivum tectorum, 

843. 
Senecin, 851. 
Senecio aureus, 850. 
Seneka, 873; Syrup of, 911. 
Senna, 874 ; Confection of, 

893; Comp. infusion of, 

895; Comp. syrup of, 913 ; 

And jalap, tinct. of, 918. 
Sensations, 56 ; Agreeable, 

57; Kinds of, 56: Moral 

uses of, 56; Unpleasant, 

58. 
Septic and aseptic, 518; 

wounds, 538. 
Septicaemia, 438. 
Sermons, reading of, 215. 
Serous tissue, 16. 



978 



GENERAL INDEX. 



Setting of fractures, 547. 

Sex, 125. 

Sexual diseases, 360-378; 
Prevention of, 374. 

Shaking palsy, 181. 

Sheep-laurel, 856. 

Shingles, 145. 

Shoes, thin, 104. 

Short sight, 592. 

Shoulder-blade, fracture of, 
553 ; Joint, dislocation 
of, 563. 

Shower-bath, 747. 

Shrinking of the brain, 173. 

Shrubby trefoil, 874. 

Sick, care of, 57 ; Children, 
nursing, 453 ; Headache, 
201-207. 

Sick-room, choice of , 756; 
Beds and beddingn i, 
758; Cleanliness in, 760 ; 
Cookery for, 789; Dark- 
ening of, 761; Domestic 
management of, 756 ; 
Fumigation of, 762; No 
cooking in, 757; Prej- 
udices and antipathies 
in, 770 ; Sofa or reclining 
chair in, 757; Tempera- 
ture of , 760; Unhired at- 
tendants in,769; Ventila- 
tion of, 114. 

Sighing, when a bad symp- 
tom, 772. 

Sight, organs of, 50 ; Long 
and short, 592; Weak- 
ness of, 591. 

Signs and abbreviations, 
810. 

Silk clothing, 103. 

Simple ointment, 892, 901; 
Syrup, 909. 

Sinapis alba, 856. 

Singultus, 199. 

Sinus, 527. 

Sippets, 795. 

Sitz bath, 750. 

Skin, 43, 134; Care of, of 
the aged, 503; Color of, 
disordered, 153 ; Dis- 
eases, 134; Nerves of, 
disordered, 153; Offices 
of, 105. 

Skull, fractures of, 551. 

Skunk-cabbage, 874. 

Sleep, 98; Amount of, 101 ; 
Disturbed, 200; Natural 
position for, 101 ; Of 
children, 451; Prepara- 
tion for, 101. 

Sleeping apartment, 756; 
In small room, 113; 
Rooms, 99; Bedding in, 
100; Beds in, 100; Fire 
in, 99; Night-dress in, 



100 ; Open fireplace in, 

99 ; Open windows in, 

99; Small, 113. 
Sleeplessness of the aged, 

504. 
Sleigh-riding as exercise, 

97. 
Slippery elm, 875 ; Poultice, 

906. 
Sloughing, 527. 
Sluice-bath, 748. 
Small-pox, 139; Diet in, 

783. 
Small spikenard, 875. 
Smartweed, 884. 
Smilax officinalis, 872. 
Snake-root, 873 ; Canada, 

886 ; Virginia, 884. 
Snakes, bites of, 545. 
Soap, 875. 
Soda, bicarbonate of, 876 ; 

Borate, 876; Sulphate of, 

876; Sulphite of, 876; 

Tartrate of and potassa, 

876 ; Soda-water and 

milk, 795. 
Sodae, bicarbonas, 876 ; 

Boras, 876 ; Et potassse 

tartras, 876 ; Sulphas, 

876 ; Sulphis, 876. 
Sodium, 875; Chloride of, 

876. 
Soft cancer, 575. 
Solanum dulcamara, 820. 
Solidago rigida, 841. 
Solomon's seal, 877. 
Soluble tartar, 867. 
Soothing inhalant, 244. 
Sore mouth, children's, 457 ; 

nursing, 440. 
Sore nipples, 426, 442. 
Sore throat, clergyman's, 

212. 
Soup, vegetable, 793. 
Spanish flies, 877 ; Cerate, 

892; Liniment, 896; Poi- 
soning by, 516. 
Spasm, of glottis, 461 ; In 

stomach, 309. 
Spearmint, 877. 
Speculum, 385. 
Spermaceti, 878; Ointment, 

902. 
Spermatozoa, 422. 
Spiced plaster, 904. 
Spiders, bites of, 545 ; Web, 

878. 
Spigelia Marilandica, 863. 
Spikenard, small, 875. 
Spinal cord, 47; Diseases 

of, 176; Inflammation of, 

176. 
Spinal nerves, 48. 
Spine, deformities and ir- 
ritations of, 584. 



Spirit of nitric ether, 858 
878 ; Of Ammonia, aro- 
matic, 816. 

Spiraea tomentosa, 841. 

Spleen, 34 ; Acute inflam- 
mation of, 297 ; Chronic 
inflammation of, 297. 

Splenitis, 297. 

Sponge, 878. 

Sponge-baths, 752. 

Spotted acne, 155. 

Sprains, 569. 

Spurred rye, 878. 

Squill, 879 ; Syrup of, 911 ; 
Vinegar of, 919. 

Squinting, 593, 772. 

Squirting cucumber, 885. 

St. Anthony's fire, 141. 

St. Ignatius' bean, 879. 

St. Vitus' dance, 187. 

Stagger-weed, 883. 

Star-grass, 879. 

Starch and sugar, 78. 

Statice Caroliniana, 854. 

Sterility, 419; Causes of, 
423. 

Sterilization of milk, 449. 

Stethoscopes, 230. 

Stiff joint, 573. 

Stillingia sylvatica, 869 ; 
Comp. syrup of, 913. 

Stimulants, 929. 

Stings of insects, 545. 

Stomach, 32 ; Affections of, 
787; Bile in, 67; Acute 
inflammation of, 301 ; 
Chronic inflammation of, 
302; Cramp in, 427; 
Movement of, 66 ; Spasm 
or cramp in, 309, 427. 

Stomatitis, erythematic, 
457. 

Stone in bladder, 345, 354. 

Storax, 879. 

Strabismus, 593. 

Stramonium, 880 ; Oint- 
ment, 901 ; Poisoning by, 
515. 

Stricture, 371 ; Of bowel, 
318. 

Structure of the body, 14. 

Strychnine, 858 ; Poisoning 
by, 516. 

Strychnos nux vomica, 
858. 

Stye, 587. 

Styptics, 540. 

Styrax officinale, 879. 

Subacetate of lead, cerate 
of, 891. 

Submaxillary gland, 31. 

Succus alterans, 945. 

Sudorific tincture, 919. 

Suet Ptisan, 794. 

Suffocation, 509. 



GENERAL INDEX. 



979 



Sugar foods, 78. 

Sugar of lead, poisoning by, 
514. 

Sugar of milk, 247. 

Sulphate of zinc, 890. 

Sulphur, 880; Ointment, 
comp., 903. 

Sulphuric acid, 813 ; Poi- 
soning by, 515. 

Sumach, 880. 

Summer complaint of in- 
fants, 463. 

Sunflower, 880. 

Sunstroke, 179. 

Supercarbonate of soda, 
876. 

Supertartrate of potassa, 
866. 

Suppers, late, 101. 

Suppression of urine, 342. 

Suppuration, 523, 526; Of 
brain, 167. 

Supra-renal capsules, dis- 
ease of, 337. 

Surgery, natural, 531. 

Surgical diseases, 517-607. 

Sutures, 540. 

Swallowing, difficulty of, 
772. 

Swamp-dogwood, 881; 
Milkweed, 881. 

Swathing, 427. 

Sweat-glands, 45 ; Dis- 
ordered, 154. 

Sweating process, 741; In 
consumption, 773. 

Sweet fern, 881 ; Flag, 881; 
Gum, 881; Oil, 859; 
Spirits of nitre, 858, 878; 
Whey, 795. 

Swelling, of lungs, 259; Of 
lower limbs, 428 ; Sud- 
den disappearance of, 
774. 

Swinging as exercise, 97. 

Sycosis, 156. 

Sympathetic nervous sys- 
tem, 48-50, 62. 

Symphytum officinale, 831. 

Symplocarpus foetidus, 874. 

Symptoms, 122 ; Table of, 
126, 132. 

Syncope, 199. 

Synovial degenerations, 
571; Membrane, 26. 

Syphilis, 360. 

Syringe, laryngeal shower, 
216 ; Nasal shower, 217 ; 
Pharyngeal shower, 217 ; 
Uterine, 390; Mode of 
using, 219. 

Syrups, 909, 913. 

Table, exhibiting the differ- 
ence between small-pox, 



varioloid, scarlet fever 
and measles, 138, 139; 
Of foods, 72, 79, 80 ; Of 
symptoms of diseases, 
126-132. 

Tag-alder, 881. 

Tamarac, comp. tinct. of, 
918. 

Tamarinds and whey, 795. 

Tannic acid, 814. 

Tansy (Tanacetum vul- 
gara), 881. 

Tape-worm, 332. 

Tapioca, 882 ; Jelly, 792. 

Tar, 882; Ointment, 912; 
Plaster, comp., 904. 

Taraxacum, 835. 

Tartar on the teeth, 603 ; 
Soluble, 867. 

Tartar-whey, 794. 

Tartaric acid, 814. 

Tea and coffee, 88 ; Cause 
headaches, 202 ; Beef, 
793, 797; Garfield, 945, 
947 ; New Jersey, 870 ; 
Sage, 872. 

Teeth, 30; Care of, 601; 
Cleaning of, 605; Com- 
position of, 31 ; Cutting, 
difficult, 459; Diseased, 
influence of on the 
health, 605 ; Filling, 604 ; 
First, 605; Names of, 30; 
Number of, 30; Origin 
of, 30; Eotting of, 602; 
Use of, 31. 

Temperance, 87; Good re- 
sults of, 87. 

Temperaments, 122, 123; 
Medication and, 123, 124. 

Temperature of the body, 
132; Symptoms indicated 
by, 132. 

Tendons, ruptures of, 569. 

Tetanus, 184. 

Tetter, 145 ; Crusted, 148. 

Thigh-bone, fractures of, 
556. 

Thimbleweed, 882. 

Thornapple, 880. 

Thoroughwort, 882. 

Throat, symptoms affect- 
ing, 128. 

Throat-diseases, 208-228; 
Curability of, 224; Worse 
at night, 215; Instru- 
ments for treatment of, 
216-221. 

Thyroid cartilage, 42. 

Tic douloureux, 190. 

Tight dressing, 116. 

Tinctures, 812, 913-919. 

Tissues, the, 16-18. 

Tobacco, 882. 

Toe-nail, ingrowing, 597. 



Tolu, syrup of, 911 ; Tinct. 
of, 915. 

Tongue, symptoms affect- 
ing, 127. 

Tonics, 924 ; And cathar- 
tics, 923. 

Tonsilitis, 222, 223. 

Tonsils, acute inflamma- 
tion of, 222 ; Chronic in- 
flammation of, 223. 

Toothache, 603. 

Toothache tree, 868. 

Tourniquet, 539. 

Towel and sponge bath, 
752. 

Towel, coarse, in bathing, 
111. 

Tracheitis, 209, 214. 

Trailing arbutus, 882; comp. 
infusion of, 895. 

Trance, 186. 

Traveling, 116; For con- 
sumptives, 254 ; For the 
poor, 118 ; Means of, 117 ; 
Seasons for, 117. 

Treatise on physical cul- 
ture, 950-960. 

Trees, cultivation of, 115. 

Trefoil, shrubby, 874. 

Trichiasis, 587. 

Tricuspid valves, 274. 

Trifolium pratense, 870. 

Trillium pendulum, 819. 

True physician, the, 12. 

Trumpet weed, 869. 

Tubal pregnancy, 418. 

Tubercular consumption, 
233; Eruptions, 363. 

Tulip-tree, 882. 

Tumors, 573; Encysted, 
577 ; Fatty, 575 ; Of brain, 
167; Of heart, 280; Of 
ovaries, 414; Of womb, 
412. 

Turkey-corn, 883. 

Turkish baths, 803. 

Turmeric, 883. 

Turn of life, 403. 

Turner's cerate, 891. 

Turnips, 82. 

Turpentine liniment, 897. 

Tmssilago farfara, 831. 

Twist in bowel, 318. 

Tympanitis, 321. 

Tympanum, 53 ; Inflamma- 
tion of, 596. 

Typhoid fever, 470 ; Pneu- 
monia (lung-fever), 268. 

Ulceration, 523 ; And ulcers, 
531; Of bones, 570; Of 
neck of womb, 386. 

Ulmus fulva, 875. 

Unbolted wheat flour, 74. 

Unhired attendants, 769. 



980 



GENERAL INDEX. 



Unicorn-root, 879 ; False, 
841. 

Union by first intention, 
540. 

Unnatural growth of bones, 
570. 

Upland Cranberry, 818. 

Upper arm-bone, fractures 
of, 553. 

Urate of ammonia in urine, 
352 ; Calculus, 354. 

Ureters, 35. 

Urethra, 35. 

Uric acid calculus, 354. 

Urinary deposits, 305 ; Or- 
gans, diseases of in the 
aged, 507; System, 35. 

Urine, characteristics of, 
346; Cystine deposits in, 
353 ; Examination of, 346 ; 
Hippuric-acid deposits 
in, 332; Inability to hold, 
344; Oxalic deposits in, 
350; Phosphatic deposits 
in, 349 ; Retention of, 
343, 773 ; Sources of, 345 ; 
Suppression of, 342 ; 
Symptoms indicated by, 
131; Urate of ammonia 
in, 352. 

Urinometer, 346. 

Urticaria, 143. 

Uterine hydatids, 407. 

Uva ursi, 818. 

Uvula, elongation of, 221. 

Vagina, inflammation of, 

416. 
Valerian, 883; American, 

888; Ammoniated tinct. 

of, 919. 
Valeriana officinalis, 883. 
Valerianate of iron, 848 ; Of 

quinia, 863; Of zinc, 890. 
Value of foods, 70, 71, 72, 

79, 80. 
Valves, mitral, disease of, 

285 ; Semilunar, disease 

of, 285; And tricuspid, 

37, 39. 
Varicocele, 584. 
Varicose veins, 428, 581, 

646. 
Variola, 139. 
Varioloid, 141. 
Varix, 581. 
Vaseline, 890. 
Vegetable foods, 70, 84, 

778 ; Poisons, 515; Soup, 

793. 
Veins, 38; Enlarged, 581; 

Inflammation of, 580, 

581 ; Enlarged or vari- 
cose, 581. 
Venereal diseases, 360-378. 



Ventilation, 60; In sick- 
room, 114, 758. 

Ventricles, 37, 274; Dilata- 
tion of, 278; Enlarge- 
ment of, 276. 

Veratrin, 815. 

Veratrum album, 885 ; 
Viride, 814. 

Verbascum thapsus, 856. 

Verbena hastata, 883. 

Verdigris, poisoning by, 
514. 

Vertigo, 200. 

Vervain, 883. 

Vesicles, 36. 

Vesicular eruptions, 363. 

Vessels, absorbent, 40. 

Viburnum opulus, 842. 

Vinegar, 883 ; Whey, 794. 

Vinegars, 919. 

Virginia snakeroot, 884 ; 
Comp. Tinct. of, 919; 
Tinct. of, 915. 

Vision, imperfect, 591. 

Vital properties of the body, 
18. 

Vitreous humor, 51. 

Vitriol, elixir, 915; Poison- 
ing by, 515. 

Vocal cords, 43; Organs, 
42. 

Vomiting, 310. 

Vulva, prurigo of, 417. 

Wading foot-baths, 753. 

Wafer ash, 874. 

Wahoo, 884. 

Walking, 93; Of infants, 
452. 

Warm baths for children, 
457; Foot, 754. 

Warts and corns, 152. 

Wash-down bath, 752 ; Tub, 
751. 

Washes, 933. 

Water, 89-92, 779; Acci- 
dents on, 512 ; Ammonia, 
815; Brash, 309; Chemi- 
cal nature of, 89; Cold, 
at meals, 65; Cure, 732; 
External use of, 251 ; 
Gruel, 791 ; Horehound, 
884; In chest, 261; In 
heart case, 287; In the 
head, 174; Impurities 
in, 90; Internal use of, 
741; Lime, 851; Modus 
operandi of, 737 ; Of am- 
monia, 815 ; Of the ocean, 
91 ; Pipes, lead, 90 ; Prop- 
erties of, 90 ; Pure, es- 
sential to health, 89 ; 
Rain, 91 ; Rules for using, 
739 ; Salt, 91 ; In scrotum, 
579; Supply, 90; Use of , 



in consumption, 251 ; For 
wounds, 540. 

Waters, medicated, 897. 

Watery pimples, 144. 

Wave or sluice bath, 748. 

Wax, 885 ; In the ear, 596. 

Weakness of sight, 591. 

Weaning, 450. 

Wens, 577. 

Weights, 810 ; French deci- 
mal, 811. 

Wet bandages, 741 ; Dress, 
743 ; Nurses, 446 ; Sheet, 
folded, 744; Sheet pack, 
742 ; Sheet rubbing, 745. 

Wheat, 80; Flour, un- 
bolted, 74. 

Whey, alum, 795 ; Mustard, 
794; Orange, 795; Ren- 
net, 794; Sweet, 795; 
Tartar, 794 ; Vinegar, 
794 ; With tamarinds, 
795 ; Wine, 795. 

White hellebore, 885 ; Oint- 
ment, 902; Indian hemp, 
881; Liquid physic, 900; 
Oak, 885 ; Pond lily, 885 ; 
Poplar, 882 ; Swelling, 
571 ; Vitriol, poisoning 
by, 515 ; Walnut, 824. 

Whitely exerciser, 953. 

Whites, 393. 

Whitlow, 645. 

Whooping-cough, 462 ; sud- 
den increase of par- 
oxysms in, 772 ; Diet in, 
787. 

Wild cherry, 885: Cherry 
bark, syrup of, 911; Cu- 
cumber, 885 ; Ginger, 
886; Indigo, 886 ; Indigo, 
ointment, 902 ; Sarsapa- 
rilla, 875 ; Snowball, 870 ; 
Turkey pea, 883; Wood- 
bine, 815 ; Yam, 886. 

Willow, black, 821 ; White, 
886. 

Wind-colic, 320. 

Windows in sleeping- 
rooms, 99. 

Windpipe, 36 ; Foreign 
bodies in, 599; Inflam- 
mation of, 214. 

Wine for old persons, 502; 
Of American ash, 947; 
Of comfrey, comp., 898; 
Of golden seal, comp., 
898 ; Of ipecacuanha,898; 
Whey, 795. 

Wines, medicated, 898. 
Wingseed, 874. 
Winter, fatty foods in, 75. 
Wintergreen, 886 ; pear-leaf, 

871. 
Witch-hazel, 886. 



GENERAL INDEX. 



981 



Wolfsbane, 887. 

Womb and appendages, 
383, 422; Cancer of , 413 ; 
Falling of, 409; Falling 
over of, 410 ; Inflamma- 
tion of, 408 ; Inflamma- 
tion of neck of, 386; 
Polypus of, 406 ; Sinking 
down of, 424 ; Tumors of, 
412. 

Woolen clothing, 103. 

Worm-powder, 908. 

Worms, 332. 

Wormseed, 887. 

Wormwood, 887. 

Wounds, bleeding from, 
539, 599; Contused and 
lacerated, 544; Derange- 
ments from, 183; Gun- 



shot, 545 ; How to unite, 
540, 543; Incised, 539; 
Of various kinds, 538 ; 
Poisoned, 545 ; Punctur- 
ed, 543; Kules for exam- 
ining and dressing, 541. 

Wrist, dislocation of, 565 ; 
Fractures of, 555. 

Wry neck, 586. 

Xanthoxylin, 868. 
Xanthoxylum fraxineum, 
868. 

Yam, wild, 886. 
Yarrow, 888. 

Yeast, 888; Poultice, 905. 
Yellow dock, 888; Comp. 
syrup of, 913; Fever, 



495 ; Jessamine, 888 ; 
Ladies' slipper, 888 ; 
Parilla, 889. 
Youth, diet in, 76. 

Zinc, 889 ; Acetate of, 889; 
Chloride of, 889 ; Iodide 
of, 889; Oxide of, 889; 
Precipitated carbonate 
of, 889 ; Sulphate of, 890; 
In poisoning, 515 ; Vale- 
rianate of, 890. 

Zinci, acetas, 889 ; Car- 
bonas prsecipitas, 889 ; 
Chloridum, 889; Iodi- 
dum, 889; Oxidum, 889; 
Sulphas, 890; Valerianas, 
890. 

Zingiber officinale, 838. 



INDEX TO THE HOMOEOPATHIC DEPARTMENT. 



A Brief Treatise on Homoe- 
opathic treatment of 
diseases, 608. 

Abscesses, 643. 

Aconite, 720. 

Acute inflammation of the 
spinal cord, 618; Of the 
larynx (laryngitis), 629; 
Of the liver, 663; Bron- 
chial, 630. 

Affections of the mind, 692. 

Agustia, 724. 

Ailments at the age of pu- 
berty, 713 ; Attending 
change of life, 714; Dur- 
ing pregnancy, 715. 

Albumen, for poisoning, 
729. 

Amblyopia, 676. 

Ammoniacal gas, for poi- 
soning, 730. 

Anasarca, 684. 

Anchylosis, 704. 

Aneurism, 704; Of the 
aorta, 652. 

Anorexia, 724. 

Anosmia, 724. 

Anthrax, 642. 

Antidotes to medicines, 
611 ; To poisons, 726-731. 

Antimonium, 720. 

Antimony, poisoning with, 
727. 

Aphthae, 707. 

Apoplexy, 616. 

Arnica, 720. 

Arsenic, poisoning with, 
727. 

Arsenicum album, 720. 

Ascites, 684. 

Asiatic cholera, 662. 

Asthma, 632. 

Aversion to food, 724. 

Baldness, 614. 

Bathing, 611. 

Barbers' itch, 649. 

Belladonna, 721. 

Bilious remittent fever,654. 

982 



Black tongue, 690. 
Black vomit, 690. 
Bleeding from the lungs, 

632. 
Bloody urine, 636. 
Boils, 642. 
Brain fever, 615. 
Bronchitis, 630. 
Bronchocele, 704. 
Bryonia, 721.. 
Bunions, 670.' 
Burns and scalds, 702. 

Calcarea carbonica, 721. 

Camphor, for poisoning, 
729. 

Cancer of the skin, 667; Of 
the liver, 666; Of the 
intestines, 667; Of the 
stomach, 666. 

Canker of the mouth, 657. 

Cantharides, poisoning by, 
728. 

Capsicum, 721. 

Carbo. veg., 721. 

Carbuncle, 642. 

Cardialgia, 658. 

Cataract, 623. 

Cephalalgia, 613. 

Chamomilla, 721. 

Charcoal, for poisoning, 
730. 

Charcoal gas, poisoning by, 
728. 

Chicken-pox, 655. 

Chilblains, 644. 

Child-bed fever, 718. 

China, 721. 

Cholera morbus, 662 ; In- 
fantum, 708. 

Chorea, 621. 

Chronic catarrh, 628 ; Dys- 
entery, 661 ; Laryngitis, 
629; Pericarditis, 652; 
Rheumatism, 656. 

Chronic inflammation of 
the bowels, 660 ; Of the 
bronchia, 631; Of the 
pericardium, 651. 



Cina, 721. 

Coal, poisoning by the 

vapors of, 731. 
Coffee, for poisoning, 729. 
Cold fever, 687. 
Cold in the head, 628. 
Colic, 706. 
Concussion of the brain, 

700; Of the chest, 700. 
Constipation, 662; Of the 

bowels, 717. 
Consumption, 632, 673. 
Convulsions, 709. 
Copper, poisoning by, 727. 
Corns, 643. 
Coryza, 628. 
Costiveness, 662. 
Coup de soleil, 616. 
Cramps in the stomach, 

659. 
Croup, 630. 
Crying, 706. 
Cystitis, 634. 

Deafness, 625. 

Delirium, 615. 

Delirium tremens, 620. 

Dentition, 708. 

Derangement of menstrua- 
tion, 713. 

Diabetes, 636. 

Diarrhoea, 660. 

Diet and regimen, 612. 

Difficult urination, 716. 

Dilatation of the cavities of 
the heart, 652. 

Diphtheria, 680. 

Diseases of the alimentary 
canal, 657 ; Of the brain 
and nerves, 615 ; Of the 
ear, 625 ; Of the eye and 
lids, 622; Of the head, 
613; Of the skin, 642; 
Of the organs of circula- 
tion, 651 ; Of the organs 
generation, 638 ; Of the 
respiratory organs, 628 ; 
Of the urinary organs, 
634 ; Involving the vari- 



HOMCEOPATHIC INDEX. 



983 



ous organs and regions, 
653, 665 ; Of women, 713; 
Of infants, 706. 

Dislocations, 701. 

Disorders of the nose, 627. 

Dropsy of the belly, 684 ; 
Of the brain, 685 ; Of the 
chest, 684 ; Of the heart, 
684 ; Of the joints, 704 ; 
Of the scrotum, 639, 685 ; 
Of the womb, 685 ; Ova- 
rian, 685. 

Dysentery, 661. 

Dysmenorrhcea, 714. 

Dyspepsia, 658. 

Dyspeptic headache, 658. 

Ear, diseases of, 625 ; in- 
flammation of, 625. 

Earache, 625. 

Eczema, 648. 

Endocarditis, 651. 

Epastaxis, 627. 

Epilepsy, 617. 

Epsom salts, for poisoning, 
730. 

Eruptive fevers, 655. 

Erysipelas, 655. 

Excessive menstruation, 
714. 

Excoriated nipples, 717. 

Excoriations, 710. 

External applications, 611. 

Extreme emaciation, 709. 

Falling of the womb, 640, 
719. 

False pains, 716. 

Febris petechialis, 687. 

Felons, 647. 

Ferrum, 721. 

Fever, bilious, 654; Cold, 
687; Eruptive, 655; In- 
flammatory, 653 ; In- 
termittent, 654; Putrid 
688 ; Remittent, 471, 654 
Rheumatic, 656 ; Scarlet 
655; Simple, 653; Spot 
ted, 687 ; Typhoid, 653 
Yellow, 654. 

Fig-warts, 667. 

Fistula in ano, 705. 

Fits, 617, 709. 

Forms of medicine for ad- 
ministration, 610. 

Fractures, 702. 

Furunculi, 642. 

Gall Stones, 665. 
Gangrene, 668. 
Gastralgia, 658. 
Gastritis, 659. 
Gastrodynia, 659. 
Goitre, 704. 
Gonorrhceal sore eyes, 623. 



Gravel, 635. 

Grippe, 675. 

Hardness of hearing, 625. 

Headache, 613, 658. 

Heartburn, 658. 

Hectic fever, 671. 

Hemorrhage from wounds, 

701. 
Hemorrhoids, 664, 719. 
Hernia, 701. 
Herpes, 647; Circinnatus, 

646. 
Hiccough, 709. 
Hives, 646. 
Hydrocele, 639, 685. 
Hydrocephalus, 685. 
Hydrometra, 685. 
Hydrophobia, 691. 
Hydropsies, 684. 
Hydrothorax, 684. 
Hypochondria, 696. 
Hysteria, 691. 
Hysteric derangement, 697. 

Ignatia, 722. 

Imbecility, 698. . 

Immoderate flow of sweet 
urine, 636. 

Imperfect action of the 
valves of the heart, 
652. 

Inability to take the breast, 
706. 

Incontinence of urine, 636. 

Incubus, 690. 

Indigestion, 658. 

Induration of the breasts, 
717. 

Infantile diarrhoea, 706 ; 
Dysentery, 706 ; Jaun- 
dice, 707. 

Inflammation of the ar- 
teries, 652; Of the blad- 
der, 634; Of the bowels, 
660; Of the ear, 625; 
Of the eyelids, 622; Of 
the glands under the 
arms, 669; Of the heart, 
651 ; Of the inguinal 
glands, 669 ; Of the iris, 
622; Of the kidneys, 637; 
Of the larynx, 629; Of 
the ovaries, 640; Of the 
pericardium, 651 ; Of the 
peritoneum, 660 ; Of the 
spinal chord, 618; Of 
the spleen, 663; Of the 
stomach, 659; Of the 
testicles, 639; Of the 
tongue, 657 ; Of the ton- 
sils, 657 ; Of the urethra, 
638; Of the vagina, 639; 
Of the vulva, 639; Of the 
windpipe, 630; Of the 
womb, 639. 



Inflammatory fever, 653; 

Rheumatism, 656. 
Influenza, 675. 
Injury of a nerve, 700. 
Insidious diseases, 686. 
Intermittent fever, 654. 
Interrupted menstruation, 

713. 
Invermination, 663. 
Ipecacuanha, 722. 
Iritis, 622. 
Iron-rust, for poisoning, 

730. 
Itch, 645. 
Itching of the anus, 664; 

Of the skin, 645. 

Jaundice, 663. 

Kidneys, inflammation of, 

637. 
Kitchen-salt, for poisoning, 

730. 

Labor, 716. 

Lachesis, 722. 

Larynx, inflammation of, 

629. 
Lead, for poisoning by, 727. 
Leucorrhoea, 641 ; After 

confinement, 719. 
List of remedies, 609. 
Liver, inflammation of 

663 ; spots, 649. 
Lock-jaw, 619. 
Loss of memory, 621 ; Of 

taste, 724 ; Of smell, 724. 
Lumbago, 656. 
Lumbar abscess, 703. 
Lung fever, 631. 
Luxations, 701. 

Maculae, 649. 

Magnesia, for poisoning, 
730. 

Malignant pustule, 686. 

Mania from excited emo- 
tions, 693 ; From depres- 
sion of spirits, 693. 

Marasmus, 709. 

Measles, 655. 

Menorrhagia, 714. 

Mental derangement, 692. 

Mercurius, 722. 

Mercury, for poisoning by, 
727. ' 

Milk (for poisoning) , 729 ; 
Crust, 710; Fever, 716; 
Leg, 669. 

Miscellaneous diseases, 
690. 

Monomania, 699. 

Morbid emotions, 694. 

Morphine, for poisoning by, 
728. 



984 



HOMOEOPATHIC INDEX. 



Myeletis, 618. 
Mucous- vomiting, 659. 
Moss, 649. 

Nasal polypus, 668. 
Nervous deafness, 626. 
Nettle-rash, 655. 
Neuralgia, 620. 
Nightmare, 690. 
Night-sweats, 250. 
Nocturnal enuresis, 636. 
Nose-bleed, 627. 
Nux vomica, 722. 

Obstruction of the nose, 627. 
Olive-oil, for poisoning, 729. 
Opium, 722. 
Otorrhcea, 625. 
Ovarian dropsy, 685. 
Ozcena, 627. 

Painful menstruation, 714. 

Painter's colic, 664. 

Palsy, 619. 

Paralysis, 619; Of the eye- 
lids, 678. 

Parturition, 716. 

Passage of gall-stones, 665. 

Pericarditis, 651. 

Pharyngeal sore throat, 
657. 

Phlegmasia dolens, 669. 

Piles, 664, 719. 

Pleurisy, 632. 

Pleuritis, 632. 

Pneumonia, 631. 

Poisons, and their anti- 
dotes, 726-731. 

Polypus of the nose, 627. 

Porrigo, 710. 

Potash and sweet almond 
oil, for poisoning, 730. 

Prickly heat, 710. 

Profuse bleeding from the 
womb, 714. 

Protracted grief, 693. 

Protrusion of the intestine, 
663. 

Prurigo, 645. 

Prussic acid, for poisoning 
by, 728. 

Pulmonary consumption, 
632, 673. 

Pulsatilla, 722. 

Putrid fever, 688; Sore 
throat, 657. 

Quinsy, 657. 

Rabies, 691. 
Rachitis, 703. 
Red gum, 708. 
Relapsing fever, 690. 



Religious mania, 696. 

Remittent fever, 654. 

Retention of the urine, 635, 
708. 

Rheumatic fever, 656 ; Sore 
eyes, 623. 

Rhus tox., 723. 

Rickets, 703. 

Ringworm, 646; Of the 
scalp, 613. 

Rules for the administra- 
tion of medicines, 609 ; 
For preserving the purity 
of medicines, 610. 

Running at the ears, 625. 

Rupture, 701. 

Rush of blood to the head, 
615. 

Salt rheum, 647. 
Scabies, 645. 
Scald-head, 614. 
Scarlet-fever, 655; Rash, 

655. 
Schirrus, 666. 
Sciatica, 656. 
Scrofula, 648. 
Scrofulous sore eyes, 622 ; 

Swelling of the salivary 

glands, 711. 
Scurf of the head, 711. 
Scurvy, 649. 
Sea-sickness, 659. 
Shingles, 668. 
Simple fever, 653. 
Sleeplessness of infants, 

712. 
Small-pox, 656. 
Snake bites, 702. 
Snuffles, 707. 
Soap, for poisoning, 729. 
Sore mouth, 707; Throat 

(quinsy), 657. 
Soreness after delivery, 

716; Behind the ears, 

710. 
Specific indications for rem- 
edies in fevers, 720. 
Specks on the cornea, 624. 
Spotted fever, 687. 
Sprains, 700. 
Squinting, 624. 
Stammering, 621. 
Starch, for poisoning, 730. 
Stiff joints, 704. 
Stings of insects, 702. 
Stone, 635 ; Bruise, 670. 
Strabismus, 624. 
Strangury, 634. 
Strong tea, for poisoning, 

730. 
St. Vitus's dance, 621. 
Stye, 622. 



Sugar, or sugar-water, for 
poisoning, 729. 

Summer complaint, 708. 

Sunstroke, 616. 

Suppression of the lochia, 
718; Of the milk, 717; 
Of the urine, 635. 

Surgical diseases, 700. 

Sweet almond oil, for poi- 
soning, 730. 

Swimming of the head, 
613. 

Syphilis, 638. 

Syphilitic sore eyes, 623. 

Teething, 708. 

Tetanus, 620. 

Tetter, 647. 

Thrush, 707. 

Tinctures, 609. 

Tinea capitis, 614. 

Toothache, 656. 

Torticollis, 704. 

Tracheitis, 630. 

Trismus, 619. 

Tumors, removal of, 702. 

Tussis spasmodica, 631, 

678. 
Typhoid fever, 653. 

Ulcerations of the bone, 
703 ; Of the womb, 640. 

Ulcers, 644; Of the scalp, 
614. 

Varicose veins, 646, 704. 

Varioloid, 655. 

Veratrum, 723. 

Vertigo, 613. 

Vinegar for poisoning, 729. 

Vomiting of blood, 659. 

Warts, on the hands, 669 ; 

On the nose, 668. 
Waterbrash, 658. 
Watery eyes, 624. 
Weak memory, 697. 
Weakness of the sight, 676. 
Wetting the bed, 636. 
White swelling, 703. 
Whites, 641. 
Whitlow, 645. 
Whooping cough, 631, 678. 
Wine, for poisoning, 730. 
Worms, 663. 
Wounds, 701. 
Wry neck, 704. 

Yellow fever, 654. 

Zinc, or white vitriol, for 

poisoning by, 727. 
Zona, 668. 



Mellin's Food 



FOR 



Infants and Invalids. 



Mellin's Food has been before the public 
for over Thirty Years, and has become a 
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Mellin's Food fulfils all the requirements of 
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any other preparation. 

CHAS. GRAEFE, M.D., 
March 28, 1896. Sandusky, Ohio. 



Write to tjs and we will send our book "The Care and Feeding of 
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DOLIBER-GOODALE COMPANY, 
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Horsford's Acid Phosphate. 

(liquid.; 

A BRAIN AND NERVE TONIC. 

This is not a compounded patent medicine, but a preparation 
of the phosphates of potash, iron, lime, phosphoric acid, etc., in 
solution, and is recommended and prescribed by physicians of all 
schools. 



Indigestion, Dyspepsia, Etc. Acid Phosphate promotes digestion without 
injury, and thereby relieves those diseases caused by indigestion of the food. 

Nervousness, Exhaustion, Etc. Acid Phosphate supplies the waste of 
phosphates caused by every mental and physical exertion, imparting new 
energy, increasing the intellectual and physical power, and is an agreeable and 
beneficial food and tonic for the brain and nerves. 

Headache. Acid Phosphate, by its action on the digestion, and as a 
nerve food, relieves the headache arising from indigestion and nervousness. 

Tired Brain. Acid Phosphate acts as a brain food, increasing the capacity 
for mental labor, restoring the tired brain, and imparting new energy to that 
organ. 

Abuse of Alcohol. Acid Phosphate is of great benefit in the prostration 
consequent upon the abuse of alcohol, restoring the nerves to their normal 
condition. 

Weakened Energy. Acid Phosphate acts as a nutrient to the cerebral 
and nervous systems, giving vigor and renewed strength where there has been 
exhaustion. 

Ill Effects of Tobacco. Acid Phosphate neutralizes the nicotine, thereby 
relieving the immediate ill effects of tobacco. 

Sleeplessness. A small dose in water, taken just before retiring, produces 
the most refreshing sleep. 

Seasickness. Acid Phosphate, taken regularly, materially relieves and 
often prevents this dreaded disease. 

Night Sweats. Acid Phosphate has commonly given speedy benefit in 
night sweats, and is useful in all wasting and debilitating diseases. 

A Delicious Drink is made by adding a teaspoonful of Acid Phosphate 
to a tumbler of water, and sweetening to the taste. It harmonizes with such 
stimulants as may be necessary to take. 



FOR SALE BY ALL. DEALERS IN MEDICINES. 

Send for descriptive pamphlet. Prepared under the direction of Prof. E. N. 
Horsford, by the Rumford Chemical Works, Providence, R. I., U. S. A., N. D. 
ARNOLD, Treasurer. 

BEWARE OF IMITATIONS. 



• ^Q'tt 



